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Baby Low Blood Sugar After C Section

Booby Traps Series: Say No To Routine Blood Glucose Monitoring For Healthy Babies

Booby Traps Series: Say No To Routine Blood Glucose Monitoring For Healthy Babies

This is the 30th in a series on Booby Traps, made possible by the generous support of Motherlove Herbal Company. Blood sugar. It’s a concept familiar to those of you who are diabetic or have had gestational diabetes, but to others it’s the last thing we think we have to learn in preparation for our babies’ birth. But in some hospitals, all babies are checked for low blood sugar. In spite of recommendations from the American Academy of Pediatrics to the contrary, “many hospital nurseries,” says this journal article, “continue the clinical practice of routine early glucose screening on healthy, term newborns.” This has significant consequences for breastfeeding. But let’s back up a bit. Why would anyone want to know about a baby’s blood sugar levels? Glucose is the primary source of energy for our cells, and it’s transported by our bloodstream. Low glucose levels can cause anything from irritability and jitteriness to seizures in babies. But only a small percentage of babies are at risk for low blood glucose. Healthy, term newborns born after a normal pregnancy and delivery are not at risk, yet they are sometimes screened anyway. Why would routine screening of all babies for blood glucose levels be detrimental to breastfeeding? Because a low blood glucose reading often results in formula supplementation, and sometimes separation of the mother and baby. Supplementation can lead to problems with milk supply and sometimes with the ability of babies to feed from the breast. According to the Academy for Breastfeeding Medicine, “it is clear that the routine monitoring of blood glucose in healthy term infants is not only unnecessary but is potentially harmful to the establishment of a healthy mother-infant relationship and successful breastfeeding patterns. Continue reading >>

How Does A Cesarean Affect The Baby?

How Does A Cesarean Affect The Baby?

For the first time in more than a decade the U.S. cesarean birth rate decreased, if only by .1%. The rate decreased from 32.9% to 32.8% in 2010. But still, one in three mothers gives birth by cesarean and scheduled cesareans for non-medical reasons have been rising. Surgical birth without labor impacts the health of newborns. Birth by cesarean poses several challenges for a baby. Compared to babies born vaginally, babies born by cesarean are at risk for health complications they are less likely to face with a normal birth. Especially if the mother did not labor, babies are more likely to have difficulty breathing on their own. With a scheduled cesarean, babies are more likely to be born preterm, before the lungs have fully developed. Respiratory complications can be serious enough to require admission to a special care nursery. With a cesarean, mothers and babies are less likely to have skin-to-skin contact immediately after birth. Skin-to-skin contact has several adaptive benefits for the newborn. Pain medications that sedate the mother can affect the newborn’s ability to latch on and breastfeed. Drugs used for anesthesia, including epidurals, cross the placenta and can make it more difficult for babies to initiate breastfeeding. The American Academy of Pediatrics encourages all maternity care providers to collaborate to support breastfeeding. That includes avoiding common but often unnecessary procedures that interfere with breastfeeding and that may traumatize the newborn. Routine procedures following a cesarean birth such as suctioning the newborn’s mouth, esophagus and airways can also make it more difficult for babies to begin and continue breastfeeding. Planned Cesareans and Late Pre-Term Birth Many cesareans that are scheduled before labor put newborns at ri Continue reading >>

Gestational Diabetes

Gestational Diabetes

Overview Gestational diabetes develops during pregnancy (gestation). Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose). Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby's health. Any pregnancy complication is concerning, but there's good news. Expectant women can help control gestational diabetes by eating healthy foods, exercising and, if necessary, taking medication. Controlling blood sugar can prevent a difficult birth and keep you and your baby healthy. In gestational diabetes, blood sugar usually returns to normal soon after delivery. But if you've had gestational diabetes, you're at risk for type 2 diabetes. You'll continue working with your health care team to monitor and manage your blood sugar. Symptoms For most women, gestational diabetes doesn't cause noticeable signs or symptoms. When to see a doctor If possible, seek health care early — when you first think about trying to get pregnant — so your doctor can evaluate your risk of gestational diabetes as part of your overall childbearing wellness plan. Once you're pregnant, your doctor will check you for gestational diabetes as part of your prenatal care. If you develop gestational diabetes, you may need more-frequent checkups. These are most likely to occur during the last three months of pregnancy, when your doctor will monitor your blood sugar level and your baby's health. Your doctor may refer you to additional health professionals who specialize in diabetes, such as an endocrinologist, a registered dietitian or a diabetes educator. They can help you learn to manage your blood sugar level during your pregnancy. To make sure your blood sugar level has returned to normal after your baby is born, your health care team wil Continue reading >>

What Is Diabetes In Pregnancy?

