I remember back in the old days when insulin pumps were brand new to 
diabetes management.  One of our nurses who was a brittle Type I (juvenile) 
diabetic got one of the first pumps.  She was really excited that she could dial 
her insulin dosages up or down depending on her blood sugars.  She felt she 
got much tighter control with the pump, which is designed to administer small 
continuous doses of insulin, rather than periodic boluses of insulin like 
injections do.  That's why PCA (patient-controlled analgesia) pumps are so 
much better than injections at providing pain relief - they administer small 
frequent doses of the pain med round the clock.
Then this nurse got pregnant.  Her endocrinologist and her OB freaked out - 
they actually told her and her husband to consider abortion, as they felt she 
would not be able to carry this baby to term.  Not only did she get to term, 
she had a healthy baby.  Then...she was told she had better not even THINK 
about breastfeeding - guess what, she did breastfeed for over a year.  And 
throughout her pregnancy and breastfeeding, her diabetes was wonderfully 
controlled with her pump.  She subsequently had another baby and 
successfully breastfed that one as well.
Since then, it has been shown that an insulin pump is a wonderful tool in 
managing diabetes during pregnancy/lactation due to the pump allowing more 
flexible insulin administration.  Of course, the mother needs close monitoring by 
both her OB and her endocrinologist.

Pam Hirsch, BSN,RN,IBCLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL   USA

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