Gestational Diabetes - a couple of questions.

[thoughtforms]

Hi,

There's a few threads, but none that really address these few things I wanted to ask - hopefully someone out there will have some ideas!

I've had GD since around 26 weeks, I'm at 36 today (christ, only 10 weeks?!), and am looking into Colostrum Harvesting - I have my first clinic on Tuesday at my antenatal clinic. I've read all the information I could find, and actually, there's not a lot out there - other than it's recommended, as baby's blood sugar could have problems once I give birth, and she may need to go on formula. Has anyone else with GD had this happen on giving birth, and were you able to breastfeed normally afterwards? I'm curious, I'm going to give it a try (god knows what the clinic will actually consist of, other than bags and syringes for the freezer), just wanted advice!

Secondly, I've been told I wont be allowed to go past my due date, and if needs be, I'll be induced. This is a bit annoying, as I'm feeling a bit like I'm losing some kind of control. Priority is the baby, of course, but I wondered if anyone else had been through this, and how to avoid having "the drip" attached, and what helped labour be achieved normally? What kinds of factors do they use with inductions - like, say if baby was on the 97th percentile (right within limits though), is there a chance that they'll do it early? (I'm hoping not, though I could live with week 39) Ultimately, it sounds like I'm in the hands of the consultants, and that a lot of decisions I might have made will be taken out of my hands - so I'm trying to work out what decisions I can make, as well.

Thanks in advance!

[thisisyesterday]

i haven't had GD but a good friend of mine did. it was pretty severe and she was threatened with all sorts. in fact, the consultant basically told her that she was rsking her baby's life by refusing to be induced

anyway, despite their claims that her giant baby HAD to be induced she went a week overdue and gave birth to a reasonable 8lbish baby who was in fine health!
she had a straightforward labour and delivery, with no drip atached or anything

remember, you are the one who makes the decisions. Hleath professionals can advise. but they cannot make you do anything you don't want to do. so make sure you';re as informed as possible (which it sounds as though you are) and make the decisions yourself!

oh, afaik you can just make sure that babies blood sugar levels are monitored after birth and just breastfeed on demand. there is no need to automatically give formula or anything, although i reckon expressing some colostrum beforehand is a good idea cos then you've got it in case baby does need something

[MadEyeballsMoody]

I had very very late diagnosed GD (at 38.5 weeks) and was also told that I would not be allowed to go past term due to the humungous, groin splitting baby I would inevitably deliver. I was induced and dd arrived on her due date weighing in at a massive 8lb 10oz

As far as induction is concerned, I was given three lots of prostin gel and my waters broke after the third lot. If they hadn't then the next step was to break them. My labour was very fast for a first baby, 4hrs from start to finish and all went normally. After the prostin gel I had no other intervention at all.

But please please, if you think you want to bf, be ready to stand your ground. DD had her blood sugar monitored every few hours and that, added to the fact that I had no bf support or instruction whatsoever, resulted in her being ff 12 hours after her birth and that was that. The mws insisted that she needed formula, and I was in no fit state to argue, not being very well myself as well as confused and knackered. And although I know it becomes less important as they get older (DD is 18 months now and I don't often think about how she was fed IYSWIM) I will never get over the upset of not bfing or rather, the upset of having that choice taken away from me. It might be absolutely fine and dandy but they might be very keen for your dc to be given formula if there are blood sugar issues. I wish I'd told them to feck off.

Good luck

[olivo]

thoughtforms, i am going this week to discuss my baby's delivery - the bf thing is something i will mention, and will report back if i learn anything. isi t a straightforward choice of bf or formula, or is there something else they can be given to raise blood sugar should they need it?

i have been told i will not be allowed to go past term and am really hoping for an elec cs anyway due to other things too, but as the others say, it is ultimately your choice.
will watch this thread with interest.

[mum27]

Hi i'm on my 3rd pregnncy with GD, first one I was induced and swore never again,it turned out, sweeps, drips, the works, I was at least 2 weeks from going naturally and it was hell but he was born 9lb 40z..average for my lot and I bf no problems at all. His blood sugar was monitored and I fed on demand. Second was an emergency c section, about 2 weeks over by my calculations and her peeling,and no way was I being induced, I bf her just fine, once again her sugar levels were monitored and I plan on having an elective c section this time and bf this one as well.Don't let them bully you if it's not what you want, they can monitor you to make sure you and the baby are both fine.

Good luck :-)

[mogend77]

I am concerned that you are being bullied a bit. You appear to have been given the impression (completely false) that choices are to be made for you. Every single decision about your pregnancy, birth and baby's care is yours and yours only. HPs are only there to advise. And it doesn't sound like you are being given very up to date or accurate advice. Latest research seems to show that there is no improvement in outcome for babies with a diagnosis or treatment of GD & that induction for GD brings only risks with no demonstrable benefit. There is also no reason in the world why your baby will need formula. Even in the extremely unlikely circs that her blood glucose was a bit low, the very best thing you can do for her is bf freely on demand. If supplementing for low blood glucose is really necessary good practice is to express a tiny bit of colostrum, mix glucose with it & syringe it in. Formula will not benefit your baby, poorly or not. And remember - a big breast feed as soon as possible after birth & no blood glucose testing before your first feed.

