Diabetes in pregnancy: are we providing the best care ... - HQIP

External commentary
Patricia Hamilton
President, Royal College of Paediatrics and Child Health
I welcome this important study conducted by CEMACH, and in particular their fi ndings relating to the
babies of women with diabetes. This work confi rms what many have suspected, namely that the babies
of women with diabetes are being admitted needlessly to neonatal units. Not only is there unnecessary
separation from the mother, but also this inevitably has a negative impact on the success of breastfeeding.
These two fi ndings are against all the principles of child-friendly hospitals that we are trying to endorse and
implement, and we hope that as a result of this report we can encourage more babies to remain with their
mothers and achieve a higher success rate for breastfeeding.
This having been said, there is also concern regarding the sub-standard neonatal management of
hypoglycaemia, as well as early feeding. With the best of intentions, junior trainees have been making
estimates of blood glucose concentrations in babies too early and acting unnecessarily at a time when
the baby’s metabolism has not yet adjusted to extra uterine life and a low blood glucose concentration
may be physiological. We hope that as a result of this report this practice will be improved.
CEMACH are to be congratulated on this careful piece of work, which will have practical implications
for the betterment of the health of mothers and their babies.
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