Infant & Toddler Feeding Guide

Comprehensive strategies for managing Type 1 diabetes during the unpredictable eating patterns of infants and toddlers

Breastfeeding with Type 1 Diabetes

Benefits for Baby

  • Reduced risk of developing Type 1 diabetes (though genetics still play a major role)
  • Better immune system development
  • Optimal nutrition for growth and development
  • Enhanced bonding and emotional security

Managing Your Blood Sugar While Breastfeeding

  • Increased caloric needs: Add 300-500 calories per day to your pre-pregnancy intake
  • Frequent monitoring: Check blood sugar before and after nursing sessions initially
  • Hypoglycemia risk: Keep glucose tablets nearby during nursing
  • Insulin adjustments: Work with your team to adjust basal rates and meal ratios
  • Hydration: Drink water before, during, and after nursing

Quick Tip: The "Nursing Kit"

Keep a basket with glucose tablets, water, healthy snacks, and your glucose meter in your primary nursing location. This prevents interrupting feeding sessions for low blood sugar treatment.

Formula Feeding Strategies

Choosing the Right Formula

  • Standard cow's milk formula: Most common choice, well-tolerated by most infants
  • Hydrolyzed protein formula: May be recommended if family history of allergies
  • Avoid: Soy-based formulas are not recommended for T1D families due to potential autoimmune concerns

Feeding Schedule Considerations

  • Consistent timing: Try to establish regular feeding intervals (every 2-4 hours)
  • Night feedings: Coordinate with blood sugar checks when possible
  • Growth spurts: Be prepared for increased feeding frequency and potential blood sugar impacts
Introduction to Solid Foods (4-6 months)

First Foods Timeline

4-6 months: Single Ingredient Foods

  • Iron-fortified rice cereal (mix with breast milk or formula)
  • Pureed vegetables: sweet potato, carrots, peas
  • Pureed fruits: apples, pears, bananas
  • Introduce one new food every 3-5 days

6-8 months: Combination Foods

  • Pureed meats and poultry
  • Yogurt (whole milk, plain)
  • Soft finger foods: well-cooked pasta, soft fruits
  • Begin cup drinking with water

8-12 months: Family Foods

  • Soft table foods cut into small pieces
  • Whole milk (after 12 months)
  • Self-feeding with supervision
  • Three meals plus 2-3 snacks

Blood Sugar Considerations

  • Monitor blood sugar 1-2 hours after introducing new foods
  • Keep a food diary noting any blood sugar patterns
  • Fruits may cause higher blood sugar spikes than vegetables
  • Consistency in meal timing helps with insulin management
Managing Food Refusal and Picky Eating

Common Challenges

  • Meal refusal: Toddlers may refuse meals after insulin has been given
  • Grazing behavior: Constant snacking makes carb counting difficult
  • Food jags: Wanting the same food repeatedly
  • Texture aversions: Refusing certain food textures

Strategies for Success

DO:

  • Offer the same food multiple times
  • Make mealtimes pleasant and stress-free
  • Involve toddlers in food preparation
  • Serve small portions to avoid overwhelming
  • Have backup carb sources available
  • Consider rapid-acting insulin after meals if needed

DON'T:

  • Force feeding or create food battles
  • Use food as reward or punishment
  • Offer unlimited alternatives
  • Skip insulin due to food refusal
  • Stress about every meal
  • Compare eating habits to other children
Emergency Situations

Hypoglycemia During Feeding

  • Stop feeding immediately
  • Check blood sugar if possible
  • Give glucose gel or liquid glucose
  • For infants: rub glucose gel on gums
  • Call 911 if unconscious or seizing
  • Recheck blood sugar in 15 minutes

Illness and Feeding

  • Continue insulin even if not eating well
  • Offer frequent small sips of fluids
  • Try soft, easy-to-digest foods
  • Monitor blood sugar every 2-4 hours
  • Check ketones if blood sugar >250 mg/dL
  • Contact healthcare team early
Working with Your Healthcare Team

Key Team Members

  • Pediatric Endocrinologist: Overall diabetes management and insulin adjustments
  • Certified Diabetes Educator (CDE): Day-to-day management strategies and education
  • Registered Dietitian: Nutrition planning and carbohydrate counting
  • Pediatrician: General health, growth monitoring, and illness management

Questions to Ask at Appointments

  • How should we adjust insulin for growth spurts?
  • What's the best approach for introducing new foods?
  • How do we handle meal refusal after insulin?
  • When should we be concerned about blood sugar patterns?
  • What are realistic A1C goals for this age?

Need More Support?

Connect with other parents navigating T1D with infants and toddlers