The Sweet Journey of a Diabetic to Motherhood and Breastfeeding

As Mother’s Day is approaching this weekend, I am reminded again of how I became a mother. It was exactly two years ago that my daughter and I finally went home from the hospital after she was born. I delivered her via Cesarean Section. I would like to share to you how I gave birth with the help of a birth plan. I may be mentioning my condition of being a diabetic and been wanting to breastfeed and the struggles that went with it. This article does not mention the benefits of breastfeeding as there are a lot of other articles that can support this. I am writing my not so easy breastfeeding journey in the hopes for other mothers who might be going on through the same struggles in choosing this method. This is not to mommy-shame formula feeding mothers. But this is to uplift mothers who want to breastfeed their little ones.

PCOS, DIABETES, and how we discovered we were expecting

I have been diagnosed with Diabetes Mellitus Type 2 or also known as Type 2 Diabetes five years ago and I have a hard time managing my sugar levels. I also discovered having polycystic ovaries (PCOS) over a decade ago which explains my irregular monthly period.  This is a factor why it was difficult for me to get pregnant. I believe prayers and the change of lifestyle gave us a baby even after getting married. I enrolled in a fitness class a month before my wedding as I was very conscious of my figure of being able to fit my wedding dress. We also took a vow even before the Pre-Cana seminar that we attended as a couple to be celibate til our wedding day. I believe we were emotionally and physically prepared for this big chapter of our lives in becoming parents. We were both praying for it. Until one time it has been a topic for us to go back to Japan during Autumn since we have been there some 3 years ago during Winter. I have been communicating with my sister about this trip and on how she wanted our mother to come with us for the first time. So, I decided to take a pregnancy test just because we have to get our visa. I wanted to check if I was fit to travel. Finally, we found out we were expecting but we have to be discreet about it until we can confirm it is for real. It took me 11 pregnancy test kits which all yielded the same result. So we went to see an OB gyne. She said it was still early to get an ultrasound if we based it on my last menstruation and advised us to wait for 2 more weeks. Then, when we got the test, my baby was 11 weeks inside my tummy already! This ultrasound results was not in coincide with my last menstruation. Well, maybe that is because I have PCOS or used to have it. But during this ultrasound and the next series of ultrasound that came with it, my PCOS did not show up. I was like PCOS-free during my pregnancy. So not sure if it is back by now as I did not have an ultrasound again since I gave birth. So, before I got to send our requirements for the application of our visa for our Japan trip, the OB gyne gave us a go signal. We were holding this still for some more days as we would like to surprise our parents during my husband’s birthday. True enough, happiness is felt from each and everyone in the party as they have been longing for us to have a baby. My husband and I were in a 9year relationship before we got married

We consulted with my OB-Gyne on how it is for a diabetic to be pregnant. I was really hoping for a normal delivery. She told me it was possible for me to have a normal delivery as long as I’ll undergo the process of labor. But for most diabetic patients, it is advisable to be induced at least around the 37th week since prolonging it puts the baby at risk especially if the sugar levels is not controlled. There were cases of stillbirths on some of diabetic patients. I also asked around some people who are diabetics and I have known some who underwent a CS section, and some also gave birth naturally because they went through labor even at the 36th week. So, my hopes was high but my endocrinologist was clearly not in favor for me to deliver normally. She prefers me to have a Cesarean section so that my baby and I would not have to undergo so much stress. She also changed my medication since I was pregnant. I was still hoping for a normal delivery since my OB was not really oppose with the idea.

During my pregnancy, I had difficulty controlling my sugar levels. I was required to monitor it everyday like 3-4x a day, but mostly I would extend it for 6x a day like before and after meal. I also logged in to a notebook everything that I ate from all the meals including the snacks. My results is usually controllable during the before meals but after the meals that’s where my problem is since I can hit more than 200. It was the first time in my diabetic life that I hit off a normal hba1c result. My determination to keep my sugar level low is there. I just could not control my after meal result.

