A Nutritional Low

I was diagnosed with type 1 diabetes sixteen years ago when my vision deteriorated from 20/20 to nearly-blind in three days. Since then, I’ve been very fortunate: not only am I still free of complications, but past the initial diagnosis I have never been hospitalized for a low or high blood sugar. No matter how low my sugar goes, I am always capable of getting to the fridge for a cup of juice — or, more frequently, to the pantry for a handful of rocket candies. This is where the trouble starts.

My four-year-old daughter Frances sits beside me on the couch. “Mummy, can I have some rocket candies?” I hand her two, and remember how I was once obsessed about her nutrition long before she could even speak.

For most new mothers, the costs and benefits of breastmilk are relatively slight. Breastmilk confers slight advantages in IQ and immunity which are largely washed out by family environment, exposure, and genetics. But formula has been shown to increase the risks of developing type 1 diabetes, allergies and asthma. It just so happens that I have all three of these conditions, which raises my daughter’s baseline genetic risk of developing them herself. I swore that formula would not pass my premature baby’s lips until she was over twelve-months adjusted, when it has been shown to be safe — this even after the nurses in the Neonatal Special Care Unit plugged formula-filled bottles in her lips, cheerfully disregarding my concerns and blithely stating that preemies don’t get nipple confusion. My daughter rarely passes up an opportunity to prove anyone wrong about anything; and so, nipple confusion she got. This necessitated several weeks of feeding with nipple shields, pumping and bottle-feeding expressed milk, and thirty-six agonizing hours trying to break her silicone habit by feeding her expressed milk by eyedropper, ending in a six-hour feeding-strike standoff. I won; she was finally persuaded to take a breast, and took her revenge by refusing to take a bottle or a pacifier again until she was nine months old.

Her prematurity also resulted in reflux. Small, frequent feedings were required to prevent her tummy from being overloaded, as well as holding her upright 24-hours per day, as any angle less than approximately 75 degrees would result in vomiting and screaming. Her very small size and slow growth pattern had not yet been chalked up to genetics, so I was paranoid about keeping calories where they belonged (in her stomach). But the worst, the absolute worst, were her teeth.

Frances broke her first teeth at three months old, and she used them. She didn’t bite. She chewed. When she nursed, she ground those centimeters of sensitive flesh between her fresh incisors with every suck and swallow; and at every feeding, the wounds grew deeper and wider. I could not refuse to feed her; she had reflux, she was growing so slowly. Over and over I took that little mouth full of all those little teeth and applied them directly to wounds that never healed — for six months. And I did that because of diabetes.

I’d think sometimes about switching her to formula, especially while I whimpered or cried through her nursing sessions. I’d think about it. And then I’d imagine, unbidden, a future scene at a doctor’s office where she too is diagnosed with type 1 diabetes and stuck with a future of health costs and needles and blood tests and measurement and constant worry. I pictured our grief and the guilt I knew I would feel if I felt there was anything I could have done to ward it off, and hadn’t. The pain of nursing her through those sessions was never as great as the grief of those imaginary diagnoses. So every time I toughed it out and let her dig those teethmarks deeper — until finally she consented to take bottles when she was around nine months old. I began pumping and bottle-feeding to give myself a chance to heal, and it all got a lot better until I gratefully switched her to whole milk at thirteen months. Now all that’s left to remind me of that possibly insane level of dedication to infant nutrition are a few hard-to-see scars.

Here I sit on the couch. My daughter is beside me, pleading for rocket candies. I could say no. I could say, “Frances my dear, for Mummy these candies are medicinal, and keep me from getting sick and ending up in the hospital; for you, they are an express train to obesity and cavities and hyperactivity.”

It’s too hard to explain to a four-year-old. After a year of letting her nearly amputate me in the service of perfect nutrition, I let her go to the kitchen to get a small package of her own.