I would think a baby generally needs comping when all is not well. This can present in a variety of ways at various times. Recently came on to special in HDU a young woman who had birthed over night (approximately 12 hours previously), spontaneous vaginal birth but pre-eclamptic in labour, Mg SO4 infusion etc.. Baby had birthed through mec liq but was vigorous with good apgars so was with mum and had "fed" on and off since the birth though not within the first couple of hours of birth as refused at this time.
So, I assisted mum (she had lots of IV tubes etc..) with three attachments in the first couple of hours of my shift and became concerned as did mum with the increasing irritability (though only when not attached well to the breast) and slight (really very slight) jitteryness of the baby. Good temp maintenance, resps and HR. Unable to express colostrum when assisting with attachment. So, I recommended to mum we check baby's bsl and she agreed: 0.6 mmol I kid you not! Double checked (sample to path)as amongst other things baby did not seem symptomatic of such a low bsl. So baby straight to SCBU, comps and IV dextrose. It took the rest of the day shift for baby's bsl's to be close to 2.5mmol. We can only hope baby is neurologically fine. Baby had not appeared to have seizures. This is one baby (I think)who would have benefitted from 3/24 bsl's. Mum was not GDM though had had GTT due to family hx of diabetes and was NOT glucose impaired, normal weight at booking , baby 37+ weeks and around 3kg, first baby, young healthy mother. The only thing not normal was the sudden onset of pre-eclampsia in labour with really elevated lft's etc.. Despite this baby appeared to tolerate labour and birth well despite the mec liq. In hind-sight I would say the mec liq was actually an indication of the baby's stress and in this case would have been a reason to do 3/24 bsl's as well as the TPR's. Would just like to add that pre-eclampsia etc.. in labour is not necessarily a indicator as the mum and baby in the bed beside this mum had a very similar situation just no mec liq. That baby fed and slept all day shift and had colostrum dripping from lips and mum's nipples after feeds. Just wanted to say I can understand the 3/24 or similar protocols for bsl's especially after complicated births (even if the actual birth is "spontaneous vaginal") as sometimes the signs and symptoms can be subtle and may be "normalised" through shift changes. Maybe I just feel bad I didn't rush the baby off for a bsl as soon as I came on or at least sooner than I did! marilyn ----- Original Message ----- From: <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Wednesday, December 15, 2004 3:12 PM Subject: RE: [ozmidwifery] feeds in 24 hrs? > >> I will tell her if I believe all is well, but there are times when a baby > > genuinely needs comping. Maureen > > > Hi Maureen and anyone else who could enlighten me on the above comment about > there being times when a baby genuinely needs comping, > > Could you please be more specific ie, at what times would a baby genuinely > need comping? > > Thanks > > Jayne > > > > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
