Testing "big babys" glucose after birth?

[arimama]

I'm a doula and I just had a client who was basically scared into a scheduled cesarean...
Any how her baby was 8lbs 15 oz. Not terribly big imo, but the hospital insisted on testing his blood sugar 4 times in the first few hours after birth because he was over 400 grams at birth.
Is this evidenced based, or just another routine "just in case" kind of thing?

[turtlewomyn]

I am sorry that your client was scared into a scheduled c/section. The exact same thing happened to me in October 2005. My baby was 9lb8.5oz.
And yes, it is standard protocol in hospitals to check the glucose of babies over 4000g. There may be some evidence somewhere that large babies have troubles with their glucose levels after birth. I think the reasoning is that "Oh, we must have missed GD, the baby will have problems controlling their glucose now." My dd was tested, and her blood glucose was just fine... every single time. I nursed her like crazy in the hospital.

I am sort of curious, are you continuing to support your client? Did you attend her c/section still? My doula sent me some info from ACOG on not inducing or scheduling a c/section for big babies (unfortunately I wasn't in a state of mind to use it to argue with the doctor). She didn't offer to come to the appt. where I was talked into the section - I was too afraid to ask, and after it was decided she gave me a partial refund, did not attend my "birth", and she didn't do the post partum visit. I did go and visit her myself later so that she could meet my daughter. I felt kind of abandoned, and wondered if this was typical of the situation.

Good luck to your client, I hope that she has a better time healing from her c-section (mentally) than I did.

[arimama]

Turtlewomyn
I'm sorry your doula didnt stick with you. I am commited to my clients no matter what type of birth they have. I will admit that my role was very different at a schedule cesarean and I felt kind of unnecessary. But my clients REALLY appreciated the emotional support.
Yes I attended the birth, I was in the OR with them and stayed about 4 hours with them afterward. I am also providing postpartum doula care for them.

For midwives, do you do the glucose testing at homebirths for big babies?
Do you even consider 8lb 15 oz big?

[Stacymama]

Not a professional, but speaking from my experience.
I had 2 homebirths with fairly good sized babies.
#1 was 8lbs. 11oz
#2 was 9lbs 12 oz
neither were tested by my midwife nor was it even suggested.
I did have the testing done myself at what 28 weeks? Which was negative.

[ckhagen]

My 10lb8oz cesarean baby was tested multiple times and I was threatened repeatedly that they were going to give him a bottle of glucose water. It was the ONLY intervention I managed to stand up for myself against. They did say it was standard to test over 4000g.

[DoomaYula]

Hmmm... not to go too OT but I attended a birth last year for a family member, not really acting as a doula, mom was not quite 37w, and baby was only 6lbs even and they insisted on testing baby's glucose too... why?

[BetsyS]

Different places I've worked have had different protocols, but the main babies I've seen tested are: less than 2000 grams, more than 4000 grams, less than 37 weeks (so technically premature), and a mom with a history of diabetes (gestational or pre-pregnancy).

My son was over 5000 grams. They did test him--they asked first, I agreed, and he was tested 3-4 times. Each time, his blood sugar was fine. I did ask what their standard was if it was low--and they said they would just encourage him to nurse more. As it was, he was pretty much latched on continuously for the entire time we were in the hospital, so it was a moot point.

[the_lissa]

My first was a hospital transfer and weighed 8 lbs, 9 ozs. My second was a home birth and weighed 9 lbs, 10 ozs. Neither had their glucose tested.

[MindfulBirth]

My second was nearly 10 lbs and I got the whole "oh, you must have had GD and we missed it line". I did consent to the testing since diabetes runs in my husbands family - baby was fine.

[Peppamint]

The midwives I know don't do the glucose testing... heck, I get the impression my babes in the 7.5lb range were "small". It seems like HB babies tend to be larger than hospital babes (our local newspapers birth announcements generally announce 6-7lb babies).

A friend of mine had a hospital birth just under two years ago and her 9lber had the glucose test and then for reasons I forget was subjected to a spinal tap and other testing as well.

[CMcC]

Yes, it's standard to test babies over 400g at our area hospitals. Not to sound like a broken record, but my sons were 8 lb 15 oz and 9 lb 14 oz..... both were fine.

[Reha]

What is standard protocol in hospitals is so often NOT the same as being back by evidence.

Routine glucose monitoring of "big babies", from my research, is NOT evidence based. It is a much better to policy to encourage and make possible for early and frequent nursing, and then watch babies for SIGNS of hypoglycemia, and then begin to monitor or treat if baby shows signs.

The other thing to ponder.....we don't honestly know what the "normal" range is for newborns, just like we don't really know what the normal levels are for pregnant women. It is completely ridiculous to be treating a baby whose levels might be deemed borderline hypoglycemia but have no signs whatsoever.

[NamastePlatypus]

I had never heard of this until this week when talking to my midwife. It is protocol here as well for me since I am 26 ( didn't think that was 'risky') and e was over 9 lbs. I have to be tested at least twice and so will this babe, and I am having a homebirth. :

[Reha]

Originally Posted by NamastePlatypus

I had never heard of this until this week when talking to my midwife. It is protocol here as well for me since I am 26 ( didn't think that was 'risky') and e was over 9 lbs. I have to be tested at least twice and so will this babe, and I am having a homebirth. :

Can't you sign a waiver? To me, it seems like there is no way any protocol can dictate what is done to you and your baby simply because it is a protocol, esp when it comes to the very shaky issue of glucose levels in pregnancy and the newborn. :

[PapayaVagina]

I unfortunately transported from a homebirth and had a cesarean. My dd weighed 10 pounds 6.5 ounces. I refused to have her blood sugar tested as to my understanding testing stress can lead to further causing a drop in blood sugar. The nurses asked me about a bazillion times while we were there if she was having any sort of signs of hypoglycemia but she never did. Their protocol was anything over 8 1/2 pounds to do it. I just did tons of skin to skin and nursed her constantly.

[NamastePlatypus]

Originally Posted by Lennon

Can't you sign a waiver? To me, it seems like there is no way any protocol can dictate what is done to you and your baby simply because it is a protocol, esp when it comes to the very shaky issue of glucose levels in pregnancy and the newborn. :

I am working on that. I am getting a HARD time for declining vaginal exams and STD tests. AR has THE strictest HB policies:

[NamastePlatypus]

Oh and another thought, what is so wrong with a healthy big baby, the med field seeems so hoped up on finding anything that is wrong. big babes run in DH's family, not diabeties, what is so wrong with that? Are they going to find some test to do to babes with dark hair now?:irk: