My greatest fear as a mother

Diabetes and Pregnancy Trying to Get Pregnant
1

I’ve been a mother for a week, but yesterday was the first time I realized that my greatest fear as a mother is not being able to care for my son (or allowing him to get hurt) when I have a low blood sugar.

I have made a policy for myself never to carry him when I am feeling low or know that I am low. I will rather let him cry in a safe place until I can treat the low and know that I am better. I am very clumsy by nature and my lows make that even worse.

Yesterday, I was very low and tried to assemble my breast pump. I dropped it and broke it (ugh!). I was very frustrated by the broken breast pump and the expense of replacing it, but then I got very emotional at the thought that at least it was ONLY the breast pump and nothing hurt my son.

Due to breastfeeding, lows seem inevitable. But I would like some advice from other mothers about how you managed your lows (or tried to avoid them) while caring for an infant and how to deal with the fear as well.

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Kristin,
First of all, I just wanted to say congratulations! I hope you are recovering well from your c-section.

I’m not there yet, but I can imagine it must be scary to deal with lows and a baby at the same time. I think Tziporah started a discussion about this topic some time ago–maybe it would help to read what people said there. And try not to be too hard on yourself. It must be a really overwhelming time. Best of luck!

3

Kristin- This is my greatest fear too. I told husband about this exact thing a few weeks ago. I talked to him about training our beagle to be a watch dog for lows. Thought about hooking up the CGM again too (even though it drove me INSANE when I wore it last year) I’m not a momma yet, but I have similar fears.

4

We agreed that I will call him every time I am low – just so he knows and asks me if I already treated it (I always like to try to do “one more thing” before treating a low). Sometimes it happens that I measure and I know that I’m low and decide to finish the dishes etc. We want to make sure that doesn’t happen.

I’m not using a CGMS, but I am going to continue to check my blood sugar almost as often as I did during pregnancy. Especially in the beginning since I think that my basals need to be adjusted still.

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Kristin,
My pregnancy was quite a challenge, but no one could have prepared me for the anxiety and lows that followed the few months after my son’s birth. But… we made it through it. I think the two main contributors of the lows was my crazy, yet predicted, sleep schedule and breastfeeding. To be honest, I had the pump and the whole nine yards but after two stressful months of not being able to conquer those dangerous lows, I had to come to grips with what was in front of me… At least my son got 2 months worth of breastmilk and while formula feeding, I could actually hold my son and enjoy the whole feeding process. I became worried that the anxiety that I was experiencing during breastfeeding was causing a very negative bonding effect between myself and my new baby boy. Although all the books say breastfeeding is best, well, you also have to look at the big picture. You’ll have to make that call. Assuming that your baby will be on a 2 or 3 hour feeding schedule, maybe you could eat a snack made of a fast acting and slow acting carb. For example, OJ would pick you up before feeding and some whole grain crackers/bread could hold you there through the feeding and afterward. You’re right that it’s ok to lay the (crying)baby in his crib while testing your sugars and/or recovering from a low. I’ll be praying for you. You can do this, I promise!

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Congrats on the new baby! Relax and take a deep breath I’m sure you are doing a magnificent job! Have you considered getting a CGM?

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The state insurance in Hungary doesn’t support it and we can’t really afford to pay out of pocket. Given that I do feel my lows, I think it still isn’t necessary. I just need to remember to check when caring for our little guy and his needs seem so much more important!

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Thanks for the support and prayers Lindsay! I will take your advice about the snacks. I’m also going to reduce my basals now that I am home alone with the baby.

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Hi Kristin - Congratulations on your baby, and for your replies over the past few months! I also had my boy, about 3 weeks ago and eventually wound up with a Csection also.

But anyways, my doc told me that immediately after giving birth mI should reduce my long-acting insulin dosage back to what it was pre-pregnancy (which is WAY less - 24 lantus daily, instead of 44 daily like I was taking at the end of my pregnancy). I was surprised that such an immediate huge decrease was really needed so quickly/immediately, but this is what I did and I was surprised that it worked out nearly perfectly (I have a dexcom so I was able to see that my blood sugars were basically flatlined when not eating, etc).

