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Toddler tips?

Discussion in 'Parents of Children with Type 1' started by GAmom, May 28, 2011.

  1. GAmom

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    I was hoping to get some tips from you wise parents who have been there done that, for a newly diagnosed 15 month old boy. I'm sorry to say that my sweet niece's little boy was dx'd with type 1 recently.:(

    My dd was dx'd at 7, so I've havent had experience caring for a baby/toddler.
     
  2. rericsimpson

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    I've only been doing this for a little over a month, but my experience so far has been to expect the unexpected. There have been highs that were too high, and lows that were too low. It seems to take a lot of trial and error to get basal rates correct for kids that are this young. We are still figuring it out.

    I am sure that there are others on the board who can provide better insight.
     
  3. GAmom

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    Thank you :)
    Is there a book anyone has recommended to you for this age group?

    Is your dd on a pump? (you mentioned basal rates, but perhaps you meant long acting lantus/levemir)

    btw your Clara looks like a real cutie! what a great smile!
     
  4. HanksMom

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    Hi

    Our son was diagnosed 7 months ago at 15 months old and has been pumping for about a month on Animas Ping. Nowhere near an expert, but more thank happy to share anything we have gleaned along the way if you have some specific questions.

    Also, it gets easier than it probably seems now, but you have to be really patient.

    Take care!
     
  5. StillMamamia

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    Granted my kid was a bit older (2yrs old, going on 3 in a couple of months back at dx), I can say that not making meal fights is a big point. Can they give the insulin during or after the meal? (supposing they're starting out on MDI!!). If at all possible on MDI to fraction the insulin dose is probably a sanity keeper.

    Testing for ketones (just in case it's needed) - if they don't have the blood ketone meter, then wringing out the pee from a diaper into a plastic cup and dipping the urine ketone sticks works as well.

    Those small baby bottles are great too for measuring liquids and food, and to take them while out and about.

    Young kids are usualy very insulin sensitive, so a small change can affect them in big ways, so better check with the endo team on this one, til they get a feel for how their kid works.

    Rewarding and distraction when giving a shot/changing a site is also helpful. The more we stress, the more our kids stress.

    I hope all goes well. The usual books recommended here are excellent resources - Dr. Ragnar Hanas' "Type 1 Diabetes", the Pink Panther book, etc, etc.

    ETA - using the lowest setting on the poker as well.
     
  6. Lovemyboys

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    My son was dx'd at 13 months and the one thing I had to find out on my own was not to treat a low with 15g of carbs as they had instructed us at the hospital. It took only about 2 carbs to bring him up. Of course everyone is different, but for the little ones, they may not need as many carbs. Also, I wouldn't have let the endo talk us out of a cgm. Now that we have it, I would have gotten it as soon as possible.
     
  7. Lisa P.

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    This is a big one, for us we needed five carbs (Selah was 17/18 months).

    Black olives as free food! Fun on the fingers, soft so less choking hazard, fatty so they satisfy.

    If you need to test urine for anything, put a cotton ball in the diaper and squeeze that out.

    Cut up grapes are good for bringing up blood sugar if it's not an emergency.

    If there's enough fat there, the best place we found for shots in difficult times was the back of the arm (the arm bacon for us old ladies! :p). You can grab the arm gently from the front with your left hand, lightly squeezing so that fat mooshes out the back, and use your right hand to inject. This gives you more control and SPEED, which is the essence of toddler shots because they forget really fast if you let them, but if you get into a wrestling match you'll both be crying for hours!

    Moco89 put this online for us, it's the "dart method" for giving shots and it made a huge difference!

    http://www.scribd.com/doc/9689292/How-to-Give-a-Painless-Injection

    Use the multiclix to test blood sugar, other lancing devices are rough on tender hands.

    We use toes because, let's face it, toddlers never keep their shoes on and their hands are often sticky even after washing! But some people question the accuracy. I figure if we use it consistently it's o.k.

    Best of luck to your neice's family, if we can help any way post away, of course!
     
  8. Jen_in_NH

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    My son was diagnosed at 20 months. We started on MDI, and always bolused afterwards. There's no way to know at that age wat they will and won't eat, and if we tried to pre-bolus, we just ended up having to give him juice to cover the difference.

