Calling All Diabetics. or anyone Need To compare notes for post-birth care plz.

[1down2togo]

when i had my son, 14 mths ago, the birth etc was okay, but i was really unprepared for what happened next.

They whisked him away to SCBU on the next floor. I had been briefly told he'd probably have to go there for a few hours to check his blood sugars, so wasn't a total surprise, what was so upsetting was that it felt like they kidnapped him.

They kept him up there for 3 days. He was in a heated cot for first 6 hours, and when i asked they said that his blood sugars were fine.

Their reason for keeping him was they kept telling me he was a sicky baby and a poor feeder.

I wasn't encouraged to visit / feed him ( bottle fed ) and felt like i was in their way when i did go up.

I was only when they got a set of twins and a poorly baby in that they then started demanding i go feed him, to the point of sending midwife in to wake me in middle of the night to go upstairs.

he was taking a couple of ounces every couple fo hours, but they said he needed to take 4 oz 4 hrly. They had inserted a nasal tube and when he stopped sucking they 'injected' the rest of his feed....which he would promptly throw back.

They also timed when i fed him and after 20mins they would take him off me and 'inject' the remainder of his feed.

He was moved 3 times in the time he was in there, ending up in a small room where they stored spare cots at the end of a corridor opposite a broom closet.

I ended up so depressed and upset that when i went to give him his feed during the night i stayed there for 5 hours waiting to catch the consultant on his rounds, he couldnt understand why my son was still there and said babies arent robots and will feed when theyre hungry.

were currently trying for another baby, and the pregnancy / labour arent a worry to me, its the after care. Was this normal? Have I / am I over reacting?

Is there anyway i can stop this happening again?

Sorry for rambling, thankyou to anyone who reads this.

hello spidey (how is your ds doing btw, hope he's ok ). it's true, you can't take insulin tablets. tablets exist which either make you more sensitive to the insulin your body's producing or push the pancreas a bit to make it produce more (i think. god, i used to know all of this ). or you can get ones which reduce insulin resistance. does any of that make sense...?

i had ds at st mary's paddington in 2002. mr teoh & steve robinson looked after me, they were fantastic. not sure what the hba1c 'rules' were, but i know i was totally obsessive and mine was running around 4% for most of my pregnancy..... i was induced at 39 weeks, had a full blown failed ventouse/forceps delivery after 24 hours in labour. i was induced in the evening & dp wasn't allowed to stay despite me being in early labour. ds was born at midnight & we stayed 2 nights subsequently i think. he was with me the whole time. insulin drip came out sometime after delivery, not long i don't think. but i stayed in the delivery room all night so i had someone keeping an eye on me.

i had dd in the homerton in 2005. great diabetes/obs team again, katerina erskine was my obsetrician. they didn't measure hba1c, used fructosamine instead (weird). i was induced at 38 weeks this time & a much faster & more straightforward labour/delivery. though i did have a small haemorrhage afterwards. she was born in the middle of the night too & they only kept me in for 1 subsequent night.

er, that's it .

Thanks bojangles.
For anyone in London - St Mary's Paddington

1. HbA1c - 7 and below
2. Antenatal care: pre-conception appointment with 2 consultants, joint diabetic/obs appointments throughout pregnancy, extra growth scans, foetal heart scan at 19 wks (3D and very cool), diabetic midwife
3. Before 39 wks depending on sugars
4. Prefer to induce as better for the baby, no idea what policy is on VBAC
5. Drip in once in active labour, out once baby is out and you are able to move by yourself (enough to test and inject). Mine was taken out the morning after emergency cs so 6 hours later.
6. CFM is the belt - CFM once the drip is in
7. Babies tested about 4-6 hrs after birth for low blood sugar, then every 3 hours until they've had 3 readings above 2.6. If low and no signs of hypoglycaemia that need special treatment are fed formula (by cup if you want to b/f). If severe then they go to SCBU and are put on a glucose drip.
8. Separation of baby from mother at any point? Only if in SCBU. No HDU as far as I know
9. State of post-natal wards and any other comments - post-natal is grim. Tropically hot, understaffed and some of the staff are quite combative. One nursery nurse when we were readmitted for ds' jaundice, a very stressful time, came to see me when I was having a hypo and trying to eat chocolate. She tried talking to me, I said I was having a hypo, she said I wasn't responding on purpose and was not interested in looking after ds. My husband explained to her that I was having a hypo. Response - I know all about diabetics she's not responding deliberately. Even the b/f counsellor with us at the time with no experience of diabetics pointed out that I looked really unwell. But some of the other staff were brilliant and really went out of their way to help us.

