Most expectant Mothers who intend to breastfeed their newborns are aware that giving birth in the hospital runs the risk of having your baby get a bottle of sugar water (aka “baby crack”) by a well intentioned but seriously misguided nurse, perhaps to pacify a fussy baby in order to let Mom sleep.Â
Another reason a newborn may be given sugar water is for “pain management” when the baby receives the synthetic K injection, Hep B shot or newborn screening tests involving a heel prick.
Besides the fact that this sugar water contains glucose derived from genetically modified (GMO) corn, giving a baby an artificial nipple before breastfeeding is established is a great threat to the future breastfeeding relationship between Mom and baby.
As a result, clued in Moms are now advised to include a “no sugar water” clause in their birth plans, with doulas and other birthing advocates remaining watchful while Mom is resting or baby is out of the room for whatever reason.
Now, there is a new game in town that is commonly being used to derail breastfeeding after a hospital birth and arbitrarily give GMO laced commercial formula to babies.
This reason is neonatal hypoglycemia or low blood sugar.
I first became aware of this problem when a friend sent me an email about it. She had been made aware of the situation by a doula from New Mexico who said that women who start off breastfeeding in the hospital are being told by the nurses that their babies have low blood sugar and they need to have formula right away. This misguided advice caused a large number of mothers to stop breastfeeding out of concern that neonatal hypoglycemia might cause harm such as brain damage.
So what’s the truth? Do babies ever need formula instead of rich, immune system boosting colostrum in the hours and days after birth due to blood sugar problems?
The short answer is a resounding NO! Â Before I thoroughly debunk the egregious practice of using low blood sugar as an excuse to give newborns GMO commercial formula, let’s go over the causes, symptoms and problems associated with the condition.
What Causes Low Blood Sugar in Newborns?
It is true that babies can suffer from hypoglycemia or low blood sugar after birth. Â Babies are at increased risk for hypoglycemia if any of the following conditions were present:
- The baby was premature, had a serious infection, or needed oxygen right after delivery.
- Mom has gestational diabetes.
- The baby suffers from hypothyroidism or has a rare genetic disorder.
- The baby experienced poor growth in the womb during pregnancy.
- The baby is smaller in size for gestational age.
Symptoms of neonatal hypoglycemia include:
- Bluish-colored or pale skin
- Breathing problems, such as pauses in breathing (apnea), rapid breathing, or a grunting sound
- Irritability or listlessness
- Loose or floppy muscles
- Poor feeding or vomiting
- Problems keeping the baby warm
- Tremors, shakiness, sweating, or seizures
It is important to note that neonatal hypoglycemia may sometimes be present with no symptoms at all.
Is Low Blood Sugar in Newborns Dangerous?
Low blood sugar can indeed be a problem for newborns if severe or persistent as it can affect the baby’s mental function. Rarely, brain damage, heart failure or seizures can occur.
Unfortunately, fear of lawsuits has generated an irrational fear of neonatal hypoglycemia that has resulted in the widespread acceptance by hospital staff that breastfeeding mothers should be separated from their babies with newborns given supplemental formula in the hours and days after birth.
This hyper fear is causing even full term, normal weight babies to be given the painful test for low blood sugar when they don’t need it and many of those to be given formula when it isn’t warranted.
Formula feeding to babies by hospital staff gives new mothers the mistaken and very wrong impression that formula is medicine and good for the baby. It also causes many breastfeeding Moms to lose faith in their ability to properly nourish their children with their own colostrum and milk which interrupts and frequently ends the breastfeeding relationship for good right at the time when baby needs it most!
No Accepted Level for Neonatal Low Blood Sugar
The fact is that there is no generally accepted level that indicates baby has low blood sugar. According to the International Breastfeeding Center, the blood sugar levels required in many hospitals border on absurd with 3.4 mmol/L (60 mg %) routinely considered the lowest acceptable blood sugar.
There is no evidence to back up such a level as the lowest acceptable blood sugar concentration.
In addition, there is no reliable method for accurately measuring blood sugar outside a lab environment. Â The use of paper strips is not reliable as they tend to underestimate the true value. Â Truly accurate measures are obtained only by the laboratory which are able to provide a reliable measure of plasma glucose or sugar.
