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Re: [IP] Pregnant pumpers....

>>>It is a little firghtning to see that everybody had rather large babies, and they all delivered early.<<< 

Only one of my babies was considered large, my second, and I know someone mentioned theirs was under seven lbs.  So they aren't ALL large.  But even if they are, being big isn't necessarily a big problem.  My large baby was every bit as healthy as my reasonably sized one.

Also, you commented on the babies being born early.  My babies were seven and ten days early, but part of the reason is that that's the way my perinatologist liked to do it with diabetic moms -- schedule an induction or c-section about a week early.  Both of mine were ready to be born.  We had considered inducing my daughter two weeks early and did an amnio to check lung maturity before we went ahead and did so.  She was ready, but was delivered only ten days early instead of the full two weeks.  

What did I have to do before hand?  Make sure my Alc's were below seven, mainly.  Also, I take Enalapril, and while trying to conceive, I took it during the early part of my cycle, and then quit after I ovulated.  I didn't take it until I knew for sure I wasn't pregnant, because it isn't good to take while pregnant.  (I could resume taking it after the baby was born, however, and it didn't interfere with breastfeeding at all.)

I had pre-eclapsia during my first pregnancy, a very common complication (especially in first time mothers) that had nothing to do with my diabetes.  I had a lot of swelling (water retention) during both pregnancies, and was told this is more common for diabetics.  Other than making me miserable, it wasn't a problem from a medical standpoint.

I also had some extra amniotic fluid while pregnant with my large baby.  This was dismissed as something that frequently happens to diabetics.  Again, it wasn't really a problem, although her large size (9 lbs. 14 oz. at birth) coupled with the extra fluid on my small frame (5', 2") made me look like I was full term when I was only seven months along!

What did pregnancy do to my sugars?  Early on in the pregnancy, as is typical with diabetics at around 10-14 weeks, I had some pretty bad lows due to increased insulin sensitivity.  But later on in the pregnancy, beginning at 20 weeks with my second and 26 with my first, my insulin needs started to go up, and continued to increase dramatically until the end of the pregnancy or close two it.  Actually, during the last two weeks, my insulin needs began to go down.  All of these things are typical.

I would say that you shouldn't panic when you have highs in the last trimester.  You should expect it.  All you can do is compensate and frequently adjust your rates accordingly.  It is also reassuring to realize that they say that blood sugars are most critical from six months prepregnancy through the first trimester than they are during the last trimester.  Highs then are going to happen, but they are not the end of the world.

Immediately after delivery, I went back to prepregnancy rates or maybe a little lower.  And, in fact, while breastfeeding my daughter it took me quite a while and several bad lows to figure out just how much nursing lowered my rates!  Breastfeeding is very good for blood sugars!!

Anyway, I hope that helps.  I've heard that birth defects are no more common in babies born to diabetic moms as long as their A1c's are below 7 from six months before conception and clear through the pregnancy.  Complications and birth defects are things to be aware of and watch for, but they aren't something to be feared more than any other mother would if you are keeping your blood sugars down where they should be as much as possible.

dxd 1985, pumping since 1990
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