Please please please read this study before making your decisions:

www.gentlebirth.org/archives/gdhgoer.html

Really HTH.

[racmac]

Please read my birth story on www.homebirth.org.uk whether or not you want a hb if will still give you some of the info that i had.

I refused induction - the Cons changed their mind anyway because it didnt fit neatly with their staffing issues over Easter

I bf immediately and they didnt even bother to check baby blood sugars - he was 7lb 13oz - so not exactly the massive baby they told me about it

if you look at the site - go to you cant have hb because you have gestational diabetes - my story is on there - Rachel

[forevermore]

i am having an elective CS due to placenta previa but also have GD. I had this with my first baby who was formula fed and i never established bf because i didn't have any suppport.

this time i am determined to have a good go of BF but worried how this will happen if a) I have an elective under general anaesthetic and dont see my baby for a number of hours (a high possibility for placenta previa....or so i have read) and b)babies sugar levels drop (didn;t with my first) and i am told to ff?

[thoughtforms]

Thank you everyone for the replies so far - they're really helpful. I honestly don't have a clue what to do (or what I can do) but you're right mogend77 - I did feel a bit bullied, or more, like I've lost some of the control I want with this birth. I guess the place to start is get my birth plan in order, and then argue each case - I wont find out more for another week and a half, at my next diabetes appointment.

Thanks also everyone for the blood sugar levels stories too - it's really reassuring to know it may not be a problem - there's so little information out there about what happens. I'm going to check the other links posted - again, thank you all, it's all good research and help.

Our last scan, little one was an estimated 6lb, which didn't overly worry me, as my husband and I were both 9lb babies - plus we know the scans aren't 100% accurate - but there's potential for a big baby anyway, which I fear they'll just blame on the diabetes!

forevermore - that was one worry I had too, although I'm guessing expressing beforehand and freezing it (like I will be trying to), would be one way of making sure baby doesn't go straight onto formula? It may be worth asking about at hospital? Good luck!

[mogend77]

Forevermore - my birth plan states that if I am unconscious for any reason, my husband is to put the baby to my breast anyway for baby to self-attach. He also has explicit written permission to hand express colostrum if it's needed. However, it's very rare to have even an EMCS under GA so I can't think why you would need one for an elective.

[hunkermunker]

This is my thread from just after I'd had DS2 which talks about what happened to me in hospital wrt bf after birth.

How well-managed are your sugar levels? If you're diet-controlled and they're not worried about the baby's size, what other reasons would there be to induce you?

Definitely express colostrum antenatally - I should've done, but the hospital wasn't set up to do it (is now though ).

[pipsy76]

I had mild GD and an elective CS (previous EMCS didnt want VBAC)4 months ago, I had rigidly controlled my BMs with diet and after reading CEMCH guidelines on caring for mothers and infants with GD decided to refuse BM monitoring for my DS immediately after birth. I had skin to skin immediately and continued with skin to skin for 48 hours with unlimited breastfeeding, if he had in anyways appeared unwell I would of course followed any advise. By doing this I feel I avoided any unnecessary intervention or encouragment to give formula. Good luck I wish you a positive experience.

[thoughtforms]

hunkermunker - thanks for the link. Crikey!

Regarding my sugar levels, they had been quite poor in the mornings, though this was when I was eating all-bran, and the sugar content was sending it sky high (despite it coming up on my GI Diet sheets as a "green" food) - whereas an omelette or scrambled egg is much better - but they weren't interested at the clinic, and stuck me on Metformin - so I take two in the evening, and two with breakfast. They did also move me to one at lunch, because I'd had two meals which took me higher than they should (cheese and pickle sandwich on wholemeal bread - then I realised the pickle had high sugar content), but I managed to persuade them I didn't need to take it (at my last appointment), and so far, so good.

It took a good couple of weeks to find food that would keep my levels as they should be - but unfortunately the doctors weren't interested in that! I suspect I'd have to take one metformin with my evening meal and one with breakfast, especially now I've finished work (and my overall levels are down), so I'm not completely diet-controlled, unfortunately. But I still think I'm controlling things reasonably well.

I've got the colostrum harvesting clinic tomorrow, anyway!

pipsy76 - thank you too - you know, with the lack of information out there, I'm just not sure what the right thing to do is - so it's good to know that's the kind of thing you can refuse. I'm just worried about putting baby in any kind of danger - which actually, it sounds like she wont be one bit.