What Is Diabetes In Pregnancy?

Having diabetes means that there is too much sugar (glucose) in your blood. Some women have diabetes before they get pregnant. Others start having it during pregnancy. Diabetes that starts during pregnancy is called gestational diabetes. If you had diabetes before you became pregnant, it may get harder for you to control your sugar levels during pregnancy. Pregnancy can make both high and low blood sugar levels happen more often. It can make diabetic eye, kidney, heart, blood vessel, and nerve problems worse. You may need to change your insulin dosage. If you were not using insulin before the pregnancy, you may need to use it while you are pregnant. If you develop diabetes during pregnancy, you may need to start a special diet. You may need to have insulin shots or take a pill to help control your blood sugar. If diabetes is not treated well before and during pregnancy, and your sugars are poorly controlled, these problems might occur: The high sugar levels in your blood might cause the baby to get too big before birth. Very large babies tend to have more problems. Babies who are very large or have other problems may need to be delivered by C section. If delivered vaginally, a big baby is slightly more likely to have an injury at the time of delivery. The baby might have birth defects, such as problems with the heart, kidney, spine, or brain. Some of these problems may be life threatening. You might have high blood pressure during the pregnancy, which can cause problems for both you and the baby. You may develop ketones in your blood and urine when you have very high blood sugar. This can cause a very serious, life-threatening condition called diabetic ketoacidosis. You might go into labor early. The baby might need to be delivered early. After delivery the baby’s blo Continue reading >>

Low Blood Sugar - Newborns

Low Blood Sugar - Newborns

Babies need blood sugar (glucose) for energy. Most of that glucose is used by the brain. The baby gets glucose from the mother through the placenta before birth. After birth, the baby gets glucose from the mother through her milk or from formula, and the baby also produces it in the liver. Glucose level can drop if: There is too much insulin in the blood. Insulin is a hormone that pulls glucose from the blood. The baby is not producing enough glucose. The baby's body is using more glucose than is being produced. The baby is not able to feed enough to keep the glucose level up. Neonatal hypoglycemia occurs when the newborn's glucose level causes symptoms or is below the level considered safe for the baby's age. It occurs in about 1 to 3 out of every 1,000 births. Low blood sugar level is more likely in infants with one or more of these risk factors: Born early, has a serious infection, or needed oxygen right after delivery Mother has diabetes (these infants are often larger than normal) Have slower than usual growth in the womb during pregnancy Continue reading >>

10 Benefits Of Skin-to-skin Contact

10 Benefits Of Skin-to-skin Contact

During pregnancy, babies are as close to their moms as they can be—getting warmth, food, protection, and oxygen from their mother’s body. Then, labor occurs and babies suddenly find themselves without immediate access to those essential needs. It is not surprising that study after study has shown a host of benefits for babies who experience skin-to-skin care (sometimes called ‘kangaroo care’) with their mothers. When babies are held naked against their mother’s skin, it is the closest they can get to being back in the warmth and security of the womb. Whenever possible, mothers and babies should be in direct contact for at least the first 1–2 hours after birth. In skin-to-skin care, the baby is naked (a dry cap is okay, as is a diaper), and is placed on the mother’s bare chest, between her breasts. A blanket should be draped over both of them for warmth. If the mother is unable to provide skin-to-skin care, due to labor or birth complications, then Dad can step in. Within minutes, you will see the benefits of skin-to-skin care become evident as both mother and baby relax. The baby’s body temperature, breathing, and heart rate stabilize. Benefits of skin-to-skin care during infancy may persist for years. A long-term study of babies who were in the NICU (neonatal intensive care unit) of an Israeli medical center after birth found that benefits persisted years later. After assessing the children at 10 years of age, the researchers found benefits for those who had skin-to-skin care, including better maternal attachment behavior, reduced maternal anxiety, enhanced child cognitive development, and mother-child reciprocity. Given the short-term and long-term benefits, it’s not surprising that proponents of skin-to-skin care recommend the practice continue thro Continue reading >>

