Breastfeeding & basal rates
Ruby McGill learns that life with a newborn baby is not always straightforward.
Baby or not, managing your diabetes can be as unpredictable as New Zealand’s weather.
Adjusting to life with a new baby can be exhausting at the best of times – throw a type 1 breastfeeding mother into the mix and the game becomes even more gruelling.
I’d spent nine months fine tuning my blood glucose levels with the Hutt Hospital diabetes team to ensure our newest family member, Felix, arrived safe and healthy.
My insulin requirements increased during my pregnancy but as I held our little man for the first time, they dropped drastically. We were prepared and reduced my carbohydrate ratios, basal rates and insulin sensitivity factor. I thought I was one step ahead. I was wrong.
I woke in the middle of the night sweating and convinced I had squashed my baby, even though I could see him fast asleep in the crib next to me. Why was I wide awake? Why did my body feel so heavy? Why was I scared?
The penny finally dropped – my blood sugars were low (2.4 mmol/L – 43 mg/dL). Okay diabetes you won this round.
The next morning we tweaked my medication again. I couldn’t be discharged from hospital until my blood sugars were under control. Four days after our little man was born I was sent home. Now the fun begins!
With a bit of forward planning and insulin adjustments, people with T1 can navigate their way through most things unscathed, but breastfeeding introduces a set of different challenges.
Feeding a new baby, on-demand, is so unpredictable it was almost impossible to avoid a drop in blood sugar levels after each feed. Surviving on broken sleep, caring for a new baby, and being smashed by constant daily hypos was a recipe for disaster. I had to do something.
The Freestyle Libre glucose monitor from Australia was invaluable because I was testing a lot! Using the Libre I was able to test my blood sugars while carrying a crying, wriggly baby by simply swiping the reader across the sensor in my arm.
When our little man slept, which didn’t happen all that often in the early months, or in the evening when my husband was home, I’d prepare and carb count a variety of snacks to get me through each feed.
With the swipe of my sensor I knew my blood sugar levels, and with a little trial and error (like so many things diabetes related) I knew what kind of snack I needed to combat the expected drop in sugars. Sometimes I got this wrong and would reach for more food or correct with extra insulin.
During these first few months I was mentally prepared to run my blood sugars a little higher than normal to avoid going hypo.
My go-to snacks included: 150g fresh cut strawberries = 6g carbs, 1 x pot of Fresh ’n Fruity Lite yoghurt = 7-8 g carbs, 4 x crackers with cheese = 15g carbs, juice box: Small = 18g carbs, Large = 26g carbs.
Before I knew it, our little man was three months old and we had found our rhythm. I could predict when he would sleep and feed (as much as that’s possible with a baby).
Breastfeeding no longer knocked me around and the hypos settled down. My premade, carb-counted snacks remain within arm’s length, because baby or not, people living with diabetes know managing it can be as unpredictable as New Zealand’s weather.