Okay, for my regular readers who are not in the child-bearing stage in their lives, I apologize, as I am sure you are looking for my next informative blog regarding food and nutrition tips for blood sugar management. Well, I promise I will get back to those types of blogs, but right now, as far as nutrition goes, I am lucky if I remember to eat these days let alone make sure I am getting all the nutrients I need. This is because my body is not my own! I wanted to write a quick blog on the trials and tribulations of being a breastfeeding mom with diabetes. I feel that the real raw details are never talked about when it comes to the challenges that can potentially be expected when diving chest first into exclusively breastfeeding your baby…oh, and trying to remember to take care of your chronic disease.
I had done so much reading and research to prepare for this baby that I could have made it a full-time job. What I learned through my search were the following key points regarding breastfeeding:
- Skin to skin as soon as possible after birth will help the baby to take to breastfeeding sooner and more naturally. *I was very lucky in that after voicing my want for skin-to-skin to every nurse and doctor that came in my room right before my c-section, that they allowed my baby to lay right on my chest while they stitched me up. This was huge! She stayed there the entire time and then when they wheeled me to recovery they put her right back on my chest to start nursing right away.
- Rooming-in (keeping the baby in the room with you and not in the nursery) improves breastfeeding outcomes. *This should be common sense! If your baby isn’t in the room with you, how can you pick up on hunger cues? How can you learn what their needs are which are so vital in the first hours and days? If you want to exclusively breastfeed, you’re going to need to wake up all the time anyways to nurse, so what would it matter if the baby is in the nursery or in your room… she may as well be right there next to you. We didn’t let our little bundle out of our site except for when they had to take her to the nursery to do newborn testing on her.
- No pacifiers? This is controversial. Some doctors and lactation consultants say that use of a pacifier will potentially deter the baby’s ability to properly latch when initiating breastfeeding, and might confuse them. Other professionals say that it doesn’t make any difference. What I can say is that there are many hospitals in the nation trying to achieve something called ‘Baby Friendly’ status, which is an exclusive breastfeeding badge of honor where they can attest to well over 90% of their new mom’s exclusively breastfeed. Part of the Baby Friendly accreditation includes not using pacifiers at all in those first few days. *We weren’t really trying to keep a pacifier from our baby girl after the first couple of weeks, but when we did finally try to give her one (when the fussiness started to make me think I was losing my mind), she wouldn’t take it anyways.
- Lactation support. *This is KEY! I took a breastfeeding class months before I gave birth, I read 2 books, I watched YouTube video’s on achieving the perfect latch and I hired a lactation consultant to come to our house (I even had her come right before the baby was born so that she could fill my husband in on everything so that he was on the same page as me). One of the main reasons that new mom’s give up on breastfeeding is due to pain and an improper latch. By utilizing the lactation consultants in the hospital, you can do your best to make sure you don’t leave that hospital without at least understanding what a proper latch should look like. We are still working on our latch everyday, and it’s been 6 weeks! It is a learned skill for both mom and baby. My lactation consultant also was key at troubleshooting a range of issues I was having, including discovering that some intense pain I was experiencing was due to a yeast infection on my breasts (this is as common as mastitis, another painful condition from breastfeeding). Once I was treated for that, the pain disappeared almost immediately.
I know that this may seem a bit obsessive, to have done this much work and preparation for something that is supposed to come naturally for both mom and baby. Not everyone has to do this much up front work!! I am just someone who likes to know what to expect, good and bad, so that I can be prepared and do my best to succeed no matter what challenges may present themselves. I can honestly say that without doing everything I did, I would have absolutely given up on breastfeeding in that first week. There would have been nothing wrong with that! But this was a personal goal of mine. Knowing that there is some small research that shows that exclusively breastfeeding for at least 2-3 months can reduce the risk of my baby getting Type 1 diabetes… I probably would have walked on hot coals while breastfeeding knowing this.
Also, I think it is important to note the following: Many people talk about the ‘baby blues’ and the shifts in hormones that can make any new mom overly emotional in the first few days and weeks following delivery. Sleep deprivation and extreme breastfeeding pain, coupled with erratic blood sugars and malnutrition (choosing between a nap and a meal…the nap often wins) can mean exagerate the baby blues and may or may not lead to post partum depression (you are allowed to just feel plain overwhelmed without it being more then that!). I had to take a step back a week or so ago and say, “Is all of this too much? Is it stopping me from enjoying my baby and all of these precious moments that will go by in an instant?” I made the decision that if the pain didn’t subside that I would start pumping and giving more bottles and even supplement formula if need be. Luckily, this revelation came right when the pain finally started to go away and when I was starting to get a little more rest. But just keep in mind, losing your sanity won’t do you or your baby any good, so no need to be a hero.
Managing my blood sugars while nursing has been no easy task, but I try to take it one day at a time. When baby is going through a growth spurt, the constant nursing acts as a natural bolus and I seem to not need that much insulin. However, when I do go high, the highs spike quickly and are difficult to get down. I have heard that if you nurse with a high blood sugar, the baby will taste ‘sweet milk’ and become accustomed to it or hate it. I haven’t found either to be the case, as I don’t think she notices when my blood sugars are high, but I would be lying if I didn’t say I felt guilty knowing she was drinking milk when I am 300. It just doesn’t seem okay. I do the best I can at remembering to count carbs, when I can remember to eat. My fears about having severe lows while sleeping are stronger than ever, as now when my head hits the pillow, I am in the deepest sleep of my life until that squeaking little noise in the bassinet next to me wakes me up for the next feeding session. I try to always make sure I check right before I crash on the pillow and I’ll eat a few glucose tabs if I’m below 110 just to be safe. I try to wear my sensor as often as I can.
