Hello Mia!
Greetings from Finland :-)
As a mother of former diabetic baby (now 11 years old young lady), RN and
breastfeeding counsellor I would say that there is absolutely no reason to
breastfeed an infant with diabetes otherwise than the normal way!!!! It can
be done, I have done it and I believe that the others have done it with the
help of their diabtes team. For a child of this age it is normal to eat
varies amounts of food at varies times a day even if she/he is not
breastfeeding, and we should try to adjust diabetes care with that. Some
1-year olds drink a bottle of milk durind the night and many breastfed
children nurse during night even occacionally between 1-2 years and older.
My very strong personal opinion is that normal life should continue as much
as possible with diabetes and luckily we have the technology for that at
hand: insulinpumps and insulinpumps with glucosensor. Breastfeeding can
continue normally with insulin shot therapy also, it could take a longer
time to adjust and figure things out, but I would think that in Sweden the
pumps would be used also in this agegroup. (With very active 1 year old a
pump can be difficult to keep attached to the toddler though. My daughter
had diabetes since birth. Since we had seen the real benefit of the pump
with a baby and changing insulin needs, it kept us keeping it with her at
that age, but it was sometimes hard.) Of course it depend also how much the
child is nursing and whether the mother was going to continue breastfeeding.
From my personal experience, breastfeeding a baby and young child with
diabetes was very good thing. Breastfeeding helped her to keep blood sugars
in better control with frequent small feedings and it comforted both the
child and mother. If the mother wants to figure out some regular
breastfeeding and eating schedule, it is her descsion, but it can be done
also with a little bit less regular style also.
What is need to be done is to figure out gradually what amount of insulin
keeps the blood sugar in better control during nights. Blood sugar normally
rises in the late night / early morning in diabetics even if they do not eat
during the night, it is fysiological - although it does not happen in
healthy body because of normally functioning pancreas (cells that produce
insulin and adjust the blood sugar balance). With insulinpump we give higher
amounts of insulin during that time, with shots it is more difficult to
figure out, but can be done somehow. If the child is having an insulinpump,
then they can figure out some system of giving meal-time insulindoses for
nursing sessions. I did give a small amount of insulin with breastfeeding
and counted carbohydrates from solid foods.
Blood sugars vary a lot with young children, it is common to have episodes
of low blood sugars during nights when parents should be sleeping, too.
Night nursing was VERY helpful way of handling that, I kept nursing my
daughter (or she kept doing it) at nights until 2,5 years, it was more easy
to simply check the sugar and took her to the breast if it were getting too
low than to wake up and get her something to eat from the kitchen and then
woke her up to eat it.
I hope the diabetes team can handle this situtation and I would be willing
to email with the mother if needed (I am working, so I can not always answer
right away, but I will answer as soon I can). I think our endocrinologist
Prof. Timo Otonkoski can also tell to diabetes team if needed that a mother
does not need to stop breastfeeding if the child has diabetes, at least he
knows that breastfeeding can continue with diabetes many years.
Best wishes,
Pia Ruohotie, RN and breastfeeding counsellor
from Helsinki, Finland
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