Hospitals Testing for Low Blood Sugar at the Wrong Time
Another problem is that many babies are tested for low blood sugar right after birth and then an hour later with formula being immediately and arbitrarily given if the blood sugar has dropped – even for normal weight, healthy, term babies!
This is totally inappropriate as research has shown that it is normal for the blood sugar in a neonate to drop in the first hour or two after birth! Â Moreover, a newborn’s blood sugar will naturally rise after the initial drop in the hours after birth – even if the baby is not fed!
Colostrum is Superior to Formula to Treat and Prevent Low Blood Sugar
A little bit of colostrum such as what a newborn would receive from Mom in the first hours after birth maintains blood sugar better than a lot of formula. Babies that are being breastfed have much higher levels of ketone bodies in their blood than formula fed babies or breastfed babies given formula supplements (Pediatrics Vol. 109 No. 3 March 2002, pp. e42). Ketone bodies are highly protective of the baby’s brain.
In addition, babies have been shown to maintain blood sugar better when skin to skin contact with the mother occurs such as would happen with breastfeeding.
If colostrum is superior to formula in maintaining healthy blood sugar levels in a newborn why then are breastfeeding mothers being encouraged by misinformed hospital staff to supplement with GMO laced commercial formula in order to treat an arbitrary condition like neonatal low blood sugar where the required blood sugar concentration is not even scientifically proven as accurate?
Simply criminal isn’t it?
What to Do if Low Blood Sugar Truly is an Issue
Suppose the rare case presents itself where an exclusively breastfed baby truly does have blood sugar levels that are dropping too rapidly or are too low? Â In those situations, mothers and birth advocates should request that the baby be given banked breastmilk, ideally fed with a Lact-Aid, and not formula. Â According to the International Breastfeeding Center, every postpartum unit should have banked breastmilk ready and available on site.
The second best option as an alternative to formula is to give the baby an intravenous infusion of glucose rather than formula by mouth.
Whether banked breastmilk or a glucose IV is given, the baby should continue to breastfeed as usual with no interruption!
Be on your guard, breastfeeding Moms as the low blood sugar excuse may be used on you to derail your breastfeeding efforts in the hospital!  Make sure appropriate action for dealing with this hospital scenario is clearly outlined in your birth plan.  Better yet, skip the hospital and have your baby at home or at a birth center instead and avoid the whole problem from the get go!
Sarah, The Healthy Home Economist
Sources:
Hi Sarah! I found this link on facebook and was very curious about the article. I was diabetic (not gestational diabetic like my first 2 pregnancies and I’m not diabetic now) my son had low blood sugar and was 5 weeks early. I expected the sugar water but what I didn’t expected was the doctor wanted me to supplement with formula. They were basically pushing formula on me. The day after he was born I still hadn’t breastfed because with the iv and the formula he wasn’t hungry when they brought him to me the next day. I told them I needed a breast pump asap so I wouldn’t loose my milk and I was willing to walk to the WIC office to get one if I had to because they were in the same building. After 6 hours of waiting I finally got a pump and started pumping then I told the nurses he would have the breastmilk first then if he was still hungry and out of breast milk then they could supplement. The pediatrician then wanted to add a milk fortifier to my milk…. I was so happy to get to go home 5 days later (we had problems with jaundice as well) I only supplemented after I nursed for 15 minutes on each breast. After a week I stopped supplementing without the doctors approval and never went back. We are now 6 months ebf 🙂
Maybe next baby have he/she at a birth center! Good for you for sticking to your guns and not giving up. Many women would have thrown in the towel. Such a crime what these doctors and nurses are doing.
After having worked at two hospitals as an Audiologist, not nurse, I can assure you that there are hospitals who truly advocate that breastfeeding is best. Many hospitals are trying hard to follow the international breastfeeding recommendations as well as family centered care (baby stays with mom 24/7). The hospitals I have worked for will encourage that new moms breastfeed their newborn more frequently when low blood sugar is an issue. The glucose water is typically only needed if baby will not latch to breastfeed. IV glucose is not recommended because it is painful for the baby (very tiny veins) and those infants that require such drastic measures are usually reaching a poor state (becoming comatose) . I just wanted to add a post that encouraged families having babies at a medical facility to let them know that many facilities will abide by mom’s wishes and not present a nipple to the infant. In cases of low blood sugar expect to be breastfeeding that baby skin to skin every hour for at least 10 minutes to encourage healthy blood sugar levels. Another option is to cup feed expressed breastmilk or formula to the infant. I did this with my first child because his jaundice levels were critically high after enduring five days of labor. A small plastic cup introduces the milk instead of a nipple so that nipple confusion does not occur. Just be sure to ask for ALL THE OPTIONS if the medical staff is telling you that extra feeding measures need to be taken to keep your baby healthy.