    We started pumping with an Omnipod 6 months after diagnosis, and that has made life so much better. I wouldn't say it's easier, as the basal rates can be a pain in the bum, but the dosing is certainly better (and easier than having to do multiple shots if he changes his mind and gets hungry)
     
  9. Lisa P.

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    One last note --

    Toddlers with a high bg might as well be on crack. They are so miserable, and they totally let you know.

    So I try to let moms of toddlers diagnosed that as awful as the diagnosis is, getting on track with insulin is going to make your kid feel so much better than he's been feeling. If you had a long run-up to onset, like we did, you have had a cranky baby for a long time. You probably don't even realize how hard life has been. In many ways, this will be a hard life. But in some ways, the coming months will be easier than the past months, because you probably don't even realize how strained and exhausted and drained you and your baby have been. It will get better now, just give it time.
     
  10. uscmedmom

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    My son is 18 months old today, and was diagnosed at 7 months. Life with type 1 and being a toddler is difficult!! I believe the hardest part is when he is low and doesnt want anything to eat. For example, last night he had a low and the only thing I could get in him was the squeezable cookie icing. I guessed wrong and squeezed out too much and a few hours later he was 370. I think its very difficult to NOT see a crazy number almost every day. I do agree only a few grams of carbs will bring them up. You dont need the standard 15g. However, we have found that one day a "plan" may work, but another day it may completely screw up his levels. Please feel free to contact me if you have any questions.
     
  11. Flutterby

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    One of the best tips that I got when K was a toddler as far as carb counting goes.. break whatever they are having up into the number a carbs, i.e if they are having toast that is 12 carbs, cut the toast into 12 pieces, that way when they are done you can look for the remaining pieces and count rather than trying to piece together a piece of toast.. same for banana's, sandwhiches or anything else that can be sliced.. we count grapes as 1 carb each, some may be a bit more, or a bit less, but it averages out to 1 carb piece.

    Pumping was the best thing we could have done for her at that age.. if you are pumping or soon will be you can prebolus a bit and as they eat bolus what they are eating.

    Sorry to hear of your nieces diagnosis. :(
     
  12. GAmom

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    Thanks!

    I so appreciate all these great tips!

    I know other parents were my best resource when my dd was diagnosed, so thanks again. I will take notes, and direct her to this thread, but I dont know how overwhelmed she is now with caring for her toddler.

    Are there any books out there written specifically for toddlers/infants?

    Any websites for toddler size med ids (that a toddler would wear?;))
     
    Last edited: May 30, 2011
  13. kiwikid

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    Sweet Kids by Betty Page Brackenridge is a great book for people starting out with D..
     
  14. mmgirls

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    I would choose a CGM over a pump if I were to have a do over.


    wheigh everything! It is so much easier to figure ut things when you are confident on the carb count. It really does not take that much more time to put a plate on the scale and weigh out either 50 or 100 grams weight of something.

    Next tip.

    choose one if you are wheight out multiple food chooses. If you have a big eater, wheigh out 100 grams weight of EACH food chooce, prebolus based upon previouse history and within the hour figure out carbs and bolus for anyting not covered in the prebolus or cover the prebolus with dessert or an extra snak/drink.
     
  15. SarahKelly

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    I read all the books recommended and actually found that they weren't that they were helpful in concept but not in practice. The best one for me was "Think Like a Pancreas" the rest I felt like just didn't work for Isaac's age and size.
    I have a million tips but honestly the best thing for me at first was to write as much down as possible (how many carbs I gave to bring up a low, how many carbs were in his most frequently eaten foods, what foods caused huge spikes, what foods were truly "free" for him), talk to the endo team whenever things didn't make sense, post on here for help and to know that they're not alone in handling it.
    Also, it helped me to just read on here quite a bit to see how many other parents had children dx as young as mine and now their kiddos are teenagers and doing amazingly well...that tidbit got me through many rough nights of no rest and lots of testing.
    If they're unsure of going for the insulin pump there are a lot of alternatives to "just" insulin - they can get it diluted if they need to or do a variety of several types of insulin to make it work for their family. Again just keep asking until they find what works for their child and their family.
    Lastly, tell them to trust their gut about it all. I can't even count the number of times that we were given a pat answer about how to treat things and they just didn't sound right...after observation and diligence I'd see that I was right and that the endo team wasn't used to dealing with such small/young children so their answers were for a different age group and I'd have to learn how to filter this information so that I'd always "test" out their ideas for a while before using them.
    Such as: correcting Isaac's lows with 15 grams of carbs (4 works just fine!), cheese is never "free" for him, random highs have been rebound highs (which nobody at the clinic told us about), diluted insulin is an option, fruit chews aren't a good choice for bringing up Isaac's lows (because he doesn't chew them up enough), there is no way to account for the amount of food that is dropped, spilled, smeared, smooshed, or just disappears by a toddler - you just have to do your best and check more often, making the tiniest changes in insulin have HUGE impact on this age so we do the three day rule (make the changes observe and check more frequently for three days to see if it was changed in the right direction), packaged food isn't always accurate sometimes it says 6oz but really it may be 8 or 9 or 10..carb factors and a good scale help tremendously with these itty bitty babes...
    so that's all I'll put on here for know, I know it's a lot, but well sometimes I get carried away :)
    I hope they're doing alright and you're able to share all your wisdom with them. ((HUGS)) to them, it's such a hard time. Take care
     
