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The best quality and most beneficial food for short and long term health that an infant or child can receive is breastmilk. This is even more true when the child suffers from an illness, such as diabetes mellitus type 1 (DM1). Breastfeeding should be encouraged in these cases (Magrath 1993).
For the practical purposes of calculating insulin dose, breastmilk contains 7g of carbohydrates (CH), mostly lactose, and 70 calories per 100 ml. Infants who are exclusively breastfed gain an average of 120 to 150 ml per kg of body weight per day. Other data to take into account are that mothers produce in their child’s first month of life an average of 700 ml of milk per day (49 g of CH), rising in the sixth month to 900 ml (63 g of CH) (Lawrence 2016 p 102, Ferris 1984).
In young infants, especially children under 1-2 years, it can be frustrating and guilt-provoking for all (mother, family and doctors) and ineffective therapeutically, to base the management of DM1 by exhaustively controlling the daily intake of food, especially breastmilk (double weighing, formulas to calculate the dose, expressing and measured administration ...). An approach which is based more on frequently controlling glycemia and administering rapid-acting insulin can therefore give better results.
Breastfeeding can and should remain on demand. Night feeds are very useful to avoid episodes of hypoglycemia.
Breastfeeding is the best that can be offered to an infant or young child diagnosed with DM1. Regular counseling is required by skilled pediatricians in pediatric endocrinology and nutritionists and parents who are highly knowledgeable in the management of diabetes.
Adequate management of infants with DM1 requires adaptation of the protocol with respect to ABM (Miller 2017).
In the absence of sufficient scientific literature on breastfed infants affected with DM1, it is instructive to read the accounts of breastfeeding mothers whose infants were diagnosed with DM1 (LLL France 2018, Erin 2018, Brittany 2018, Esther 2015, Caoimhe 2013, Theresa 2013).