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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