Hypoglycemia in breastfed neonates.

Healthy, full-term infants are programmed to make the transition from their intrauterine constant flow of nutrients to their extrauterine intermittent nutrient intake without the need for metabolic monitoring or interference with the natural breastfeeding process. Homeostatic mechanisms ensure adequate energy substrate is provided to the brain and other organs, even when feedings are delayed. The normal pattern of early, frequent, and exclusive breastfeeding meets the needs of healthy full-term infants. Routine screening or supplementation are not necessary and may harm the normal establishment of breastfeeding. Screening should be restricted to at-risk and symptomatic infants. Symptomatic infants need immediate assessment and intravenous glucose therapy, not forced feedings.