Breastfeeding with Type 1 Diabetes

by anonymous mother
Pakistan

I am a diabetic mother living in Pakistan. I have three sons aged between nine months and nine years. I have breastfed all of them, and the youngest is still nursing.

I was diagnosed with type 1 diabetes at the age of 12. It came as a shock to me and my family because no one we knew had been diagnosed with this kind of autoimmune disease; it definitely didn’t run in our family. I spent my childhood in England and was taught very well how to manage my diabetes there.
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After moving to Pakistan, I once fell into a coma due to high sugars, but that was due to the glucometer showing incorrect results. Since that experience, I occasionally get my glucometer checked at the laboratory. I am currently injecting insulin four times a day, three times before meals and one long-acting.

It is very tough in Pakistan to find a husband if you have a life-long disease. But how God brings people together is amazing. My in- laws-to-be actually consulted with doctors before making the final decision about my suitability.

I have always adored children, and one of my fears was not being able to have any of my own. Diabetes can sometimes cause fertility problems, but I had heard of some diabetic women having three children which gave me hope. I was fortunate enough to fall pregnant only three months after getting married!

I had to manage my diabetes very carefully during my pregnancy. My endocrinologist told me to make sure my blood sugar always remains between 4 and 7 mmol/L, which was challenging and became a source of anxiety. My gynaecologist made sure that I had an ultrasound monthly to check everything was okay with the growing baby.

I was told from the beginning that the baby needed to be delivered via C-section. I’ve since heard different information, such as is stated in this website, but at the time I had complete trust in my doctor, who had handled numerous cases of type 1 diabetic mothers.

Finally, the day of the planned C-section arrived. My baby was cute and chubby, and I was relieved to hear that he was perfectly healthy and did not have diabetes.

My doctor told me that exclusively breastfeeding my baby was important for the benefit of my child and myself, and that formula milk would increase the risk of my baby developing diabetes. This advice helped me to persevere during the first few days when my baby had some difficulty nursing. Apart from some supplementation in the first week, he exclusively breastfed for six months. My doctor said to feed on demand and that I would have to wake up in the night until he was about two years old. A lot of people gave me contrary advice, but I ignored them because I completely trusted my doctor.

My eldest child weaned during my second pregnancy, at about 14 months old. The second pregnancy went smoothly, but I went into labour at 36 weeks and ended up having an emergency C-section. My baby’s blood sugar level was low and he was kept in the intensive care unit for the first day to check that his lungs were fine. In spite of this separation, nursing this baby was very smooth and I breastfed him for 18 months.
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I wanted to have a third child, but my doctor had very clearly told me to have no more than two children. I don’t know why she gave that advice, which I have not been able to find corroborated by any information online – perhaps it was outdated, because modern technology allows us to control diabetes much more effectively than in the past – but she was firm about it. She sternly warned, “Patients who don’t listen to me sometimes go blind or have kidney failure.” As my doctor’s advice had served me very well up to that point, I decided to follow it again and we resolved to be content with our two little munchkins. But as the years went by, I felt a strong urge to have another baby. When the boys started school, I felt lonely and started a job teaching at a school. Other teachers were often becoming pregnant, which made me feel even more broody! It took me several months to convince my husband.

While researching, I found medical advice that multiple pregnancies are fine so long as blood sugar levels are well controlled. Eventually, my husband agreed and we got pregnant after a seven-year gap. We had a baby boy.

Breastfeeding this time has again been going well, although often it seems he wants to breastfeed all the time!

When my baby was two and half months old, I resumed my teaching job. It has daycare on site so I can go there to breastfeed whenever my baby needs it. In the early months, that meant around every two hours. Now that he is nine months old and eating a range of foods, he doesn’t need breastfeeding so often.

Breastfeeding has been a wonderful experience. It has helped to keep my blood sugar levels down because the process of manufacturing milk in my lactating body uses glucose, so I need to inject less insulin and it is easier to keep my blood sugar levels stable. But most importantly, breastfeeding reduces the risk of the baby developing diabetes.

Editor’s note: For further reading about breastfeeding with type 1 diabetes, check out this article from LLL in the UK:
https://www.laleche.org.uk/diabetes-and-breastfeeding/

Close to the Heart Vol. 20, No. 1 (Early-Year 2019)
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