Becky,
The beauty of being on an insulin pump is that the mother can adjust her
basal levels, her carb to insulin ratios, her correction/insulin sensitivity
ratios (working with her CDE/care provider of course) as she figures out her
post-partum lactating levels will be, carb/insulin and correction ratios can
differ depending on time of day.
A possible example, I could see that a mother who's baby gets into a reverse
cycle nursing pattern might find that her insulin sensitivity at night
becomes greater than before the baby nursed frequently at night, and she
might find that she needs to change her nighttime basal rates or
carb/insulin ratio... The good thing about the pump is that an experienced
pump user will be able to be easily responsive to a changing situation and
keep the tight control which is so important to her health as a diabetic.
My husband is a T1 with a pump, for just over 4 years. Which is where I come
by my experience about what a pump can do.
LLL has a pamphlet about diabetic mothers and breastfeeding as well. The BAB
also includes this information. "One study found that diabetic mothers
planning to breastfeed nursed longer when they followed a recommended diet
of increased calories (Ferris 1988). This extra food provides the energy
needed for milk production. The mothers who consistently ate less than
recommended stopped breastfeeding earlier than planned. Ferris concluded
that a diabetic mother needs a knowledgeable dietary counselor, as well as
other support people, for breastfeeding to go well."
Also in the BAB "During breastfeeding, a mother's insulin requirement may be
significantly less than it was before she became preganant (Butte 1987)
Davies (1989) found that after birth breastfeeding mother needed to decrease
their insulin dose by 27% of their pre-pregnancy dose to avoid hypoglycemic
reactions. However, each mother's response to the physical changes of
pregnancy, childbirth, and breastfeeding will be individual.
It makes sense that a nursing mother could have a decreased insulin
requirement, it also makes sense to me that a mother on a pump would be able
to make adjustments more responsively than even a mother on MDI (multiple
daily injections), on MDI a diabetic is typically using both long acting
insulin (one type is Lantus) for one injection daily to cover basal rates
and then rapid acting with food. On a pump she has more flexibility and
control.
Ruth
LLL Flagstaff
Subject: Type 1 DM/insulin pump & BF
>
> Does anyone have any good articles that discuss BF for women with Type 1
> DM who are on an insulin pump=3F I'm not sure exactly what else she is
> looking for, but one of our Diabetes CDEs is looking for info...
>
> Thanks. Please email to [log in to unmask]
>
> Becky S.
> Sioux Falls, SD
>
>
>
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