Can CSII assist women with type 1 diabetes in breastfeeding?

The health benefits of breastfeeding to both mother and child are well
recognised and several studies show a protective effect of breastfeeding
against type 1 diabetes in the child (Virtanen et al, 1991; Gerstein, 1994;
Pettitt et al, 1997). Despite this motivating factor, prevalence of breastfeeding
among UK women remains low (Hamlyn et al, 2002). For women with
type 1 diabetes, evidence suggests that optimal glycaemic control during
pregnancy, labour, delivery and the postnatal period is an essential
component of successful breastfeeding (Ferris et al, 1988; Neubauer, 1990;
Neubauer et al, 1993; Ostrom and Ferris, 1993; van Beusekom et al, 1993;
Hartmann and Cregan, 2001). This article examines the use of continuous
subcutaneous insulin infusion (CSII) in breastfeeding women with type 1
diabetes. The experiences of five such women at Liverpool Women’s Hospital
are described, and the cost-effectiveness of the use of CSII is explored.