I’m a CLEC and also working on my BSN with a minor in nutrition, specializing in pediatric and neonatal nutrition. In this article, you say “The second best option as an alternative to formula is to give the baby an intravenous infusion of glucose rather than formula by mouth”. I disagree. IV solutions are only indicated if an infant is unable to take an oral feed.
IV dextrose solutions used by hospitals contain aluminum and intravenous infusions of aluminum are not as easily removed by the human body and can bio-accumulate. Preterm infants who receive Total Parenteral Nutrition through an IV have been shown to have slight neurological delays when compared to preterm infants who did not receive TPN.
In this instance, giving formula is the lesser of evils when compared to a IV dextrose solution. Although formula contains aluminum as well, orally obtained aluminum is easier for the body to eliminate than aluminum given through an infusion.
There’s also the side effect of causing HYPERglycemia, and infants who are given IV dextrose solutions are oftentimes kept in the NICU until blood sugars can be stabilized. Whereas if you give a clinically indicated amount of formula (5-10mL’s), the infant stays with mom. Keeping an infant with the mother results in much greater breastfeeding outcomes.
The Academy of Breastfeeding Medicine has outlined a protocol for neonatal hypoglycemia and says that whenever possible, oral feeds are always preferable to IV sugars, even feeds with formula.
Oh, but I also want to mention that if an infant is on an IV dextrose infusion, the mother can (and should) still breastfeed. The issue is getting to that point. If an infant has blood sugar that is truly low, but is asymptomatic, then that is when oral feeds with expressed/banked breast milk or formula should be preferred. The purpose of giving small amounts of formula to infants with low blood sugar is specifically to prevent them from ending up on an IV for several days. So any chance nursing and neonatal staff have of preventing even larger interventions is usually taken.
But unfortunately most hospitals are not trained in how to give “clinically indicated” amounts of supplements. 5-10 mL’s of banked milk or formula, delivered with a syringe or an at-breast supplementer is better than just cramming a bottle in the baby’s mouth.
Oral feed with GMO dextrose solution is not a good idea for a breastfed baby and threatens the nursing relationship. An IV would be preferable although banked donor milk would be even better fed with a Lact-Aid.
I didn’t say anything about giving an oral feed with a dextrose solution. I said that giving an oral feed with formula is preferable to an IV. IV dextrose contains aluminum, IV infusions of aluminum are more risky for infants than orally-obtained aluminum, preterm infants and neonates are at a much higher risk of experiencing neurological delays as a result of intravenous infusions that contain aluminum.
Infants given IV dextrose are usually transferred to the NICU too, where they are separated from the mother. IV dextrose solutions also have to be weaned off of slowly, so as to avoid reactive hypoglycemia. So infants who receive IV dextrose remain in the hospital longer and are subject to more interventions.
Formula, while not ideal, is a much lower level intervention than IV glucose BECAUSE a) no maternal/infant separation b) lower levels of aluminum c) earlier hospital discharge d) prevents hypoglycemia from escalating to a level where it would require an IV.
Wherever possible, infants should always be given the lowest level of intervention that promotes the greatest possible outcome. And in a situation where expressed or donor milk is not available, formula is the next best choice over putting the infant on an IV.
There is simply no good scientific basis for recommending the use of Intravenous infusions of glucose over oral feeds with formula.
