Diabetes and Breastfeeding: The Reality!

April 2, 2013By 13 Comments

 

photo22Okay, 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.

 

 

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Comments (13)

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  1. kassie says:

    For those less inclined to plan so well, here’s a little success (?) story… I had no skin-to-skin when either of my boys were born (1 in NICU for 2 weeks, one in Special Care Nursery for 24 hours). Didn’t sleep in the same room as my first for a month and my second for 3 nights. First one was bottle fed as we learned to nurse (haberman feeder, a great bottle for this situation). Lactation support was limited to a hospital provided pump and quick visit from a nurse. Both nursed exclusively for 3 months and primarily for 2 years. My point? Know as much as you can going in but don’t get discouraged if things don’t go as planned/hoped/expected. There is a certain amount of luck to all this, and determination is your greatest asset. And in the end, what matters is that the baby gets fed. Kudos to all moms with diabetes juggling all the extra factors!!

    • Diabetes says:

      All great points Kassie! I hope my readers know that I always try to specify, my situation is just that, my situation, and that there are many other success stories that are accomplished among other diabetic mom’s, the scenerios are endless! Glad to hear that successful breastfeeding can be achieved under any circumstances, and with luck of course!

  2. Thought I’d share my experience too… One used a pacifier; one used her thumb. The pacifier is WAY easier to get rid of! My babies slept in their own crib in their own room (I’m a BIG fan of sleep and I did NOT sleep well with a baby in the room). Breastfeeding was a challenge – I did it for six and seven months, respectively, and glad I did. But it was not easy. I kept juice nearby for breastfeeding lows; however, over time I tended to run high and not low. I think I’m the only mom who gained weight while breastfeeding. I was eating basically crackers, since the kids were gassy and I couldn’t figure out what was causing it, and yet gained weight. Go figure!! The most important thing (I think) is to not make ourselves crazy or beat ourselves up. Do what works and love your baby. 🙂

    • desperate diabetic mum says:

      Hello there,

      I stumbled upon this blog and your entries as I was trying to look into high blood sugars during breast feeding. I have been breast feeding for 2 weeks or so now and yes, I have had one or two hypos but a more recurrent theme has been persistent and very difficult to bring down hypers. I don’t want to eat any carbs while my blood sugar is still high, so I end up not eating very much on those days when I have those difficult to bring down highs.

      I totally agree that breast feeding is so much more complicated with all the strips, insulin and other bits and bobs we have to carry. I feel really tired both physically and I suppose psychologically as I didn’t expect it to be so hard. I also didn’t expect these highs. I thought I would be battling lows, so not sure if I am an exception and what is causing the highs if I am using up so many more calories to breast feed. Do you think it’s hormones causing the highs? Whatever it is, I can’t wait for it to be over as it is too much stress!

      • Diabetes says:

        Hi! Ugh, I feel your pain! I’m sorry you are going through not only all the crazy post-partum hormones that really peak at 2-3 weeks after the birth, but that your battling the exhausting high’s of this crappy disease. Good for you for breastfeeding though! Just know, it’s OKAY if you decide you need to supplement with formula for your own sanity, don’t beat yourself up about that if it comes down to it.
        As for the highs… well, I would imagine by this point your milk has already fully come in, so any impending low BG patterns would have probably already hit you by now. The exact same thing you are going through happened to me. I NEVER had any bad lows while nursing in the beginning (not until some of the major growth spurts hit, and I had to make more milk to keep up with my baby’s growth did I then see some plummeting numbers creep up out of no where). I would definitely touch base with your Endo and see if he/she is comfortable with you trying to maybe go back to your pre-pregnancy basal rates and insulin ratios. It’s SO hard to find anything to eat when you are breastfeeding and a diabetic. I remember very clearly always feeling SO hungry but like I couldn’t eat a darn thing because of how it would either effect my numbers OR potentially make my baby gassy and fussy. It stinks! If you have access to a breastfeeding class at your local hospital, I would highly recommend going and talking to other mom’s, so that you can at least find people who can relate to you on that level.
        As for the food though, don’t starve yourself for the sake of keeping your blood sugars in check. It sounds like you just need some adjustments. Your baby is sucking all the nutrients right from you, leaving you feeling completely drained, 100x more then a mom without diabetes who is breastfeeding. Fuel up on high fiber foods and lean protein… like just keep grilled chicken in your fridge to munch on when your starving and just need a quick bite. Make sure you are staying hydrated with lot’s of water…and don’t mistake that thirst for a high blood sugar and blindly take insulin without checking your blood sugar on your meter first. It’s a rooky mistake… assuming your high because you are thirsty, when indeed breastfeeding moms are usually always thirsty!
        Just try to take it one day at a time, because even when you do get the go ahead from your Endo to adjust your rates, you will still have days where you are 400 and you haven’t even eaten anything yet that day. It’s the mystery of your metabolism during breastfeeding and how much your baby needs. It effects our blood sugars more then anyone has ever researched.
        I actually just spoke on a patient panel for the T1D Exchange, about how there needs to be more research for diabetic mom’s and nursing and how it effects our control. Hopefully I got some people to listen!
        Hang in there!
        Regina

  3. desperate diabetic mum says:

    Hi Regina,

    Thank you so much for your words of encouragement and advice! I went to see my doctor after a breastfeeding counsellor with T1D suggested I might have mastitis which could be causing my highs. It turned out I have a urinary tract infection (in addition to possibly a bit of mastitis), so I’ve been given some antibiotics which I can take whilst breastfeeding. Can’t wait for them to clear the infection – hopefully, that will bring in some normality. Although as you said, sometimes, you don’t eat anything, there’s nothing wrong with you and yet you get these inexplicable highs – most likely our hormones acting up.