It was clean - even the bathrooms/toilets. There's only one single room and that goes to mothers with twins or babies in SCBU.

They sent an endocrinologist to see me every morning. She said she was one but thought that 11 was an unreasonably high level and I should stay in hospital to get it better. Stupid idea in my book. She did not warn me about huge and sudden lows when your milk comes in.

oh and when I was in labour the midwives kept on using my meter to test with cos it was better than theirs

And one more thing - because you're high risk you get induced on the labour ward which is ghastly as I got woken at 3am by the sound of women at the end of 2nd stage - the part when they really scream. On the plus side I got to stay in the recovery room all night afterwards and that meant that my dh could stay with us because they're allowed on the labour ward at any time.

same deal here with the meter tigger .

totally randomly, i was assigned a room at the end of the corridor on the post-natal ward with a double bed in it . we had a great party atmosphere going on!

Bojangles I agree it is really good to talk about diabetes and to 'hear' the voices of others and their experiences. I'm only the mother of a diabetic so I love to learn there are all these sensible, articulate 'normal' people leading full adult lives with diabetes.

Oh, this is all so interesting - never 'met' other diabetic Mums before - so lovely to know am not alone!!

Ditto with monitor but they actually let my husband test mine for me during active labour. Used my monitor on baby too as theirs was playing up.

Tigger, I was induced on labour ward too - you really don't need to hear woman screaming during labour when you are a very scared first time Mum do you? HDU was also on the labour suite and I had to put up with 2 nights post birth listening to the screams - like something from a horror movie!

What was everyone else's Hba1C like during pregancy? - mine usually hovers around 6 and I was considered to be immacutely controlled - am amazed that Hoxton can get a reading of 4 - did you go hypo lots?

Hoxton - your first labour sounds like mine - nightmare induction, husband sent home etc, failed ventouse but managed to get her out with forceps. Massive pph after, blood transfusion - what joy!

With DS they never got me on the sliding scale as it was an emergency CS - it wasn't till afterwards that they suddenly thought about it - blood sugars were fine though.

Interestingly, my diabetic consultant said that they have had quite a few mum's with type 1 recently who were very well controlled and didn't have any real problems until around 36 wks when the placenta started to fail so they are now much more aware of likely problems and will look at delviery earlier if necessary. She said this was in contrast to many of the mums with worse control who seemed to sail through without problems. Think she may be doing some research into it - may have to get pg again just to help out her study

If they'd offered me a cs at 3am that morning I would have accepted immediately! Saying which when they finally said I couldn't go any further my reaction was to burst into tears and vomit. Amazing how your perspective changes...

My hba1cs were usually under 6 except for the last one which was 6.3. I'd never been that low before in my life other than the honeymoon period when I was 3.

That's really interesting about the 36 wk thing. I always thought that the placenta failing was a hangover from days when it was much harder to control blood sugars because of no home monitoring and pregnancies would result in a very high stillbirth and defect rates. Bit depressing as good control is meant to prevent that and low blood sugar in baby.

Hoxton were you on tablets or insulin during pregnancy? If insulin what on earth did you do to get such great results?

Oh and I loved steve robinson and mr teoh. I asked my consultant if I could have steve robinson permanently as my consultant (mine is retiring so not too offensive) and was told he only does pregnancy. Permanently pg vs some other consultants - hard choice.

If I may just divert from the topic even further briefly ...

I'm wondering what insulin regimes you are are on. My ds is on Mixtard 30 and I find it rigid as we spend our days clock watching and feeding his insulin.

