Insulin pumps for children: a parent's guide

Max started using an insulin pump when he was three. It's the reason Captain Lantus exists: Max decided his pump was like Iron Man's chest, keeping him alive and making him a superhero. Here's what we've learned.

What is an insulin pump?

An insulin pump is a small device that delivers insulin into the body through a thin tube (cannula) placed just under the skin. Instead of several injections a day, the pump gives:

• Background (basal) insulin: a small, steady flow throughout the day and night.
• Extra (bolus) insulin: a larger dose for meals and snacks, or to correct a high blood sugar.

The cannula is usually changed every two to three days. Some pumps have tubing that connects to the pump on a belt or in a pocket; others are "patch pumps" that stick directly onto the skin.

Pumps and CGMs working together

Many children now use a pump alongside a continuous glucose monitor (CGM), a small sensor that measures glucose levels around the clock. In a hybrid closed loop system, sometimes called an "artificial pancreas", the CGM and pump talk to each other through an algorithm that automatically adjusts background insulin. You still need to tell it about food.

In England, NICE has recommended hybrid closed loop systems for children and young people with Type 1 Diabetes, with the NHS rolling them out gradually. Ask your diabetes team what is available for your child.

What families often like about pumps

• Fewer injections, which can make a big difference for young children.
• More flexibility around meals, snacks, parties and activity.
• Small, precise doses, which can be helpful for little ones who need tiny amounts of insulin.
• With a closed loop system, help overnight, which can mean more sleep for parents.

Things to think about

• A pump is worn all the time, so think about where it goes for sport, swimming and sleep.
• Cannula changes take practice. Numbing cream, distraction and a superhero attitude help!
• If insulin delivery stops, for example if a cannula comes out, blood sugars can rise quickly, so families need a backup plan from their diabetes team.
• Pumps don't suit everyone, and injections are a great option too. The right choice is the one that works for your child and family.

Helping your child love their pump

For Max, the pump was never something to hide. It was his power source. Giving it a name, decorating the case, and seeing heroes like Captain Lantus wear one all help children feel proud rather than different. As Max puts it: "My insulin pump doesn't hold me back, it powers me forward."

Free guide

Our free illustrated guide Understanding Insulin Pumps explains how insulin travels through a pump, with Poppy Star, and busts some common pump myths. There's also Understanding CGMs for sensors.

Please note: this article is general information written by a parent, not medical advice. Always follow the plan and advice of your child's diabetes team.

Gary RapsonMax's dad and the author of the Captain Lantus books. Max was diagnosed with Type 1 at 18 months old.