A 38-week-old small-for–gestational age female infant is born after an uncomplicated pregnancy with appropriate prenatal care. Maternal serologic findings are reassuring including negative group B streptococcal testing. Artificial rupture of membranes occurs at the time of repeat cesarean delivery, and the infant’s Apgar scores are 8 and 9 at 1 and 5 minutes, respectively. Cord arterial blood gas measurement shows a pH of 7.33, Pco2 of 41 mm Hg (5.45 kPa), and base excess of 4.

The NICU team is called to assess the infant 2 hours after birth when a temperature of 97°F (36.1°C) is obtained. The infant is found to be well-appearing and in no acute distress. Point-of-care glucose concentration at that time is 64 mg/dL (3.5 mmol/L). She is placed in skin-to-skin position with the mother, a plan is made for repeat evaluation in 1 to 3 hours, and a first breastfeeding attempt is to...

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