My son Will has been pumping for 1 1/2 years starting at the age of 3. Young children have some unique pumping problems. Probably the most frustrating thing was figuring out how to keep the pump in! My son is a typical active boy who constantly wrestles with his brother and two sisters or is crawling on the ground or climbing trees. Besides this we have a swimming pool that he practically lives in during the summer. All these things presented us with challenges to keeping the pump set in. The method that works best for us is to first spray his skin where we are going to insert with Tincture of Benzoin. Next we apply a piece of tape, we use IV 3000 then we insert a Silohette insertion set through the tape. Finally we cover the whole thing with another piece of tape with a hole cut in the middle. We find the Benzoin not only keeps his tape secured it also protects his skin from allergies. The Silohette set works best for a child my son's age since you can visualize the cannula and always know if it is in or not.
Another key to keeping a pump set in is to buy the shortest tubing made and to keep the tubing wrapped around the pump and the pump placed into a deep pocket. My son even wears pants or shorts with deep pockets to bed. By doing this the tubing rarely gets caught and the pump is out of sight out of mind.
My son's HgbA1c's have consistently been in the low 6's. I feel the secret to our success is to accurately weigh and measure all food. If a food does not have a label I weigh it in grams and calculate the amount of carbohydrate in the food by using Carb factors. I have figured out how much insulin my son needs per 1 gram of carbohydrate. After I calculate how many grams of carbohydrate he is eating I then multiply this by the amount needed per 1 gram of carbohydrate. This gives me an exact amount of insulin to give per the pump. For a small child even being off by .1 can make a difference!
Some other tips: Always be prepared by carrying extra batteries, tape and insertion sets with you. Check your child frequently for best control. For small kids, Sweet Tarts which raise the blood sugar about 10 points or so per tart are great for lows. Follow this treatment with a food high in protein, my son likes Kudos bars or peanut butter and crackers. Make sure you treat these foods with the appropriate amount of insulin. Small kids may need their basal rates changed often due to growth spurts. Be prepared to check basal rates, especially at night by having your child fast after dinner and then checking blood sugars every 3-4 hours.
My final tip is for those of you with young kids pumping. Find yourself at least one other person other than your spouse that you can train to take care of your child and occasionally take a break! Diabetes care, especially with a young child can be exhausting and cumbersome. I have a good friend who I have taught over time every trick I know. She can insert the sets and calculate amounts of insulin as well as I can. For the first time since Will was diagnosed with diabetes almost 3 years ago my husband and I have been able to go away overnight! That little break made all the difference in the world to me, it was very refreshing.
Good luck to all of you caring for children with diabetes. Don't forget God is in control and prayer really does help!
Kathy Spain, Mother of Will, age 5
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