I assume most adults are on MDI or pumping but as I don't know any it's all guesswork.

My ds's reluctance to go on MDI is the fact that he'd have to inject at school. Did you inject at school?

I have gestational diabetes and started insulin a couple of weeks ago. I take NovoRapid 5-10 minutes before a meal (whatever time that is) and Levemir before bed. My levels are hovering around 6.5 before meals and 8 at 2 hours after. Trying to improve on those.

I read about stress that in type 1 diabetes mental stress can get glocose levels to go up or down. In type 2 they usually go up. Physical stress makes blood glucose levels go up in both types 1 and 2 diabetes. So labour could be both physical stress & mental stress. With type 1 diabetes it might explain why overall levels were just fine (a poster further down).

Spider, I have been on the DAFNE course (dose adjustment for normal eating) and I inject a base insulin twice a day of insulatard (many use glargine) and then I inject novorapid on a ratio of 1 unit of insulin to 1 carb portion - all taught on DAFNE. I understood that this course was going national and would be available for children too. It does mean more injections but gives more flexibility. When I was first diagnosed I had to feed my inlsuin doses lots and ended up putting on quite a bit of weight.

Can sympathise with the school thing, luckily for me (?) I didn't develop my type 1 until my twenties so didn't have to deal with this. How old is your DS?

Tigger and other diabetics- more digression but my current HbA1c is 7.7 (usually much lower but having a bad spell prob caused by cutting down on bf) - anyway we are thinking of trying for a third but not too happy with current reading but know with a bit more effort I could bring it down again - question really is did you have good control before getting pg? and for how long before getting pg was it below 6?

bojangles - I tried to have good control b4 getting pg. The results were 7.0 and 6.7. I never had lower than 6 before I was pregnant. Usually somewhere btwn 7 and 9 depending on period of my life. I found it much easier to control once I was pregnant.

spidermama - I was diagnosed in 1983 when a very different system was in place. Instead of the emphasis being on testing and injections it was on controlling the food you ate to match your insulin. I was on one injection a day (before breakfast)until I was 8 then 2 a day (before breakfast and supper) until I was about 22/23 and now 3 a day (all above plus one before bed). I prefer it this way as I'd have hated to inject in school and still don't like taking it to work. I'm on pork insulin - I tried human for 3 years and had a very bad reaction to it. After a while of doing this system you get good as estimating how many carbohydrates are in the food you eat. It's definitely better than when I was young when everything was weighed out before I could eat it and no sugar whatsoever. If you want to find out more about how to do it there's usually plenty on this site www.iddtinternational.org/

Fixed doses are rigid to a certain extent but so long as you always have supplies with you it's not too prohibitive and most people get pretty grumpy if they don't eat when they're meant to.

Slight correction - never been below 6 or anywhere near it during the time I've been in control of it. I think it was better before the age of 11.

Spidermama - I mix long acting and short acting at different times of day
am - mixture of 2
supper - short actign
bed - long acting plus a bit of short if I'm high

i am type 2 but use insulin in pregnancy, although i inject insulatard before i go to bed. when i was b-feeding ds i also had to be on insulin, but educated myself before having dd & could go back to my tablets whilst b-feeding her (i take metformin).

i was obsessive about my blood sugar, especially with ds (1st pg). i remember crying once as it was 9 after a meal & i had to go walk round the block alot! i tested my blood about 10 times a day. and i was hypo quite a lot....

i get very very insulin resistant in pg so need enormous doses (i won't tell you, it's terrifying!). when i had dd they ordered special insulin from america for me (the pharmacy loved me....) which is 10x the strength so that made things easier, although i had to draw it up each time with a syringe. ick.

Hox I've heard about these extra strong insulins. I remember when my ds first started he was on one unit in the morning and two in the evening. one and a half years on he's already up to 17 and 10.

Bojangles and Tigger I've heard about DAPHNE and am a little daunted. I gather it's quite hard to get your head around all the carb information, but at the same time I'm keen to crack on with it so we can start establishing good habits early on. I'm trying to balance my enthusiasm with his retisence to inject at school.