Feeding Refusal and Illness
Reviewed by CDE Mehandi Sharma · Updated
This is the situation that frightens parents most, and it is the one worth having a written plan for before it happens.
A baby with diabetes who is refusing feeds or vomiting is in a genuinely different position from a healthy baby doing the same thing. Treatment has been given or is due, reserves are small, and things move fast at this size.
The two dangers pull in opposite directions. If treatment has been given and the feed does not stay down, blood sugar can fall too low. If illness is driving blood sugar up and insulin is withheld because the baby is not eating, ketones can build and your baby can become seriously unwell.
- Check blood sugar much more often than usual — your team will give you an interval.
- Offer small amounts of milk frequently rather than a full feed at once.
- Check ketones if you have been shown how, and if glucose is high.
- Watch for dehydration: fewer wet nappies, dry mouth, no tears, a sunken soft spot.
Go to hospital without waiting if your baby vomits repeatedly, will not feed at all, is drowsy or hard to wake, is breathing fast or deeply, or has ketones with high readings.
For a small baby, the threshold for seeking help should be low. Being sent home reassured is a good outcome.