Things to consider when you are expecting:

1. Discuss with your husband how you want to deliver: normal delivery or Cesarean; will you breastfeed or bottlefeed; will you use cloth diapers or disposable diapers, would you want to room in the baby
2. Attend seminars or any kind of preparations that you need. If there are prenatal exercises or classes around the city, take advantage of it. If you want to breastfeed, to use cloth diapers, to babywear, gather information and be acquainted with all your choices.
3. Prepare necessary things for your delivery
4. Choose your doctors
5. Choose the hospital
6. hire helpers especially for first-time parents

If you are diabetic, you have to include monitoring your sugar levels on a daily basis and your daily food intake.

Initially, we wanted this first OBgyne. Since I am diabetic, I have an endocrinologist so I had to make sure that both of them can be in the hospital of our choice. As I was scanning through some recommendation, I later found out that I wanted the other hospital, which is Maria Reyna Xavier University Hospital. It took a while for me to convince my husband that we change my OBgyne and the choice of hospital since My OBgyne does not go here. It was against my will to change her but I wanted the best experience in which I think this hospital was the only right choice because I was aiming to breastfeed and room-in my baby. The previous choice that we had, I gathered some information that they are not into rooming in the baby and I do not want that experience. I hope I am not right about it at this time since this experience was two years ago and the years before this. Good thing that my endocrinologist is based in this hospital. I am not sure how far I was when I changed my OB. I think I was already five months (I had to recheck this info). This OBgyne does not really accept new patients unless the pregnancy is a high risk one. I am not sure if my condition is labelled as such because there are no forbidden activities for me. Maybe I think because I am diabetic that she still accepted me. I explained to her that I wanted to change hospital and my previous OBgyne is not based in this  hospital and another thing I considered is that the clinic of my endocrinologist is just beside her clinic. They have the same views with my previous OBgyne—that it is possible for me to have a vaginal delivery. At first she said that maybe I can be induced at around 38 weeks. She also checks on my daily monitoring of my sugar level tests. When I was near to give birth maybe around 35 weeks, she was not happy with my results. There were improvements like making it down to 160 after meal. But, this is not enough. I think it only took me twice to hit off the ideal result at less than 120 after meal. So she was frank about it that I should not delay my delivery to more than 37 weeks. As I was nearing the target week, she was scheduled to have an out of town trip or was it a convention. She gave me a date that if I can go into labor and if she is still around, she would still handle me. But my baby is not ready yet though I was given something to make my cervix “softer” and somewhat be ready. She had to endorse me to another OBGyne.

She prepared all my data for my next OBgyne. I have already discussed the important things I want to experience:

• to try for a normal delivery
• to experience Unang Yakap which includes this process:
  1. drying my baby immediately
  2. skin to skin contact with my baby
  3. delayed and proper cord clamping and cutting
  4. have my baby latch and breastfeed
• to room in my baby
• to exclusively breastfeed my baby
• to particularly endorse our chosen pedia

When I got to meet the assigned OBGyne, I still emphasized all my concerns. I really wanted for my wishes to be granted. She agreed to it that we will try the normal delivery. On the night before I was advised for admission, I got pieces of advice that I should have a birth plan. It may have been too late for me to present it with my OBgyne, but I tried to prepare and I had it handwritten since I did not have a printer.

Making my birthplan right before my hospital admission

I was admitted in the morning and there were a lot of staff who attended to me. I was interviewed numerous times. I also made copies of my birth plan and I presented it to them. Normal practice of having a birth plan is to discuss this with the doctor. Though I may have raised my concerns already with my doctors verbally but a birth plan is a formal written of your wishes. The only time I got to present this is during my admission.

I was induced twice and I did not feel any pain at all. I kept walking around the delivery room. I can hear another patient going into labor, but I did not went through with that. I did not have any contractions during the first time I was induced. The second time I was induced, there were contractions but they were not consistent. My OBgyne decided that she should perform Cesarean section since my baby’s heartbeat went low. I was informed about this and I had to agree since I really want her to be safe.

The night after I was admitted, I delivered a healthy tiny baby girl. She was a lowbirth weight baby but a healthy one. She had a good latch. I kept in mind the things I have learned from the seminar on breastfeeding.

