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Date: | Wed, 9 May 2007 23:30:59 +0300 |
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Hello Donna!
I have a little experience working with diabetic mothers, some of them had
insulin pumps. I also happen to live with 8 year old daughter, who has had
an insulin pump since she was five weeks old...
Insulin pump is a great thing to deal with diabetes and it does not require
any extra efforts compared to insulin injection therapy during lactation. On
the contrary in my opinion! If the mother is motivated to treat her diabetes
well and is an expert with her own condition (and they usually are
especially during pregnancy and breastfeeding), an insulin pump makes it
much easier for her to adjust her insulin doses according her blood glucose
levels. The hormone changes that happen during pregnancy, delivery and
postpartum affect mothers need for insulin and with the pump it is much
easier to adjust insulin doses since you can give very accurate and small
amounts of insulin at a time if needed and adjust basal insulin rate very
accurately. The mothers may suffer for hypoglycemic episodes for themselves
during breastfeeding and they may need extra snacks and being careful with
they own treatment (blood glucose monitoring) although they can easily lower
insulin administration with the pump. The experience I have had with these
mothers is that they do great job treating their diabetes, but many need to
lower their insulin doses and still have to be careful with eating enough
and more than usually to keep hypoglycemia episodes away. Their blood
glucose might change rapidly lower during breastfeeding especially in the
first months unless they eat enough snacks.
In Finland it is still common to separate type 1 diabetic mothers and their
babies at early postpartum period to monitor and treat newborns possible
hypoglycemia. So type 1 diabetic mothers must face the challenges that this
separation makes to their breastfeeding relationships. It is common to give
newborns supplementary feedings / iv-glucose infusion until their blood
glucose levels are stabilized. The diabetic mothers must work harder to
establish breastfeeding than non-diabetic mothers. I find this very unfair
and frustrating.
Warmly,
Pia Ruohotie, RN, breastfeeding counsellor and mother-to-mother support
group leader
mother of two daughters and very lovely nursing 9 months old son
from Helsinki, Finland, Europe
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