Here is a list of some of the benefits of breastfeeding and below it are a list of all the things to consider when you have diabetes and you are breastfeeding:
- Promotes bonding between baby and mother
- Helps mom recover better after birth (uterine contraction, decreases bleeding, etc)
- Eliminates need to prepare, mix and wash feeding equipment
- Saves money spent on formula
- Breastmilk is high in natural antibodies, probiotics and vital nutrients that no formula can exactly mimic that are essential for baby’s growth and developement
- Decreases risk of breast cancer and ovarian cancer for mom
- Aids in maternal weight loss (burns an extra 300-500 calories a day!)
- Provides immune protection for baby (breastfed babies may not get sick as often)
- Prevents or decreases risk of allergies and autoimmune diseases such as type 1 diabetes, asthma and some digestive disorders.
- Many cognitive and emotional/psychological benefits
*Note: pumping breastmilk is very beneficial and better than no breastmilk at all. However, mom’s who do not feed right from the breast and choose to only pump (from the beginning on) run the risk that their milk production will go down a lot sooner. Having the baby feed right from the breast is a different sort of sucking then any pump can truly mimic so there may be a chance that the breasts will not continue to produce enough milk to keep up with growth for a long stretch of time. Also, pumped breastmilk that is refrigerated or frozen, while still amazing as far as nutritional properties, does break down a bit nutritionally and isn’t as potent as milk directly from the breast. Most lactation consultants will recommend not introducing a bottle until week 4-5. This will help so that the baby can get comfortable with use of a bottle without getting confused. Also, if you are going to just exclusively pump, and put ALL that work into pumping, storing, washing, etc., why wouldn’t you just feed right from the breast if you are able to?
Oh, just on a side note, so that people don’t think I am a breastfeeding crazy person… I strongly support the use of formula. There are many different kinds of formula out there, and for the most part any will do. However, if you are looking to reduce the risk of allergy and autoimmune diseases, you should choose a formula that has broken down proteins. Ask your doctor for more info. While breastfed babies have softer stools and don’t spit up as much as formula fed babies, formula is perfectly great when mom is unable to or chooses not to breastfeed. I strongly believe in the research that supports formula with broken down proteins. Why would you want to feed your baby a formula that has whole protein (exposing the baby’s tiny tummy to these giant particles?) Not enough mom’s ask their pediatricians about the specifics of formula options, so I highly recommend you research this as much as you would research a daycare; after all, it’s what you feed your baby all day!
The reality of breastfeeding with diabetes: (the picture above says it all!)
- I can’t find a comfortable spot for my pump when I’m nursing. My nursing pillow makes my pump dig into the side of my hip.
- I have to carry a number of things with me in my diaper bag and have on all floors of my house: meter and test strips, insulin in case my pump runs out in the middle of the night because I forgot to change it during the day, glucose tabs, nipple creams, gas drops for baby, my breast pump and parts, extra strength tylenol for any pain, extra test strips…the list goes on!
- It’s difficult to remember when the last time I changed my pump site was because all my days and nights blend together. I have to write this down to keep track.
- I have gotten blood from my finger on my baby’s onesie, which makes me feel bad.
- I actually just remembered while I am typing this that I need to order more test strips from my online pharmacy as I am running low…crap.
- You not only feel completely helpless when you are low in the middle of the night, but when you are nursing your baby and you can see the juice box on the table in front of you but you can’t reach it… it’s when you wish telepathy was real and it could wake up my snoring husband in the other room.
- You are more susceptible to infection; yeast infection on your breasts, mastitis (which includes fever and flu-like illness), especially when your blood sugars are running higher. Luckily, the act of nursing alone helps to protect your body, but some things are unavoidable.
- You are doubly as exhausted as anyone else who is in your shoes. Battling the ups and downs of blood sugars along with any pain and sleep deprivation, it’s harder than anyone ever tells you it is. But it is SO worth it to just suck it up for a short time!
- Carpel tunnel syndrome: some people with diabetes are more susceptible to this, and so imagine constantly manipulating your wrists to get your baby’s squirmy little head to latch on, and then holding it there. We have these rolled up fabric pieces all of the house to use to put under my wrists to ease the pressure when nursing; although when I can’t find one or it’s out of reach when I sit down to nurse, it’s extremely frustrating. Also, my little one is fussy at the end of the day for hours on end, and so my left arm/shoulder/wrist feels like it’s on fire most of the time from holding her for long periods.
- Taking the time to pump; and I’m not talking about insulin pumping. Now that I am at the stage where I am beginning to pump my breastmilk to start storing it away, I have very limited time. I have to make a choice, for the 1.5 hours my little one naps at a time, I can either: eat, shower, pump my breastmilk, and try to change my pump site somewhere in there, or maybe do some much needed house cleaning.
- Support: Spousal and family support is KEY! If people don’t get that you are completely overwhelmed and exhausted, and if they expect too much from you emotionally or physically then they are not being helpful or understanding and you should not have them around. Some may assume you are overwhelmed by blood sugar shifts or hormone changes, but don’t let anyone’s assumptions mask what is really going on, you are a NEW MOM and you just need TIME (it also doesn’t mean you have post partum depression, as you are allowed to cry for no reason at all)! Surround yourself with those that can be sensitive to your needs right now and don’t need anything from you in return, those who will be understanding but not pushy. My husband has been key in my success as a new mom and especially my success with breastfeeding. He is always neutral and helpful and mostly just lets me vent.
This was a lot of information for a blog post, and I am happy to elaborate on any of this if anyone wants more details. I don’t want this information to scare people away from all the benefits of breastfeeding, or on the contrary make people feel that breastfeeding is the only way. Every baby is different and every mom, or diabetic mom, is also different. Do what makes sense for you and your baby.