The scientific reason is that oral formula has been proven to interfere with the breastfeeding relationship. GMO formula is just as bad as GMO dextrose solution. They are both horrible options and saying formula is better is splitting hairs. If the baby can receive an IV and not get oral formula which induces nipple confusion in the baby and frequently rejection of the breast, that is the better option even though it does cause more work for hospital staff which of course they won’t appreciate. IV glucose is also the option recommended by the International Breastfeeding Center for actual cases of low blood sugar but then again hospital staff isn’t exactly known for being big supporters or advocates of breastfeeding so it’s not surprising to see formula preferred and flat out pushed on mothers regardless of how it negatively impacts the long term breastfeeding relationship. Whether or not a child is breastfed has a huge impact on the lifelong health of a child as opposed to the very short term, expedient choice of oral formula. Hospital staff like expedient and efficient solutions to problems and don’t very often consider the long term ramifications of their recommendations.
As a labor and delivery and pediatrics nurse, I find your assessments of the entire situation misguided. I believe that exclusively breastfeeding is best. But there are also times when intervention might be needed. The least amount of intervention is always tried first. I can not even begin to tell you how much time I, as well as the other professionals involved in direct patient care, have spent in a new mothers room trying to help her successfully breastfeed her newborn. Expedience was not a part of the equation. I agree with Laura. Giving a newborn an IV is far more invasive. Maybe you don’t have much experience on a l & d unit, but assisting the mom to “cup” feed while still holding her baby or setting up an at breast supplementing system where a micro tube is gently placed by the nipple and the newborn receives a small amount of formula as she is skin to skin at the breasted is not interfering with the breastfeeding relationship, but encouraging it.
There is plenty of aluminum in infant formula too. http://www.naturalnews.com/038220_aluminum_infant_formulas_toxicity.html
And, it isn’t a tiny bit of formula if the breastfeeding relationship is derailed which happens a lot and the baby ends up on commercial formula until weaning!
As for bringing your own formula to the hospital, good luck with that. Hospital staff don’t like this at all. I’ve been told by parents who try to bring in the homemade formula which is way better than even organic commercial formula (some of these still have GMOs in them by the way) that it quickly gets rejected.
There is plenty of aluminum in infant formula too. http://www.naturalnews.com/038220_aluminum_infant_formulas_toxicity.html
And, it isn’t a tiny bit of formula if the breastfeeding relationship is derailed which happens a lot and the baby ends up on commercial formula until weaning!
I agree with Laura and Patti. I’m a nursing student, graduate in about 6 months. The hospitals I have done my clinicals at always advocate breastfeeding. Some patients even report they are breastfeeding nazis!
Anyways, it is always best to do the least invasive procedure first – meaning formula. No, it isn’t ideal and can interfere with breastfeeding, but would you rather your baby have an IV? They are way more prone to infection with an IV, especially when infusing glucose.
My last clinical rotation I was on the post-partum floor and one of our patients had gestational diabetes. Her baby had hyperinsulinemia, which causes hypoglycemia. We tried breastfeeding, but the baby wouldn’t latch on after several attempts, or when she did, didn’t feed for long enough. She was highly irritable and extremely difficult to console, even after trying skin-to-skin. Her blood sugars were crashing and something needed to be done quickly so she didn’t have to go to the NICU. We gave her formula and it temporarily stabilized her blood sugars. My shift ended after that, but without formula that baby would have been in even worse shape.
While I am definitely of the opinion that breast is best, sometimes you can’t do everything the exact way you want it. I am against formula, but I wouldn’t put my child at risk because I was too stubborn to give it to them if it meant keeping them out of the NICU.
Wow, you really hate nurses! I have been a nurse for over 25 years and I fully support breastfeeding, skin to skin care, etc. I am there to work, and sure don’t look for short cuts in caring for patients. In my opinion, anyone who would have an IV inserted into their baby rather than give them formula for low blood sugar is awful! In most hospitals, once the IV is in , the baby is in the nursery or NICU. That takes the baby from the mom…the WORST thing you can do to a breastfeeding baby. And, every hospital I have worked in follows the standard of glucose >40 is OK in the first 24 hours, as long as the baby is nursing, and if it is lower, have them nurse, then check it 45 min after to see if it is increasing. We are not evil people trying to take babies from their mothers. I have seen babies seize from low blood sugar. And, we don’t test them unless they are Large for gestational age, small for gestational age, preterm, infant of diabetic mother, or other medically indicated risk factors. Get your facts straight!
I didn’t read this closely, but I’d say you might both be recommending something not supported by AAP. AAP states first mom’s milk, then donor milk, THEN glucose water, THEN formula.