I had also heard that breastfeeding makes bloodsugar dip, but I actually do not. I don’t know if it’s because I tense up a little still when I hold him, but my bloodsugar always skyrockets (a good 50 pts up) when I breastfeed him, and then after I am done, it comes back down slowly (it consistently does this/ it’s clear to see with the dexcom). While I am actually breastfeeding him, I do not go low. I don’t know if I’m the exception, or maybe some people don’t decrease their long term insulin (or basal) enough after birth and think that the going-low is due to breastfeeding instead? Are you back down to your pre-prego dosages?

Even though I am back to my prego dosages, it’s still is definitely scary having to worry about going low with the baby, and especially potentially while holding him, or while no one else is around, etc. Other than using the dexcom to beep at me when I’m low, and not trying to remember not to hold him unless I’m positive that I’m not crashing, those are the only ideas I’ve come up with so far!

I was also wondering (unrelated to your question though!) - how large did your baby wind up being when he was born? (i remember you were concerned about that). My 37 week ultrasound said my baby was ~7.5lb but he would up being 8lb15oz! (born a week and a half later). He also needed a glucose drip even lthough my A1c was 5.5-5.7 throughout pregnancy and controlled really well throughout labor and cSection! Did your boy wind up needing this also? I’m wondering how common a glucose drip is even when control is really good (hopefully all my effort of being in good control weren’t all for nothing being he was still so large and needed the drip anyways, but I guess better safe than sorry!

Congratulations again, and good luck with the lows!

I also thought of another question - when your bloodsugars are really high, do you actually pump and throw out your milk and formula feed (to prevent him from eating the ‘sugary’ milk?). I have not been doing this, plus I wonder if when my bsugars are high if the milk ready-to-go now is bad of if it’s really the next serving that gets ‘sugary’ and should be dumped?

Thanks! Congrats again! (sorry this is so long-winded!)

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I also returned to my pre-pregnancy insulin levels immediately after the birth (which is about half of my pregnancy doses), but even that is TOO much. I think that my lows are mostly related to breastfeeding, but it could be from too high basals. It’s hard to tell since I am breastfeeding every two hours or so.

Our son ended up weighing 4230 g (9 lb 5 oz). So he really was a big boy! They did not officially predict the weight at the ultrasound (because the technician said that it is too inaccurate), but they were guessing less than 9 lb I think!

Our son did not require any intervention for low blood sugar, but that might be because they let me nurse him BEFORE they measured his blood sugar. He only got a tiny bit of colostrum while I was lying on my back in the recovery room, but it still may have made a difference. His blood sugar was 2.3 mmol/L (41 mg/dl) and the cut off for treating the low at the hospital where I was is 2.0 mmol/L (36 mg/dl). I know that the cut off varies according to the hospital. The doctors seemed surprised that his blood sugar didn’t drop further. So I guess that most babies do. I was actually low when I came out of the c-section. So I guess that my blood sugar was normal to low when the cord was cut.

I have not yet had a really high high (despite eating large quantities of ice cream!!). So I have not decided what to do with the milk. I think that I will likely just feed him and not throw away the milk. I heard from others that it didn’t cause any problem.

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I needed maybe 80-85% of my pre-preg insulin in those early weeks, and I snacked or had juice at nearly every breastfeeding session. I kept glucose tabs in every room, in my little basket with my testing/nursing supplies, near the bedside, everywhere. If I needed to put her down, I had the pack’n’play or the bouncy seat.

The fear is normal, but I would remind myself that her needs were simple and that she would not suffer while I took care of myself. All you can do is monitor your blood sugars and make sure the baby is as safe as possible. If you’re doing that, you’re going to be fine, Kristin. :slight_smile:

I worry about what would happen if I were to pass out. Then I remember that I’ve never passed out from a low and that I’m just as vigilant, if not more so, than before I was a mother. Yes, it could happen, but I just have to take the same precautions I always have to make sure it doesn’t.

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I’ve fed my daughter when my blood sugar was in the 40s and when it was in the 400s. I have never noticed her notice a difference and she’s perfectly healthy at 17mos. I know that there is one doctor out there who recommends pump and dump over 150, but every doctor and both lactation consultants I’ve worked with say there is no danger to the baby from drinking milk at various blood sugar levels. The composition of the milk is already sweet and fatty. Unless I haven’t felt well enough to complete the task of breastfeeding, I’ve fed her regardless.

