Hello Mia!


Greetings from Finland :-)

As a mother of former diabetic baby (now 11 years old young lady), RN and 
breastfeeding counsellor I would say that there is absolutely no reason to 
breastfeed an infant with diabetes otherwise than the normal way!!!! It can 
be done, I have done it and I believe that the others have done it with the 
help of their diabtes team. For a child of this age it is normal to eat 
varies amounts of food at varies times a day even if she/he is not 
breastfeeding, and we should try to adjust diabetes care with that. Some 
1-year olds drink a bottle of milk durind the night and many breastfed 
children nurse during night even occacionally between 1-2 years and older. 
My very strong personal opinion is that normal life should continue as much 
as possible with diabetes and luckily we have the technology for that at 
hand: insulinpumps and insulinpumps with glucosensor. Breastfeeding can 
continue normally with insulin shot therapy also, it could take a longer 
time to adjust and figure things out, but I would think that in Sweden the 
pumps would be used also in this agegroup. (With very active 1 year old a 
pump can be difficult to keep attached to the toddler though. My daughter 
had diabetes since birth. Since we had seen the real benefit of the pump 
with a baby and changing insulin needs, it kept us keeping it with her at 
that age, but it was sometimes hard.) Of course it depend also how much the 
child is nursing and whether the mother was going to continue breastfeeding. 
From my personal experience, breastfeeding a baby and young child with 
diabetes was very good thing. Breastfeeding helped her to keep blood sugars 
in better control with frequent small feedings and it comforted both the 
child and mother. If the mother wants to figure out some regular 
breastfeeding and eating schedule, it is her descsion, but it can be done 
also with a little bit less regular style also.

What is need to be done is to figure out gradually what amount of insulin 
keeps the blood sugar in better control during nights. Blood sugar normally 
rises in the late night / early morning in diabetics even if they do not eat 
during the night, it is fysiological - although it does not happen in 
healthy body because of normally functioning pancreas (cells that produce 
insulin and adjust the blood sugar balance). With insulinpump we give higher 
amounts of insulin during that time, with shots it is more difficult to 
figure out, but can be done somehow. If the child is having an insulinpump, 
then they can figure out some system of giving meal-time insulindoses for 
nursing sessions. I did give a small amount of insulin with breastfeeding 
and counted carbohydrates from solid foods.

Blood sugars vary a lot with young children, it is common to have episodes 
of low blood sugars during nights when parents should be sleeping, too. 
Night nursing was VERY helpful way of handling that, I kept nursing my 
daughter (or she kept doing it) at nights until 2,5 years, it was more easy 
to simply check the sugar and took her to the breast if it were getting too 
low than to wake up and get her something to eat from the kitchen and then 
woke her up to eat it.

I hope the diabetes team can handle this situtation and I would be willing 
to email with the mother if needed (I am working, so I can not always answer 
right away, but I will answer as soon I can). I think our endocrinologist 
Prof. Timo Otonkoski can also tell to diabetes team if needed that a mother 
does not need to stop breastfeeding if the child has diabetes, at least he 
knows that breastfeeding can continue with diabetes many years.

Best wishes,
Pia Ruohotie, RN and breastfeeding counsellor
from Helsinki, Finland

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