Infant Of Diabetic Mother

Infant Of Diabetic Mother

Definition A fetus (baby) of a mother with diabetes may be exposed to high blood sugar (glucose) levels throughout the pregnancy. Alternative Names IDM; Gestational diabetes - IDM; Neonatal care - diabetic mother Causes Women may have diabetes during pregnancy in 2 ways: Gestational diabetes is high blood sugar (diabetes) that starts or is first diagnosed during pregnancy. Other women have type 1 diabetes before their pregnancy begins. If the diabetes is not well controlled during pregnancy, the baby is exposed to high blood sugar levels. This can affect the baby and mom during the pregnancy, at the time of birth, and after birth. Infants who are born to mothers with diabetes are often larger than other babies. Larger infants make vaginal birth harder. This can increase the risk for nerve injuries and other trauma during birth. Also, C-sections are more likely. The infant is more likely to have periods of low blood sugar (hypoglycemia) shortly after birth, and during first few days of life. Mothers with poorly controlled diabetes are also more likely to have a miscarriage or stillborn child. If the mother had diabetes before her pregnancy, her infant has an increased risk of birth defects if the disease was not well controlled. Symptoms The infant is often larger than most babies born after the same amount of time in the mother's womb (called gestational age.) Other symptoms, mostly caused by low blood sugar, may include: Blue or patchy (mottled) skin color, rapid heart rate, rapid breathing (signs of immature lungs or heart failure) Newborn jaundice (yellow skin) Poor feeding, lethargy, weak cry, seizures (signs of severe low blood sugar) Puffy face Reddish appearance Tremors or shaking shortly after birth Exams and Tests Before the baby is born: Ultrasound performed o Continue reading >>

What Happens After Baby Is Born With Gestational Diabetes?

What Happens After Baby Is Born With Gestational Diabetes?

What happens after baby is born when you've had gestational diabetes will depend on your type of birth and your birth plans. Babies born to mothers with gestational diabetes are at risk of hypoglycaemia (low blood sugar levels) and so it is recommended that babies have their blood sugar levels checked following birth in addition to the usual newborn checks. What to expect after baby is born - checks on babies born to diabetic mothers Neonatal or newborn hypoglycaemia Newborn babies of diabetic mothers when there has been poor diabetic control in pregnancy will often struggle with their own blood sugar levels after birth. This is due to the baby overproducing their own insulin whilst growing in the uterus to help process the excess sugars passed from the mothers bloodstream. These babies may have high insulin levels persisting in the first few days after birth which can result in hypoglycaemia as they are no longer receiving excess sugar from the mothers bloodstream and they may struggle to regulate their own insulin production to normal levels. Babies of mothers who have had reasonably good blood glucose control may still suffer with low blood sugar levels after birth too and so it is recommended that all babies born to diabetic mothers (including gestational diabetes) have their blood sugar levels checked. Testing baby for hypoglycaemia following birth with gestational diabetes In the majority of hospitals, newborns born to diabetic mothers are routinely monitored for hypoglycaemia. Each hospital is different as to how they monitor the blood sugar levels, but the procedure is the same. A midwife or nurse will heel prick the baby to obtain enough blood to be tested on a blood glucose test monitor, the same as we use to monitor our own blood sugar levels throughout the p Continue reading >>

Infant Of Diabetic Mother

Infant Of Diabetic Mother

How does Diabetes in the mother affect the baby before birth? When a mother has diabetes, her body does not control blood sugar normally. Blood sugar is controlled mainly by insulin. Normally, blood sugar rises after meals. The body responds by putting insulin into the blood stream. The insulin helps the sugar get into the body's cells that use the sugar for energy and growth. With diabetes, there is not enough insulin released by the body causing the blood sugar rise abnormally high. When a mother's blood sugar is high, so is her baby's inside her because sugar travels across the placenta to the baby. The baby's body can and does make insulin. If the blood sugar is high, the baby makes extra insulin to keep its own blood sugar normal. Diabetes may be present before pregnancy, or it may appear during pregnancy. Diabetes which occurs only during pregnancy is called "gestational diabetes" and appears after the first few months of pregnancy. In gestational diabetes, diet alone often controls the blood sugar level, but sometimes the body needs extra insulin. Diabetes which exists before pregnancy usually requires insulin and often gets worse during pregnancy. Keeping blood sugar in the normal range is very important in pregnancy. If a woman has diabetes for several years, the blood vessels in her body may be more narrow or show changes of aging. These same changes can occur in the blood vessels to the placenta. Problems of the developing baby can include: Large size. The high sugar and high insulin together may make the baby grow larger than normal. Small size. Usually when the mother has had diabetes for several years and has changes in her blood vessels. Increased risk for malformations or birth defects. This is more common when diabetes started before pregnancy and/or wh Continue reading >>

Low Neonatal Blood Glucose Levels In Cesarean-delivered Term Newborns At Khartoum Hospital, Sudan

Low Neonatal Blood Glucose Levels In Cesarean-delivered Term Newborns At Khartoum Hospital, Sudan