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Thanks for your replies and encouragement! Today another question came up:

I gave a bolus and then our son started crying and was obviously hungry, but I was only half way done with my dinner. I wanted to feed him immediately and did (but ate a cereal bar while feeding him). As I become more experienced at breastfeeding, I think that I could feed him at the table while eating, but for now, breast feeding still requires both of my hands!!

Does anyone wait to bolus until after you eat??? I am thinking of doing that for a while when I am alone with our son.

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Usually, I’d strap on my “My Brest Friend” and just feed her right at the table, drizzling her with couscous or whatever it was that wouldn’t stay on my fork. :wink:

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As you know, I am still pregnant, but I can relate to what you’re talking about–when I’m at work (as a nurse), I usually wait to bolus until after I’ve eaten (or at least till I’m about halfway through) because I never know when I’m going to get called away from lunch to attend to a patient. It seems like not a bad idea for you when you’re alone, especially if your bg is low or low-ish before you start eating. If nothing else, it may help your peace of mind.

Thanks for continuing to ask questions post-baby. It helps those of us who aren’t there yet to think about what’s coming!

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Could you also try a dual wave bolus? that might help…

FWIW, my lows from breastfeeding didn’t last over a month. I’m still nursing at almost 9 months and don’t notice the lows at ALL. I kinda miss them. :slight_smile: I remember thinking, oh, maybe around 2 or 3 months that that grace I used to have with pregnant lows and carbs that seemed to disappear into thin air (ie. I could eat whatever I wanted and my sugars didn’t do much) had gone away.

I would probably bolus after the meal if you’re still running really low, AND if you don’t want to follow Melissa’s advice of just feeding while you’re eating. I also kept fast sugars by my nursing table (juice, fruit cups, applesauce, things that “slide” easily). :slight_smile: Those helped a lot.

It will get easier, I promise!

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Thanks Tziporah!!



I may start using the dual wave bolus if I’m not low before eating. I hadn’t thought of that!



I think that I already am going through the transition that you described. In the first weeks, I needed 20-40g to cover a breastfeeding. Now I can breastfeed without eating anything and without going low and only eat if I am borderline low. I know that I was worried about the lows, but I also admit that I liked being able to eat half a box of ice cream and pizza without going high!! It appears that those days are over. Perhaps it was just designed to be a nice holiday after a tightly controlled pregnancy. Now back to the reality that I still have to limit carb intake :slight_smile:



I look forward to feeling like a breastfeeding pro who can eat and feed at the same time, but I’m not there yet!!

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Hi - I haven’t gotten breastfeeding-while-eating down yet either! I don’t have a pump so I can’t use the wave suggestion, so I just try to make sure that I always have a spare (pumped) bottle of milk ready so I can just grab it from the fridge, stick it in the bottle warmer, and feed it to him while I continue to eat.

19

It was recommended for me to snack before BFing. If I still got low, I should set the temp basal to 50% or even suspend the pump. I had a hard time with lows with my last pregnancy, and I hated having to stuff my face so much. It is definitely a challenge since BF mothers burn off so many calories in just that act alone.

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Somethings I’ve done to deal with lows while being home alone with my little one:
-Stash glucose tabs everywhere. Couch cushions, nightstand, changing table etc.
-Depending on where I am when I feel low, I put her in the safest place possible in that room. So if it’s her room, then she goes in her crib. If its the kitchen I put her on the floor and hand her a toy.
-I’ve programed 911 into one of the speed dial spots on my cell phone.
-If I feel low at all, I treat 1st and test later. Meaning I eat a tab or two and then go find my meter. If it says I’m ok, then I recheck in 20 minutes and do a small correction of insulin if necessary to cover the tabs I ate proactively.
-I always wear my medic alert bracelet when out in public and I’ve also programmed my husband’s cell # into my phone as an ICE contact (In Case of Emergency)

If its one of those lows that doesn’t seem to want to come up, I call my mom and talk to her until I’m in range.