by Anne Eglash MD, IBCLC, FABM
Can an infant or toddler who nurses frequently continue to breastfeed when diagnosed with diabetes?
The Academy of Breastfeeding Medicine recently published its protocol entitled ‘Breastfeeding an Infant or Young Child with Insulin-Dependent Diabetes’ in Breastfeeding Medicine Journal February 2017.
In the past, many families with a young diabetic child have found themselves at odds with the endocrinologist’s recommendation to wean, based on a belief that the frequency of nursing and volumes taken during breastfeeding are too difficult to control. However, we know that breastfeeding is important for the child’s health, particularly since diabetes is a risk factor for more severe infectious diseases. This protocol specifies recommendations on how to manage insulin and blood sugars in a child who is breastfeeding. The good news is that weaning is not major strategy.
According to the Academy of Breastfeeding Medicine Protocol’ recommendations on breastfeeding the child with insulin dependent diabetes mellitus, which statements are accurate (choose 1 or more)
- Three ounces of breastmilk has approximately 7-8 grams of carbohydrates.
- The toddler who nurses frequently should not be allowed to nurse more often than every 3 hours, to allow for accurate blood sugar readings.
- Pre- and post-feed weights help to determine how much breastmilk a nursing child takes during a typical nursing.
- Diabetes management is complicated, so that best outcomes require families to put their diabetic infants on a regular breastfeeding schedule, to prevent hypoglycemia and hyperglycemia.
- Bottle feeding breastmilk is optimal because it is easier to control carbohydrate intake in the child.
See the Answer
The answer is A and C
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Milk Mob Comment by Anne Eglash MD, IBCLC, FABM
This is an important protocol because it normalizes breastfeeding in a world of pediatric specialty care. So often we, as breastfeeding supporters, find ourselves advocating for breastfeeding families in situations where the other party does not grasp the health and psychosocial values of breastfeeding. In my world, this happens in pediatric and adult subspecialty care. If breastfeeding seems complicated or presents an ‘unknown’ risk, a weaning recommendation seems highly likely. For years those of us in breastfeeding medicine have armed families with data to share with their endocrinologists about why they should be allowed to continue nursing. This protocol has several common-sense, straightforward recommendations on how to carb-count a breastfeeding or breastmilk feed. It also acknowledges that the diabetic management plan needs to be tailored to the patterns of breastfeeding and the needs of the mother-infant dyad! This is an excellent protocol for all of use to share with families who already have had their world turned upside down, so that they can keep some sense of normalcy in their lives.