بررسی تاثیر تغذیه با شیر مادر بر قندخون نوزادان با وزن بالا

Background and purpose : The low amount of blood sugar in neonates is an important and prevalent problem which needs serious attention because of its cerebral complications. High birth weight is one of the risk factors for hypoglycemia. There is no general agreement about how to approach the high birth weight neonates who do not have the symptoms of hypoglycemia but are at a high risk of it. In some centers the neonates blood sugar is checked before beginning the breast feeding and treatment but it imposes risk of opening the vein, hospitalization and also cost of care. So in this study the effects of breast feeding on blood sugar in high birth weight neonates have been studied. Materials and methods : This study is a before/ after clinical trial on high birth weight neonates (BW>3800 gr) who were born in Imam and Razi University hospitals. Each neonate was its own control and the intervention was breast feeding. Simple sampling method was used to recruit the subjects and the exclusion criteria were neonates with symptomatic hypoglycemia, blood sugar less than 30mg/dl and absence of breast feeding in the first 2 hours after birth. After measuring the blood sugar, breast feeding was done and then 0.5 and 2 hours after that, the blood sugar was measured again and compared with the first amount (before breast feeding). Results : A total of 94 neonates with birth weight of 4120+234 and 39.6+1 weeks of gestational age were studied. Most of the neonates were at the first and second parity (38.2% & 40.4%) and given birth through caesarian section (63.8%). History of hypertension in 7.2% and gestational diabetes in 6.4% were positive. Blood sugar at birth was 52. 25+ 15.5 mg/dl and blood sugar of 0.5 and 2 hours after breast feeding were 56. 89+ 14. 45 mg/dl and 68+ 14.5 mg/dl respectively. The differences between the blood sugar at birth and after 0.5 and 2 hours of breast feeding were significant (P<0.05). Birth weight and the commencing time of breast feeding were the factors significantly related to neonates blood sugar. Conclusion : Breast feeding increases the blood sugar in high birth weight neonates and decreases the chance of being in hypoglycemic group and this effect in Neonates with near normal birth weight, early onset of breast feeding and longer length of time after beginning the breast feeding is much more significant.