Dear all
Does anyone have experience of managing type 1 diabetes in a breastfed baby
aged under 1 year?
The family are long-term breastfeeders - as you will see from their account
below, the medical team are very supportive, but no-one here has met this
situation before. They have asked me to post as widely as I can.
If you have supported a family in this situation, we would love to hear from
you. Please contact me direct.
Many thanks,
Jayne Joyce
Oxford, UK
e: [log in to unmask]
My 11-month old daughter, X, has been diagnosed with type I
diabetes after being rushed to hospital two weeks ago with severe
diabetic ketoacidosis. She has recovered extremely well from the DKA,
however we are now faced with the prospect of finding a treatment regime
that works for a baby who has always been breastfed on cue and whose
nutrition is still primarily breastmilk, with additional solid foods
besides.
I have been told that it is rare to be diagnosed under the age of one.
The paediatric diabetes nurse specialist who is working with us has only
seen 2 or 3 babies in the 6 years she has done this job, and X is
their first breastfed baby.
We are on a steep learning-curve regarding diabetes and its treatment.
X has been started on basal bolus insulin treatment. As far as I
understand it, the amount of insulin given with meals is determined by
calculating the carbohydrate intake. The paediatric diabetes team are
open about the fact that we're all working in the dark regarding the
breastfeeding (and to their credit, no-one has yet suggested that it
should be stopped, or even limited). It feels as if we're trying to work
out her insulin needs without knowing the carbohydrate load of most of
her meals, whether it was a meal at all, how long it will be until her
next meal, etc, etc. The only guidance I've had so far is to give a
bolus insulin dose after every feed longer than 20 minutes' duration.
The suggestion that the duration of a feed tells us anything at all was
met with incredulity at the breastfeeding clinic, but we do need to find
some way to prevent the rises in blood sugar that inevitably follow.
At the moment her insulin is administered manually using a pen. It is
likely that we'll change over to a pump system within a month or two.
With this system I think we should be able to set a variable basal rate,
which may deal with the issue of night feeds, and we should have finer
control over the bolus doses as we can administer doses of 0.0* units,
whereas the smallest dose we can give at the moment is 0.5 units.
I feel like we have an excellent team of paediatric diabetes experts,
and excellent breastfeeding experts... Is there anyone who
has experience of both? Are there examples of diabetes being well
controlled in a breastfed baby? Can I access this information, and does
it exist in the first place? Any guidance would be very much appreciated.
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Messages in this topic (2)
2b. Re: type 1 diabetes in a breastfed baby under 1 year
Posted by: "Karen" [log in to unmask] kazrbutler
Mon Apr 6, 2009 9:03 am (PDT)
Hi Jayne,
Jane Inglis, LLL Portsmouth would be useful for you to contact. She has
experience of caring for a young child with diabetes and has helped me when
I've been supporting mothers of babies with diabetes.
As Jane works, best to contact her in the evening.
LLLove, Karen
LLL Coventry
_____
From: [log in to unmask]
[mailto:[log in to unmask]] On
Behalf Of Jayne Joyce
Sent: 06 April 2009 16:54
To: [log in to unmask]
Subject: [GBlc] type 1 diabetes in a breastfed baby under 1 year
Dear all
Does anyone have experience of managing type 1 diabetes in a breastfed baby
aged under 1 year?
The family are long-term breastfeeders - as you will see from their account
below, the medical team are very supportive, but no-one here has met this
situation before. They have asked me to post as widely as I can.
If you have supported a family in this situation, we would love to hear from
you! Please contact me direct.
Many thanks,
Jayne Joyce
Co-Leader, La Leche League Oxford, UK
e: [log in to unmask] <mailto:jaynejoyce%40yahoo.co.uk> co.uk
My 11-month old daughter, X, has been diagnosed with type I
diabetes after being rushed to hospital two weeks ago with severe
diabetic ketoacidosis. She has recovered extremely well from the DKA,
however we are now faced with the prospect of finding a treatment regime
that works for a baby who has always been breastfed on cue and whose
nutrition is still primarily breastmilk, with additional solid foods
besides.
I have been told that it is rare to be diagnosed under the age of one.
The paediatric diabetes nurse specialist who is working with us has only
seen 2 or 3 babies in the 6 years she has done this job, and X is
their first breastfed baby.
We are on a steep learning-curve regarding diabetes and its treatment.
X has been started on basal bolus insulin treatment. As far as I
understand it, the amount of insulin given with meals is determined by
calculating the carbohydrate intake. The paediatric diabetes team are
open about the fact that we're all working in the dark regarding the
breastfeeding (and to their credit, no-one has yet suggested that it
should be stopped, or even limited). It feels as if we're trying to work
out her insulin needs without knowing the carbohydrate load of most of
her meals, whether it was a meal at all, how long it will be until her
next meal, etc, etc. The only guidance I've had so far is to give a
bolus insulin dose after every feed longer than 20 minutes' duration.
The suggestion that the duration of a feed tells us anything at all was
met with incredulity at the breastfeeding clinic, but we do need to find
some way to prevent the rises in blood sugar that inevitably follow.
At the moment her insulin is administered manually using a pen. It is
likely that we'll change over to a pump system within a month or two.
With this system I think we should be able to set a variable basal rate,
which may deal with the issue of night feeds, and we should have finer
control over the bolus doses as we can administer doses of 0.0* units,
whereas the smallest dose we can give at the moment is 0.5 units.
I feel like we have an excellent team of paediatric diabetes experts,
and excellent breastfeeding experts... Is there anyone who
has experience of both? Are there examples of diabetes being well
controlled in a breastfed baby? Can I access this information, and does
it exist in the first place? Any guidance would be very much appreciated.
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