1. let the baby latch, even if you think the baby is not getting anything since you cannot see any milk yet, as long as baby is sucking, has enough output, baby is getting enough. (newborns must poop everyday and must have wet nappies)
2. Most newborns want to sleep all the time, encourage the baby to latch every 2-3 hours. Lead your breast towards the mouth or tickle the feet
3. try different breastfeeding positions until you can find a comfortable position
4. do skin to skin most of the time, if it helps, try to wear the baby (make sure to be equipped with the knowledge, seek help if necessary)

Finally, my becoming a mother has been granted. I love the feeling of being able to touch her for the first time. I have a very nice birth story of her.

I just looked up the internet for ideas of what a birth plan is. Here is my version in the simplest way I want it:

I was not able to discuss in detail with my OBgyne about the presence of my husband inside the room, I did not specify it on my birthplan which room I wanted him in. In my experience, he was allowed to be in the Labor Room, but not on the delivery room where the Cesarean operation was done. Somehow, my birthplan was still followed. The choice of an Anesthesiologist was not followed because he was out of town. They informed me of the available doctor and I agreed. I am so grateful for this experience. I may have encountered different doctors with my pregnancy but I still got to deliver a healthy baby.

The presence of my birthplan helped that my wishes were granted. The only regret I had of having it was not being able to inform our family. There were members of our family who prefers us not to room in the baby but with good intention. Given that we are still new parents, we do not have the experience to take care of a newborn. With my condition being a Cesarean patient, I understood that they were after for our wellness. So, our pedia insisted that I still be granted the rooming in of our baby since my desire of having a normal delivery was not granted and since my baby has no health issues. During this time, I was not aware of this circumstance maybe I was still asleep or still resting that I had to leave everything to my husband for other decisions like the clothes my baby has to wear. I know I would be mad if this decision was not followed and so I am grateful for the people who made it possible for me to grant what I wanted and which I know is beneficial for me and my child.

With this circumstance of not being in sync with the views of some of our family, I am so fortunate to have them during this important moment. They only mean well for us. So, they looked and hired for some help care that would assist us. Although we already hired our own helper, they were skeptical of the skills especially on being able to handle a newborn. So, they asked from the hospital staff and they were able to tap a firm who offered this kind of services. They hired them and there were two people who took turns with the shift for two days. They assisted me when I need to feed, to go to the toilet when my catheter was removed and made sure that my baby would latch every two or three hours— so there were times I was asleep, that they would lead my baby to latch. So they slept with us in our hospital room too. This experience is so nice. I can really say that I have a beautiful birthing experience even though I delivered via Cesarean section. I was able to savor the moment of being able to breastfeed my daughter as I was always been looking forward to doing so.

Real Breastfeeding Struggles

Ever since I gave birth, it took only two days for us to go home. We were contemplating to continue hiring these health care providers. But we wanted to try on our own since we have to learn. If we cannot still handle it, we have to contact them. So we went home. The first day went well. We gave her the first sunbath. The real struggle started on her fourth day or the second day of being at home. She was really really fussy and would cry a lot. We tried from changing the diapers, but still, she was very fussy.

It was this day that we decided to go back to the hospital and seek help from a pedia. We were scheduled to go back to her pedia on her fifth day for a follow-up. But we could not wait any longer as I was so worried about my daughter not getting enough milk from me because she refused to latch. I was also terrified with the article something like: “f I had given my baby just one bottle, he could still be alive”.

My husband and I were already crying and arguing. He wanted to give in to giving formula. But I did not want to. We already planned this. The risks that I was thinking was so great. One of which is, she might not like the milk. My niece underwent some trial and error with her milk. I did not want that for my baby. She was already crying and I was thinking to give her formula milk might put her more in danger, like upsetting her tummy. Who knows? I did not want that chance at all. I am diabetic, and formula milk has sugar and this increased my worries more. I know I have milk. She was able to latch in the previous days. I know there are solutions to this. Breastfeeding will always be the best option for me and I have to exhaust all measures to be successful in our breastfeeding journey.