I went into my first labor and delivery with a detailed birth plan, which included, “no artificial nipples at any time, and no glucose water at any time.” Breastfeeding went well, and yet the hospital staff administered glucose water immediately following a breastfeeding session, “Just to make sure she didn’t get low blood sugar.”
I delivered the next 5 babies at home.
Thank you, Sarah, for yet another rational and excellently written article.
My little one’s blood sugar was at 23, very low. She did not exhibit any signs of low blood sugar. They tried to give her formula, unfortunately I did not speak up. My husband went home researched, came back to the hopsital outraged and refused any further attempts. They gave her a glucose drip for 3 days and then she was able to maintain her levels. Besides my husband stepping in baby refused any formula. By God’s grace I was able to express about 10 ml of colustrum, which amazed the staff, and we were able to give that to her by dropper to continue to keep her infused with it.
Hooray for hubby! He’s a keeper 🙂
I plan on having my first child in a birth center or at home . I will be breastfeeding and I don’t plan on vaccinating. A baby shouldn’t be going through all of this!
Hello Sarah, I suppose you won’t publish this since you excised me from comments over the Costco/Carrington Farms discussion (in which I was never rude, just emphatic.) Nevertheless, I want to thank you for this informative and useful article. THIS is the kind of research and reporting that makes your blog both interesting and helpful and I appreciate it (even though my babies are long since grown.) Good job!
Melinda, glad you enjoyed the article but please note that this blog is not just about research based articles but also about anything that I or one of the contributing writers feel might be useful, helpful or interesting to others such as the Costco article which I am very proud to have written and I stand behind 100%. Just because some don’t like or disagree with what I’ve written doesn’t mean I will change or apologize for my opinion or rewrite/water down the article to suit their tastes. 🙂
When I had my 3rd baby (in a different hospital than the first two) they “required” glucose testing for all the “large” babies born over 8 lbs. My baby was born at 8lbs 2oz so they really pushed me to consent to the testing but I refused it. That was the first I had heard of glucose testing babies so it’s interesting to read your post on it!
I wish I had this information 10 years ago! My third child (first daughter) was my largest, 8 lb. 13 oz. She was born in a military hospital with a staff of incompetents. Because she was my third, I figured they would listen to me when I said things were getting close, but of course they decided they knew more than me. Her birth was rapid (after many hours of sitting through labor, since they would not let me walk), and the newbie “doctor” nearly dropped her because he was more concerned about fiddling with the bed than catching. I still get upset about that and the many other stupid and cruel things that happened that day. However, after freaking out about a non-existent heart murmur, they started checking her blood sugar. I was never asked for consent. They told me it was too low, so I tried to feed her. With the pressure of nurses crowding us, it did not go well. I was hounded and never left along long enough to properly feed her. She was a little difficult to get to latch, but having successfully fed my boys for a year + each, I knew I just needed to be allowed to have some peace and quiet to start teaching her. But alas, that was not to be. They started threatening me with formula feeding her if her numbers did not get to X by Y time, which of course did not help either one of us, so I did what I could and then insisted that I give her the bottle if one was to be given. Had my husband still been there, instead of home getting our other children, I would have considered leaving. In the end, I gave her one bottle and then spent weeks trying to correct her lazy sucking and poor latch. Not to mention the smell of the first several diapers! My mother, a nurse, eventually arrived and questioned them about the blood sugar numbers and said that they were, from what she had been taught, not low enough to warrant taking action. So they just ignored me for the rest of my stay, which could not have ended soon enough. And yes, it was obvious they were ignoring me as I was one of two women there!
I loath baby formula. After having used it with my first born and having issues for 11 months straight, I also learned A LOT about it. It’s crap! Only recently did I learn it is packed with GMOs as well. I was determined to give my other children ONLY breastmilk. They didn’t have any of the issues my first born had because I breastfed.
It’s sad they feed the baby formula at all the first few days, as the tummy of the child is SO very tiny! 1 to 2 oz is A LOT really for that tummy to take.
And I am totally with you, have the baby at home or birth center. 🙂 It’s REALLY SO much better! My last was born at home, and it’s far superior of a birth experience then that last two at a hospital. 🙂 She’s also the first child that is COMPLETELY clear of all drugs.