    Once my infection clears I’ll have to start contending with lows rather than highs. Ah, the fun and games of being a diabetic mother – I’ve already mastered the art of checking my blood sugars whilst breast feeding. I am turning into a bit of a breast feeding ninja / Shiva.

    Yes, hope your comments on the patient panel will be listened to. I received a lot of care during my pregnancy and once I gave birth and got home, much of this support has gone and it is very hard juggling being a diabetic, breast feeding and being a new mum.

    take care and thanks again for listening and replying to me!

  4. Concerned Mom says:

    I am a first time mom and recently diagnosed as diabetic. Struggling with balancibg my levels. My sugar levels are usually high, between 120 and 180 specifically later in the day. How is this affecting my baby when I breastfeed? Is she at risk of getting diabetes?

    • Diabetes says:

      This is a great question. I am not a doctor, so I can only tell you what my own doctor has told me or what I have heard through other moms with T1D who breastfed. First, there is barely any reasearch at all on breastfeeding when you have T1D. This is something I am advocating for and have shared this with a room full of researches at the recent T1D Exchange meeting. Second, there is no evidence to show breastfeeding while having T1D will cause your child to get it. In fact, I do recall seeing a statistic somewhere that breastfeeding for at least 6 months can decrease the risk if your child getting diabetes by at least 37%. I have heard that there is a chance the baby may shy away from your breast if the milk is ‘sweet’ when your blood sugar is high. I personally think that’s a bit far fetched. My daughter nursed for six months straight when my blood sugars ranged anywhere from 60-400 at times. The most important thing you can so is to try to keep up with her growth spurts as they relate to your blood sugars. Because when the baby has a growth spurt and your nurse ing more frequently, your metabolism is going strong making more milk which in turn could make more lows. I would talk to your doctor, and try to utilize the features on your pump like temp basal rate for these instances. Hang in there!

      • Allie says:

        My daughter is almost 4 weeks old now. She has been randomly projectile vomiting ; there is no clear pattern or cause of this and it’s very frustrating when she does it a couple times a day then goes for days without. I’m wondering if it has anything to do with my blood sugar being high and it affecting my milk, or all the juice I chug when my blood sugar is low. Has anyone had this issue or anything similar?

        • Regina says:

          First and foremost I would follow up with her pediatrician. Spit-up could be due to many different reasons and some lactation consultants argue that it is or isn’t due to something in the mothers diet if the mother is breastfeeding. I highly doubt it is due to your blood sugars. Check with a lactation consultant at a breastfeeding group and also consult the pediatrician. If you are supplementing with formula at all, that could be a simple fix of just switching formula. Best of luck and try to take care of yourself!

  5. Christine says:

    I would like to know how you got your sugars under control while BF . I feel like for the last, I don’t even know, however many months I can’t control my numbers. My son is almost 6 months now and I’m still battling ups and downs, I know for sure they were good for like the first month. I’m not a bad eater, I go to the gym (not everyday like I did before he was born), don’t really eat processed foods, don’t go to fast foof places (except Subway), I’m just lost….. Any advice would be beneficial, Thank you☺

    • Regina says:

      Hi Christine,
      I’m sorry that you are struggling so much getting your blood sugars under control while you are still nursing. I wish I had a magic answer, but unfortunately there isn’t. Know that you are not alone! It is extremely challenging to nurse, take care of a baby and your diabetes (I commend you for making time to exercise even a couple of times a week!). Nursing mom’s with T1D are an area in diabetes that is not well studied. There is very limited data available out there on how best to manage diabetes for long-term breastfeeding (more then just the first couple of weeks after the baby is born). The only advice I can give you, although you already may have figured this out since your little one is six months… is the dreaded GROWTH spurts. If you google the common times when a baby experiences growth spurts in the first year of life, I guarantee you will see a correlation between your blood sugar fluctuations and the babies growth spurts. For example, your milk production will ramp up when your baby is ravenous and constantly feeding, which can lead to more low blood sugars, then in the blink of an eye, as soon as the constant feeding stops, your milk production will decrease and thus resulting in higher blood sugars. Also, if you are starting to wean him from nursing let’s say, during the night, then your milk production will quickly slow down or stop completely which again may result in high BGs out of no where. The best advice I can give is to try to make note of these patterns so that you can do your best to anticipate them. The good news is that you have already passed all the non-stop major growth spurts in the first six months of life. There are still a few more to go though. In an ideal world, if you can take advantage of a continuous glucose monitor, this would obviously help. However, even just testing more frequently is just as important. Lastly, don’t let your BGs stress you out right now…it’s difficult, because you spent 9 whole months working your butt off to have perfect blood sugars and now your lucky if you have time to shower let alone check your blood sugars! You aren’t going to do too much damage with erratic blood sugars at this point in your post-partum period, as long as you are not having severe lows or high blood sugars with ketones. Keep your doctors and educators in the loop too! I hope that helps…

  6. Rachel says:

    So glad I found this article! It’s easy to think that no one knows how I’m feeling, when in reality, there are so any type 1 diabetics who are mothers. The blood on the onesies, the skipped meals, the forgetting of the age of sites – completely understand! Tack on hypothyroidism and it’s an exhausting mixture. Breastfeeding for four months now! Hoping to go for a year. Thanks for posting your experiences. 🙂

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