When we got to the hospital, we were referred to another pedia since our pedia of choice was not around. We were so concerned that my daughter would be dehydrated. When we got to the clinic, we were referred to undergo some tests. It was painful to see her in pain but I had no choice but to let her take the tests and figure out what’s wrong with her. Maybe she was feeling something else. When we went back to the clinic, my daughter finally latched. It was a relief she was able to latch. The pedia said it could be on the positioning. I was too awkward in holding her. She also mentioned about cupfeeding, that it takes skills to do this. If this problem still persists at home, she advised us to go back and ask for breastmilk in the NICU if she would refuse to latch again.

That night, my baby was still able to latch but not as great as before. I know something is not right again. We had to go back to our Pedia again, which is our scheduled check-up. I was so worried since it has been a long time my daughter nursed on me for a long time. I think it was around 6 am since I last nursed her, then we were entertained at around 11 am. Her output was very low. When we got there, my husband saw other babies who held onto feeding bottles. He questioned why can’t we be like them? Why not feed my baby my breastmilk through the bottle? We tried to raise this to our Pedia. She strongly advised us to stick direct latching. Before we give in to bottle-feeding my breastmilk, we should try cupfeeding first. She said that we must exhaust all measures before giving in to formula feeding. In our case, we went thru the necessary steps before we consider giving her a bottle even with my own breastmilk on it.

I admire mothers who can produce breastmilk for their babies and store them for their consumption. Not all women are gifted with this as not everyone has the same reaction to pumps. One risk we considered not giving in to bottle feeding, it may lower my supply as baby is sucking less. Producing breastmilk is on a supply and demand law. While pumping may be a solution as a means of a demand, but not all have favorable reactions towards a pump. I was scared I cannot live up to this and since my baby is latching directly, it was understandable if I cannot take a lot of output from my expressed milk.

I was being introduced to different kinds of breastfeeding position because clearly, I was having a hard time doing it. Our pedia also gave us a go signal to run for the NICU if we would encounter latching problem again and she tapped some nurses who could do the demonstration for us for cupfeeding. She gave us two bags of breastmilk in case of an emergency, we would have something to give her. And, yes, we went to the NICU on that night. I brought one of the bags that was given to us. From then on, I was so determined to express my own breastmilk. I only used my hands and from days after I used the Haakaa pump which I just placed on one side of my breasts while I express the other side. I did not have the chance to store my breastmilk on our ref yet because what I express, we usually cupfeed it to her.

I am so fortunate and blessed enough to support groups in my community. They have been my source of information and inspiration as they too are mothers who went through the same struggles. One peer counselor visited me at home, lend me her nursing pillow to help me with the positioning. And one theory she had why my baby refused to latch was because my breasts are both so engorged that she finds it hard to latch. When engorged, milk may have been clogged and making my baby fussier coz the milk flow is slow.

It took us almost two weeks for her to go back to latching directly on my breasts. There was just one time, my husband tried to cupfeed her that he noticed my daughter was being playful on it. So we tried to let her latch to me again. I was so relieved that she was able to latch back. Every time she sleeps, I find time to express and store my milk on the freezer. With this great step, when our ref could not accommodate any more bags, I donated some to my Pedia, to pay forward the kindness of giving us the breastmilk when we needed it. We only got to use the one bag of breastmilk that was given to us, so we returned the other bag as I know other babies would need it.

Remember, if you choose to breastfeed, it is possible, it can be done. Here are the things that I did that made me successful in breastfeeding my daughter:

• Hide all feeding bottles
• Join seminars or classes and let a family member join
• Join Facebook support groups where you can read experiences from other mothers on their success stories
• Learn and read all the methods needed to breastfeed such as cupfeeding, wetnursing, and when to bottlefeed your breastmilk
• Find a Pedia who are breastfeeding advocates
• Find a hospital  strictly implements breastfeeding
• Seek help when needed
• Pray all the time especially most struggles is not just limited on how to handle your baby but may also be on an unsupportive environment

For every problem in your breastfeeding journey, there is always a solution. Reach out.

If you are based in Cagayan de Oro, join Modern Nanay of Mindanao. If you are anywhere in the Philippines or you are a Filipino and would like to connect with other mothers who have the same goal in attaining your own breastfeeding journey, join Breastfeeding Pinays. Read the pinned post or try searching for topics which might help you with your breastfeeding struggles.