Just wondering what other’s experiences have been…after giving birth, did you/your endo cut the TDD down to very little (or nothing)? (I’ve heard some women don’t even need insulin for a few days afterwords) And for those who breastfeed, how did/do you handle that? (eat alot, reduced boluses?) TIA
My experience was a little different. I had my pump suspended throughout the birth, but started it up again soon after and needed the same pregnancy insulin rates (which was about 3x my non-pregnancy basil rates) until 2 days afterward, when my insulin needs plummeted and I went back to my pre-pregnancy rates almost immediately. I think there might have been one intermediary setting in there, but it soon was reduced again.
I was really stunned how dramatically my insulin needs changed. This was about a day before my milk came in and I think that was probably a contributing factor. I really didn’t need much insulin while nursing and if I was going to be nursing for a while, I just suspended my pump. I did not suspend every time, though.
I did lose a lot of weight post-pregnancy and I attribute that to nursing! Remember to drink a ton of water for nursing, too. If you need a sugar boost, mix a little juice into the water and drink it while nursing.
Thank you for asking this, this is one of my biggest concerns surrounding giving birth and have no idea what to expect. I was going to post the same question, hope we get a lot of wonderful answers!
I am type 1 and I have two little ones. Both times the first day I didn’t take any insulin. Giving birth is like the honeymoon phase for our bodies. Even the first week, my TDD was about half. It amazed me how breastfeeding lowered my sugars- so I did keep cutting back. In the beginning it was hard, because the constant feedings took a lot of time. But as a mom, you have to remember to eat too. It does get easier as the baby grows and feeds less often and faster. Around the 6-8 week mark, I was feeling more settled. I was always hungry when nursing, so I ate regularly. Some new moms don’t eat often enough, so then they would need to reduce the background basal insulin. Just listen to your body and keep testing your sugar levels. Drink lots of water when nursing.
My endo told me to switch to my pre-pregnancy basal rates immediately after the birth, but that I would likely need to use temporary basals of 70-80% for the first few days.
I had a lot of lows the first few days, but I think that I did need insulin. I was using about 30-50% of my pre-pregnancy basals. Breastfeeding lowered my blood sugar a lot. So I highly recommend bring juice or other easy to consume fast acting carbs with you to the hospital. I brought 1 liter of juice and it was gone in half a day.
Once I got home from the hospital, I was needing to eat 20-30g with every breastfeeding (which is a lot when you are feeding 12+ times a day). I must admit that I enjoyed it after the strict diet during pregnancy. I ate a half a container of ice cream one day (with no bolus) and never went high! After about 3 weeks, things settled down. Now I think that one breastfeeding lowers my blood sugar about 1 mmol/L (18 mg/dl). I need to eat about 10g of carbs to stay level. I am now using my pre-pregnancy basals and boluses, but the first three weeks, I indeed needed a lot less insulin.
I would be afraid to take no insulin, but be prepared to need a lot less and have fast acting carbs that you can eat with one or no hands (while breastfeeding).
My endo and Medtronic RN told me to cut down my basals by half after delivery, double the carb ratios and the sensitivity. This didn’t work for me, so I ended up making gradual changes within a week. When BFing, I suspend my pump. If I don’t, I go anywhere in the 30-50s.
My basal rates were 30-40% my pregnancy rates (which were lower than my pre-pregnancy rates) for the 1st 3-5 days. I remember having to reduce my carb ratios too. Things leveled out about 3 weeks after delivering.
Like most of the ladies who have posted, breastfeeding lowered my blood sugar about 20mg/dl each time. I ended up keeping glucose tabs or juice boxes stashed in all the areas I breastfed. (You don’t want to try to carry a newborn with you to the fridge when your blood sugar is in the 40s.)
Try to get some foods that you can eat with one hand, bananas, granola bars, cheese sticks, milk, apple slices, PB&J etc and snack on those while you breastfeed. I found it was easier to stay hydrated if I had a cup with a straw as well. Something about the straw just made my life easier.
Also, now that I’m trying to wean my daughter, I’ve noticed that I’ll have higher blood sugars during the time I’m no longer breastfeeding. (A lot higher, say 50-70 pts higher.)