  16. Lisa P.

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    We loved these:

    http://lettersnwood.homestead.com/cwdflink.html

    Which we found here:

    http://www.childrenwithdiabetes.com/d_06_700.htm

    I also loved tattoos. You can special order temporary tattoos so that when you go to a park or other big gathering your kid will have info on her, and you can put diabetes on there. In a pinch, my husband used a sharpie on her tummy! Sounds like a case for CPS, but she loved having her name written on her!

    It was one of my terrors, having Selah separated from me when she was too little to explain anything at all, so if we went anywhere with crowds, etc. I tended to like having two id's on her. I also figure paramedics and etc. won't be as likely to think of a little kid like that having a medical condition, I know they are trained to look for it but I liked to make it clear!

    I've never seen any book tailored for toddlers.

    The Hanas book was the best I found for info that applied more widely. The others tended to forget not everyone was an older child or adult, although my memory might just be wrong about that.
     
  17. StillMamamia

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    http://www.grandmasandy.com/index.html

    Take a look at the above website. It has an online book tailored to younger kids (not that young, but still, helpful to explain things in kids' language).

    Hope it helps.
     
  18. AlisonKS

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    for medical id, we've used this one for a few years http://fiddledeeids.com/adjustable-childteen-medical-id-bracelet-p-60.html we found that it was hard to find boyish medical id's that were small, plus when he had metal ones he liked to bang it on the wall and scratch the paint off. Love boys!
    Agree w/not giving insulin until after the meal. Try to take as many classes as possible so you can learn insulin to carb ratios. Stupid hospital sent us home with he must eat xyz carbs and get a certain amount of insulin. You can't tell a toddler to eat 30 carbs in 30 minutes, sometimes they will, sometimes they won't. Our hospital wouldn't let us do anything except for the original plan until I took their mandatory classes-which were worthless since I learned everything here and the classes on nutrition were very outdated and more geared to type 2's.
    Get glucose gel. It's fast, can squirt half of it in the mouth. My son hated the cake gel. Honey also works but it's harder to measure-one time we found some honey stix and they worked great if the child is old enough to not worry about bottulism (I can't spell).
    The biggest lesson for me is if you don't like the plan your endo has made-get a new one. It is possible for pediatric endo's to be out of touch with what a toddler with diabetes is like.
    Probably the most annoying thing I heard, which is now true-it gets better. That grunting screaming toddler will grow into a child who may tell you he is low/high.
     
  19. Lisa P.

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    Yes. There are a few things that are so different with toddlers, and a good endo will know that. He won't necessarily know everything about treating a toddler, but it is essential that he understand it is different from treating a 20 year old and that he be on the lookout and listen to feedback.

    CGM technology is a good example. For some toddlers it is spot on, but I think for most their bg varies so quickly that it can make CGMing different. We still love the CGM, but if we had tried to use it the way some older kids and adults here do, we'd have been in grave danger. An endo needs to be aware that toddlers can use CGM tech, but that they usually have to use it differently.
     
  20. rericsimpson

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    We've just used the Pink Panther book so far. There are a few more that I want to check out based on some recommendations on this site.

    She is on a pump. They told us at the hospital that the main reason they were putting her on a pump was because she was going to need such tiny amounts of insulin (especially in the honeymoon phase) that we'd have trouble drawing it for an injection accurately.

    For us, it has been helpful to keep careful logs-because we have so many erratic highs and lows, being able to plot a mean/average is extra important. And we call our diabetes team a great deal to adjust rates based on those averages.

    She's a sweet baby-thanks for the compliment.:eek:
     

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