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A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical conditions that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. PurposeT o provide guidance in the first hours/days of life to: Differentiate transitional neonatal hypoglycemia from persistent pathologic hypoglycemia Prevent clinically significant hypoglycemia in newborn infants Appropriately monitor blood/plasma glucose levels in at-risk term and late preterm neonates Manage clinically significant hypoglycemia in newborn infants to prevent neurologic injury Maximize breast milk provision to babies Establish and preserve maternal milk supply during medically necessary supplementation for hypoglycemia or during separation of mother and baby. About the 2020 Revised ProtocolKey research articles before 2014 were retained and more recent information was added from primary studies and compilations. Specific studies were assigned a level of evidence, and Strength of Recommendation Taxonomy (SORT: A, B, C) 1 was used for recommendations. The SORT rating system addresses the three key elements (quality, quantity, and consistency) recommended by the Agency for Healthcare Research and Quality. Levels of evidence are applied after each specific recommendation in brackets, e.g., [A], [B], [C].Recommendations are updated based on the last 6 years of new information and critical older studies. This clinical protocol is intended to provide practitioners with pragmatic evidence-based guidance to keep infants safe while mini-

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A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.

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