FROM: Sturgess, Frances Coulter
TO:[log in to unmask]
SUBJECT: infant with diabetes
DATE: 03-19-97   01:39 EST
PRIORITY:


Another altar of ignorance primed--I am sure it is harder to calculate breast
milk into a diabetic diet plan since it does change and it is harder to
measure amounts to even make the calculations.  *However!* ABM has PLENTY of
SUGAR in it, and although I haven't seen a chart on the glycemic response of
brmilk vs ABM (i.e how fast the blood sugar goes up after eating it) I have
trouble imagining that it is any *worse* and certainly all the benefits are
worth preserviing!!!

My impression of the treatment of Juvenile OnsetDiabetes is that it is much
more flexible than the adult, because its so hard to deny children what their
peers have to eat, and their activity levels vary (which also makes their use
of blood sugar less predictable ) since they are  on insulin anyway, which can
be titrated to match their glucose load.  Perhaps an 18mo oldis too little for
continuous insulin infusion via a pump, but surely they can do blood glucose
monitoring sufficiently easily and frequently that they could compensate for
not knowing "exactly" how much he/she drank??? and give more frequent insulin
until some pattern is established?  It sounds bad, having to do more shots and
fingersticks (not something any parent wants to do to their baby!) but I would
guess they have to do them anyway with ABM and the forementioned natural
variablity of blood sugar levels in children.
    I do not at all mean to minimize the anguish and concern diabetic
management demands of parents and providers in giving the best care in this
very stressful situation, but I also feel it could work out if full and
careful consideration is given to the benefits of brfdg as well as the risks.

Do the dietitian and the doctor support breastfeeding generally?
Unfortunately, although breastfeeding is *nutritional* it does not get a lot
of coverage in general curricula.  If this is a pediatric hospital, I would
suppose the RDs are better informed than not, though.  Hope this helps.