Preschoolers and pumping

I am looking to switch my nearly 4yr old over to a pump before she starts school. I am wondering what issues/difficulties others have dealt when pumping this young if any?

Hi Jen, My son Cody just turned 5 last week, was diagnosed Feb. 2012, and we started him on the Animas Ping insulin pump on June 21st. Since day one on the pump we knew we made the right decision!! I love having him on the pump, it has given him so much more freedom to eat when he wants and what he wants. After much research I really liked the Ping, it's waterproof, (he wears it in the pool), and it has a great remote, which I love. I just have to be within 10 feet of him to be giving him his insulin after I check his blood sugar. I also got him a great little fanny pack to hold the pump, (it's called a spibelt.) It makes it very comfortable for him to wear the pump and sleep with it on. The only negative thing I can think of is that I have to change out his infusion set every other day, which is a little time consuming, but still well worth it! Let me know if you have any further questions. Good luck!! :)

We are likely going to go with omnipod, also because it is waterproof (and tubeless). We do a lot of boating and water sports in the summer and even tho the ping is waterproof I thought we still wouldn't let her wear an expensive pump in the lake. If she lost it, it would be gone. With a pod, you are only out the pod, not the whole cost of pump. We've done a saline trial and she did well with it.

What I am wondering is who helps with the bolusing when the child is in school? There is no nurses on staff in any of our school systems here, she can't work the PDM by herself, or carb count. Both her dad and I work, so we can't be there. For kindergarden and grade one I was told that there would likely be an aide to help, but I don't know if they would administer insulin via pump or not. And what about corrections? We will move to a pump end of this month or beginning of Sept.

One thing to keep in mind with the Omnipod is that there pod failures are not an unlikely occurrence. And when a pod fails and insulin isn't getting delivered, a small child can go into DKA VERY fast. I looked into the Omnipod, but decided against it for that reason. Also, when a pod fails, you lose all the insulin in it. Not very economical.

Regarding water activities - any pump can be affected by water. I've heard some people say that the pods come off much more easily in water and the PDM (which has to be with you at all times) is not waterproof. The Ping is waterproof, and I know many people have worn it in the water. That said, I'm of your mindset and would not wear anything that expensive in the water. I use the Revel and when I do water activities, I put it in an Aquapack to keep it dry. So far, so good! Also, using a plastic bag and a Spibelt also works quite well. I've done this on long runs before in the rain and my pump has stayed nice and dry.

Jen, It depends on the and school district as to the policies on insulin dosing.I do not know the exact pump policy in the disctict I just retired from after 32 years,as I never saw a pre-school, primary, nor elementary school-age kid on the pump in my 32 years with an urban,primariy low-income public school district. I just know that school employees, including nurses, were not allowed to dose insulin through injections for meals for elementary kids,even for corrections. These young kids were on sliding scales and the mothers had to come in for lunch time injections or any other corrections when needed.Many staff memebers, myself included, volunteered to help out in an emergency ( needing a glucagon shot or meal + correction injection); but we were told the legal liability is too high. I wish I could help you out with the situation with the pump. However, I only knew of middle schoolers snd high-schoolers who as older children,over 12, who were allowed to do their own dosings and corrections; but only in the nurse's office with a written plan from the doctor and supervison by the school nurse.. In my school district, the kids cannot even test their blood sugar without the nurse being there to look and to record it. Diabetic kids are only assigned to the relatively few schools that have a full time nurse to do that and to hel monitor the corrections. The days sht school nurse was nt there , the school secretary watched as the child took her own blood sugar, but mom still had to come in for lunch time bolusses. the nurse and the secretary, who ever it was, monitored and recorded the data.
Some diabetic chikdren have 504 plan, a legal document that requires the district to follow the doctor's written medical protocols in order to facilitate their success in the academic environment. A 504 plan does not require that the school district hire additional personnel. At least, that is how my former district interpreted it.

Find out what you can do to get a trained person to help with dosing. I also would suggest you send in her lunch home-made so their is no guessing about boluses from a already provided carb-count. Still, I do not know a fool-proof plan as to how you can legally require a school district to provide trained assistance aides to your daughter. Some of the richer school districts in our area have done this for insulin-denpendent diabetic students, but mine was not rich at all. I only know of one on one aides being provided for the Special Ed students whose parents "legalled up" and asked for one.
You may have to do that too. Talk to the admnistrators in your disrict, and aroach them kindly and matter-of-factly, with documents from nyour physician about what your daughter needs as a pump user.. I suspect that you have done that already. Then check with the JDRF or ADA in your area for assistance with a 504. If your daughter is a "special needs" student or can be termed as other health imaired, you may have to go that route, with an IEP Individualized Education Plan. Not easy do do in the district I was in because the child has to shoiw potential or current educational disabilities that show an "adverse effect on educational performance". Kind of hard to prove with a n4-year old who does not currently show cognitive or learning problems due to a chronic condition. Check with the other parents on this forum.

Hope after you can get these most important issues straightend out;and that you will have a healthy,happy litle girl who is experiencing a productive and rewarding school year.

God Bless,

Sorry about the typos. I could not get my not so nimble fingers nor the editing function to "stick" this morning.

