Hello, I am second semester junior nursing student. I have some questions about Type 1 Diabetic mothers who are breastfeeding. 
        As a student, I have heard very little about this topic and I found in a journal article that very little information exists to provide guidance for these mothers who wish to breast feed (Dobson & Murtaugh, 2001).  A problem they may face is delayed lactogenesis.  This was found through a study by Murtaugh, Ferris, Capacchione, and Reece in 1998.  But this was in contrast to a study by Chapman & Perez-Escamilla in 1999 which showed that women with a minor medical condition (i.e. Type 1 Diabetes) were not different from those with no medical condition when it came to breast feeding incidence and the time of onset of lactation.  I was wondering if anyone has had experience working with mothers who have Type 1 Diabetes and what there experience has been with breast feeding.
        I was also wondering if and how insulin levels change while lactating compared to when not.  Do these mother’s need to follow a special diet?  
        I look forward to any information that can be given and thanks for the responses. Thank you, Julie Evenson, Student Nurse, University of North Dakota.



Chapman, D.J. & Perez-Escamilla.  (1999).  Identification of risk factors for delayed 
        onset of lactation.  Journal of the American Dietetic Association, 99(4), 450.
Dobson, B. & Murtaugh, M.A.  (2001.)  Position of the American Dietetic Association: 
         breaking the barriers to breastfeeding.  Journal of the American Dietetic 
         Association, 101(19), 1213.

Murtaugh, M.A., Ferris, A.M., Capacchione, C.M., & Reece, E.A.  (1998).  Energy
          intake and glycemia in lactating women with type 1 diabetes.  Journal of the 
          American Dietetic Association, 98(6), 642.


        
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