Go to: Letter to the Editor There has been a recent dramatic increase in the rate of cesarean delivery [1,2]. There are many fetal and perinatal complications of cesarean delivery e.g. obesity, allergies, metabolic disturbance, and lower blood glucose levels in the offspring [3-6]. There are few published recent data on neonatal glucose levels during cesarean delivery [6-8]. Glucose is the main source of energy for organ function in neonates. In particular, glucose is an exclusive source of energy for the function of the central nervous system in neonates [9]. The definition and management of neonatal hypoglycemia are controversial and there is no constant cut-off point for low levels of neonatal glucose [10]. A case–control study was conducted at Khartoum Hospital, Sudan during April to June 2012 to investigate glucose levels in neonates born to women who delivered by elective cesarean. Cases were women delivered by elective cesarean (before labor) and controls were consecutive vaginal deliveries. In both arms of the study, women were at term (37–41 completed weeks of gestation), newborns were ≥ 2500 g at birth, there was no history of fetal problems, and Apgar scores were 8 or higher at 1 and 5 minutes. Newborns of mothers with any medical disorder, ante/intra-partum complications, newborns with signs suggestive of perinatal stress, and instrumental delivery, and those who required intensive resuscitation and care were excluded from both cases and controls. Mothers who underwent cesarean delivery were fasting for at least 6 h before cesarean delivery. All vaginally-delivered infants were placed at the breast immediately after delivery. Every newborn had a venous cord blood sample obtained from the umbilical cord and another sample was taken 2 h later from a peri Continue reading >>

High Blood Sugar In Pregnancy Puts Baby At Risk

High Blood Sugar In Pregnancy Puts Baby At Risk

Print Font: CHICAGO — The higher a pregnant woman’s level of blood sugar, the greater the risk to her newborn — whether the mother has diabetes or not, the largest study on the problem suggests. More women opting for preventive mastectomy - but should they be? Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring. The findings released Friday may lead to more women being diagnosed with diabetes during pregnancy and given stricter diet advice or medication to lower blood sugar. The research involved more than 23,000 pregnant women in nine countries. It found a surprisingly strong relationship between the blood sugar levels of the women and the rate of big babies and first-time Caesarean sections, said lead investigator Dr. Boyd Metzger of Northwestern University. The newborns also were more likely to have low blood sugar levels and high insulin levels if their mothers’ blood sugar levels were higher. The problems can lead to obesity, diabetes and high blood pressure later in life. Risks for large babies Large babies risk shoulder damage and other injuries if delivered vaginally and lead to more C-sections, which also pose health risks to mothers and babies. Large babies were defined in the study as those bigger than 90 percent of those born in the local population, so large Thai babies would be smaller than large U.S. babies. Researchers reported the findings Friday at the American Diabetes Association’s annual scientific meeting. The higher the mother’s blood sugar, the more Continue reading >>

Neonatal Hypoglycemia (low Blood Sugar) And Birth Injury

Neonatal Hypoglycemia (low Blood Sugar) And Birth Injury

Glucose is crucial to brain development, as it is one of the only sources of energy the brain can use. Neonatal hypoglycemia is a condition in which a baby’s blood sugar falls very low within a few days after birth. These low glucose levels impair the growth process, and brain cells start to die. Neonatal hypoglycemia is one of the most common neonatal metabolic issues, and one of the most easily treated. Infants with neonatal hypoglycemia (NH) experience a dangerous drop in their level of glucose (also known as blood sugar) in the first few days after birth. Babies need glucose for energy, and most of the glucose is used by the brain. Before birth, the baby gets glucose from the mother through the placenta. After birth, the baby gets glucose from breast milk or formula. Glucose is also produced in the baby’s liver. Neonatal hypoglycemia is one of the most common metabolic problems in babies, and severe NH is one of the leading causes of brain injury. Neonatal hypoglycemia is not difficult to recognize, and usually it is very easily treated. Untreated NH, however, can have serious consequences because an infant’s developing brain tissue depends on a steady supply of glucose as its main source of fuel. When brain cells receive insufficient glucose, they start to die. Risk Factors for Neonatal Hypoglycemia There are some medical conditions that make low blood sugar levels more likely in some infants. These include: Babies who are small or macrosomic (large) for gestational age Preterm and postterm babies Babies who were born to diabetic mothers Babies who have a serious infection or who needed oxygen right after delivery Babies who had poor growth in the womb during pregnancy Babies with low thyroid hormone levels (hypothyroidism) Babies who have certain rare geneti Continue reading >>