My son, Caleb, started pumping shortly after turning 4. The biggest issue I would say we had was his insulin sensitivity as his dosing was so small. It was manageable. Just something we needed to be mindful of. The other thing with preschoolers, it to make sure the other kids know what the pump is, that it's important to your child's health and not to touch it. One child tried to rip Caleb's Pod off one day out of curiosity.

Just wanted to mention, our Pod failures are extremely rare. Perhaps two in the last eight months so that's out of about 120 Pods.

Thanks for all your replies. First off, I am in Canada, so we don't have 504 plans, but there is a "safe in school" sort of thing. I do plan on sending lunches from home and I can do a temp basal for the hour after lunch to cover those carbs to eliminate school staff having to bolus. They would then only be required to make sure she eats what is needed. But I don't need to explain to you all why this way of managing is a little worrisome. But I suppose it would not be much different than giving NPH at breakfast and controlling carbs at lunch. MBP, we have 100% unliminted coverage on insulin so I am not concerned so much about wasting. Our TDD is only about 8 1/2u so we would be wasting what is left in the resivoir anyway. You sure seem to lobby agaist omnipod frequently, and I appreciate your comments, but it has just too many positive attributes for us to be swayed. Every pump has failures. The PDM only needs to be with you for boluses, so it can be left behind and a basal rate would still be administered. I have heard nothing but good things about the customer service with omnipod as well. Choosing a pump for our 4yr old is not something we have come to easily, but choosing to use a pump in general is a no brainer.

Do you in Canada having something like FMLA that provides up to 12 weeks total time off to care for a family member. FMLA can be used in a variety of ways. It doesn't necessarily need to be the whole 12 weeks, but you can take an hour here, and hour there type thing. It basically protects your job. That might be an option if you have something similar to that in Canada so you can at least go and medicate your child.

I think chosing a pump is a very personal thing, and ultimately you have to pick what you are comfortable with, but I to have to say the high number of pod failures I see people talk about was the number one reason I didnt go with Omnipod, that and I found it really bulky. But once again it is a very personal choice, and ultimately I think being on a pump is probably about the best way to go for a type 1.

I have thought about and continue to think about switching from MDI to the omnipod, I will not do a pump with a tube, the newer pod which is still awaiting FDA approval is 40% smaller and much lighter than the one in use currently. Waterproof and discrete, that is what I am looking for in a pump, the bells and whistles which are in the works though nice to anticipate are not a big sell for me. I have not read here or elsewhere about a significant number of pod failures and the vast majority seem to be fairly happy with their decisions, whether pod or ping, or revel, or whatever. It seems as though the parents in the Omnipod user group are quite enthusiastic about the kind of control they have with the pod and are uniformly pleased with the perfomance and quality. Like I said I am still not sold on any pump but if I do eventually switch it will be to a pod.

It's a big decision and I waffled back and forth for years, but once I did it, lol I could kick myself for not doing it YEARS ago. Tubed or not, the pump just gives you such freedom, and I think much better control.

I haven't waffled at all, in fact until I joined here a couple of months ago, I hadn't even heard of the omnipod, and the company headquarters is a stones throw away from my house ! I also had never even considered a pump probably because after 37 years of mdi I am very comfortable with it. But I am concerned that the hormone changes of menopause could throw a wrench in to the works and I would rather be armed ahead of time. My CDE who I have known for the better part of 20 years was shocked when I mentioned my interest in a pump. Supportive of course, but shocked none the less.

I think if you decide to make the switch you will love it. While I wasn't all that impressed with Omnipod. One thing I can say I did like about them, was I think you have up to 30 days after buying there system if you arent satisfied, your not stuck with it. Where as if you go for a tubed pump...after you get it, your insurance locks you in until the warranty is up which could be 4-5 years.

My co-worker has a minimed pump and cgm. I don't want to have to wear a belt every single day or pants for that matter so a tubed pump is not even a consideration. My insurance is very comprehensive so I am not overly concerned with being stuck with a pump I do not like or is not working for me. I have asked a lot of questions on this site and have received some excellent info, suggestions, etc. I know a pump will offer me better control, but I am definitely waiting until the smaller pods come out. They're of course already available in Europe but I live in Massachusetts, so I'll just have to wait.

LOL EVERYTHING comes to Europe first. I love my Minimed, but lol Im not really a dress kinda girl. So it works for me.

I'm not a dress kind of girl either or a belt kind of girl and you're right the Europeans get everything first.

I wear a MM 522 and I just stick my pump inside a baby sock, then safety pin the sock to my padded bra. Use the remote to bolus in very formal settings. At Around friends and family ,even in restaurants, I just turn awasy and "whip it out!!" (LOL- the pump I mean.) And I AM a dress kind of girl. Wear sun dresses all the time in the summer.Disconnect when I swim or do aqua aerobics.

Love the pump much more than injections. I was a long time one shot a day insulin user, diagnosed in 1967.. and when I started MDI in the mid 90's,I was NEVER really found of 4-6 shots a day.

God Bless,

I have a Ping, and don't feel at all limited in what I wear. If I wear pants or a skirt, I just hook it to my waist (I don't even own a belt!). With cargo pants I throw it in the pocket. With dresses I hook it to the front of my bra. I personally am not impressed with what I've heard about the omnipod and reliability is more important to me than tubing. (which you get used to pretty quickly). Just my opinion. YMMV.

I also wear sleep shorts under loose sundresses and ...well, to sleep! Tallybelts and spibelts are other options for pump carrying..lots of options!