Sharon writes:

<My brother was a Type 1 diabetic (he died in 1975 of kidney failure)
so I have a 'basic' understanding of that disease process, and a bit
about hypoglycemia as well, but apparently I still do not have a very=20
good understanding of glucose metabolism.  I did wonder how this
baby was doing OK without insulin.  and...I thought diabetes was=20
'never' found in infants. =20
 
Do you (or any other LC's out there) have any resources for me to=20
seek further information on this topic?  Jean I do appreciate your
patience with this lay-person.>

Losing your brother must have been very painful, to this very day.
Thankfully, researchers are learning more all the time about glucose
metabolism, and I suspect there is a lot more to learn. It is a very
complicated subject.

I doubt that this baby's problem falls in any way under the category of
"diabetes" at all. Blood sugar control problems are not all tied directly
to diabetes. I think you may be confusing what amounts to "apples and
oranges". It may just be better for most of us to accept what the NICU
says and does about infant blood sugars, and keep concentrating on
improving the breastmilk supply and latching and all the LLL and LC
things we know how to do that many, many of the NICU nurses don't.
Realize that keeping up the milk supply so it's there further on down the
pike, encouraging skin to skin contact, and helping the baby to ingest
the milk when he has the NICU "permission" to do so, is where you fit so
much better into the picture. Some NICU personnel may highly respect your
specialized knowledge and want to learn more of what you know, as well as
be willing to answer questions so you can help explain things to
individual parents.

Learning something about gestational diabetes and PCOS may at least help
you appreciate the support such mothers need all the way through the
perinatal period. And learning more about adult diabetes as it pertains
to the care of the diabetic nursing mother would benefit all of us. But
however much that learning about infant blood sugars from perinatal
medicine and nursing literature might interest you, it probably won't
change your clinical LC practice one bit. If there is anything new on the
horizon about glucose metabolism that will change your practice, such as
supply issues, etc. it will be monumental enough that you are likely to
learn about it in JHL, at ILCA conferences, other continuing ed programs,
from new breastfeeding texts and on Lactnet. So my advice is to keep up
your lactation continuing ed opportunities, limit and craft your comments
to be supportive to the parents, and don't fret so much about the blood
sugar jargon.

Jean
**********************
K. Jean Cotterman RNC, IBCLC
Dayton, OH USA






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