Question about Blood Sugar Issues in Preemies - Mothering Forums

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#1 of 7 Old 03-16-2007, 10:23 PM - Thread Starter
 
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I am currently 35 weeks now and I am trying to hold out for 36, which will be Tuesday. I am having problems with my uterine scar and have a lot of pain with contractions so each day I wonder if this is the day.
In the past we have had ABO incompatibility issues, I pretty much expect jaundice because we have had home health care in the past for this. However one of my concerns has become Low Blood Sugar issues. I was told the last time that the reason they were checking my 36 weeker for low blood sugar was because I did not do the GD screening, so this time I had on my forms for the hospital and put in my chart that I didn't want my baby pricked for this every few hours because I refused the GD screen again. Now I am reading this could be a concern for a baby born at this gestational age.

How often does it need to be checked? What causes it to be low? poor feeding? Is there any way I can avoid it? Does it need to be checked at birth?
Also, my last baby had a hard time maintaining her temp but we did skin to skin contact with warming blankets and we dressed and swaddled her tightly to help with that.
Is there anything else I should be prepared for? The last time I was just completely oblivious but this time I am more aware and want to be in the know ahead of time.

Thanks so much ladies for your time! I've learned so much the last few months reading this forum.
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#2 of 7 Old 03-16-2007, 10:53 PM
 
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My firstborn was born at 38 weeks with low blood sugar. His levels were about 12 at birth and quickly fell. I had an emergency csection because we couldn't find his heartbeat after 5 minutes of looking. I tested negative for gd at the time my ob gave me the test and I tested negative again 2 weeks before giving birth when we thought I might have been.

I was told that regular testing for low blood sugar was not done unless a baby exhibits signs of low blood sugar. I'm sorry that I don't remember what the signs were. However he spent 11 days in the nicu for low blood sugar, failure to eat (he had no suck at all), and jaundice. In fact they readmitted him 2 days after coming home for jaundice, we stayed an additional 4 days after the 11. I remember being told that jaundice was common in low blood sugar babies. I remember the neo telling me I had to have had gd because babies just weren't born with low blood sugar. I disagree with him as did my ob.

My twins were born at 36 weeks but they were never tested for blood sugar as they showed no signs of low blood sugar. Both twins spent some time in the nicu.

I probably didn't answer your questions but that was my experience.
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#3 of 7 Old 03-17-2007, 03:28 PM
 
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Avraham Chaim was tested for low blood sugar. I am not sure what the signs were but he was 36 weeks 5 days and not breathing, so they were running tests any which way.

His blood glucose was low and after they started the drip it was high so he was tested hourly so they could adjust the glucose in his IV. It had to be changed frequently for the first week. After that he was cheked every three hours and then once a day until discharge.

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#4 of 7 Old 03-20-2007, 02:33 PM
 
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Here is the rationale and general guideline for glucose screening:

Infant is less than 36 weeks: usually have less fat stores and may burn more energy staying warm and may or may not be eating enough. Also immature liver contributes a small part due to regulation of glucose control.

Infant is less than 2500 grams: partly due to same reasons above to include infants who have decreased stores of energy due to poor placenta function or they are small for age and have higher energy needs.

maternal refusing GD screening in itself is not a reason to do the screening.

Also the risk of having brain damage from low blood sugar is considerable so it is generally thought that the impact of heel stick sampling is not as severe as missing a low blood sugar baby. If an infant is having clinical or observable signs of low blood sugar we dont really know the effect on the brain tissue. Babies tolerate a glucose that would have you and me on the floor in a coma and breastfed infants also use ketolysis to generate energy (which is not registered on the glucose screen).

Also any observable signs of low blood sugar or signs of illness would be a reason to test. Hope that helps you!
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#5 of 7 Old 03-20-2007, 04:08 PM
 
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I'm late and don't have a lot of information on the blood sugar issue, but it's Tuesday, and I'm hoping you are still pregnant.

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#6 of 7 Old 03-22-2007, 01:12 AM - Thread Starter
 
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Thanks for the information. After doing some reading I think I am going to comply with the testing. I am having my baby tomorrow. I am keeping my fingers crossed for no special nursery or NICU time.
I had an US today and they are estimating her weight between 5.8 and 6lbs, she looks good, as does the placenta and she was doing practice breathing exercises -- a good sign I am told.
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#7 of 7 Old 03-22-2007, 01:15 AM
 
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Good Luck tomorrow and Congrats. She soungs like a big girl. Praticing breathing is great!

: for no NICU time and smooth delivery.
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