Evidence On: Induction Or C-section For A Big Baby

Evidence On: Induction Or C-section For A Big Baby

What is a big baby? The medical term for big baby is macrosomia, which literally means “big body.” Some researchers consider a baby to be big when it weighs 4,000 grams (8 lbs., 13 oz.) or more at birth, and others say a baby is big if it weighs 4,500 grams (9 lbs., 15 oz.) or more (Rouse et al. 1996). Babies are called “extremely large” if they are born weighing more than 5,000 grams (11 lbs.) (Hehir et al. 2015). A baby is also called “large for gestational age” if its weight is greater than the 90th percentile at birth, in other words, if it is bigger than 90% of all other babies born at that same gestational age (Rouse et al. 1996). In this Evidence Based Birth® article, we will cover the evidence on induction or C-section for big babies. Please read our Disclaimer and Terms of Use. How common are big babies? About one in ten babies is born big in the United States (U.S.). Overall, 8.7% of all babies born at 39 weeks or later weigh between 8 lbs., 13 oz., and 9 lbs., 15 oz., and 1.7% are born weighing 9 lbs., 15 oz. or more (U.S. Vital Statistics). In the table below you can see the percentages listed separately for women who are not diabetic, those who have gestational diabetes, and those who have Type I or Type II diabetes. Among women with gestational diabetes, researchers have found that the higher your blood sugar when you’re first diagnosed with gestational diabetes, the more likely you are to have a baby who is large for gestational age (Metzger et al. 2008). However, women who manage their gestational diabetes through diet, exercise, or medication, bring down their chances of having a big baby to normal levels (7%) (Landon et al. 2009). The most detailed evidence we have on typical care for big babies comes from the U.S. Listening to Mothers S Continue reading >>

Large For Gestational Age

Large For Gestational Age

What is large for gestational age (LGA)? Large for gestational age is used to describe newborn babies who weigh more than usual for the number of weeks of pregnancy. Babies may be called large for gestational age if they weigh more than 9 in 10 babies (90th percentile) or more than 97 of 100 babies (97th percentile) of the same gestational age. This is based on U.S. statistics from 1991. About 1 in 10 babies born at 40 weeks' gestation in the U.S. in 1991 weighed more than 8 pounds, 13 ounces (4,000 grams) at birth. Three in 100 babies weighed more than 9 pounds, 11 ounces 4,400 grams). Babies born earlier than 40 weeks are considered LGA at lighter weights. Babies born after 40 weeks are considered LGA at slightly higher weights. Overall, babies born in the U.S. in recent years weigh a little more than they used to. Normal ranges for birth weight may also be different, based on ethnic background. What causes babies to be LGA? Some babies are large because their parents are large. Parents may pass along this trait to their children. A high birth weight can also be related to the amount of weight a mother gains during pregnancy. Women who gain a lot of weight during pregnancy often give birth to babies who are large for gestational age. Diabetes in the mother is the most common cause of babies who are large for gestational age. When a pregnant woman has high blood sugar, she can pass that along to her baby. In response, the baby's body makes insulin. All the extra sugar and the extra insulin that is made can lead to fast growth and deposits of fat. This means a larger baby. It also means a risk for low blood sugar right after birth. At that point, the mother's supply is no longer there, but the baby's insulin levels stay high. Which babies are at risk for LGA? If a baby Continue reading >>

Infant Of A Diabetic Mother

Infant Of A Diabetic Mother

What are the classifications of maternal diabetes? Why are the classifications important? What are the risks to the infant? What can be done to decrease the risk of complications to the infant? What special tests may be required for a diabetic mother during pregnancy? What special tests may be required for the infant after birth? What special treatments may be required for the infant after birth? What is the risk of the infant developing insulin-dependant diabetes? Jan E. Paisley, M.D. Fellow in Neonatal-Perinatal Medicine William W. Hay, Jr., MD Professor of Pediatrics, Director of the Training Program in Neonatal-Perinatal Medicine Director of the Neonatal Clinical Research Center Section of Neonatology, Department of Pediatrics University of Colorado School of Medicine Denver, Colorado What are the classifications of maternal diabetes? The classifications of maternal diabetes are outlined in Table 1. Why are the classifications important? The classification of diabetes during pregnancy is important because the outcome of both the mother and the baby are related to the severity and the duration (represented by the different classes) of the mother's diabetic condition. In mothers with gestational diabetes, there is an increased risk of large (macrosomic) babies and babies with low blood sugars (hypoglycemia) after birth; however, the overall risk of complications is low. Large babies and babies with low blood sugars also are associated with Classes A, B, C, and D.1 Large (macrosomic) babies increase the need for cesarean section delivery because the baby can be too big to pass through the mother's pelvis and vaginal canal. Class F mothers have the highest risk of delivering abnormally small babies with poor growth while inside the mother's uterus.1 Class F mothers also Continue reading >>

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