Dealing with a child's night low without wake-up

Sustained lows at night are sleep killers for our kids. I have discussed what we do for this before, but a recent post of @Thomas causes me to write this up as a separate thread:

@Thomas, I wonder if your daughter might be able to use a trick we use:

  • first, we use mostly milk at night: it is not quite as fast as juice but I figure it does not represent an excess of calories (since he needs to take milk everyday, and we adjust his milk consumption the next day to take into account his last night)

  • milk is supposed to be a sleeping drought, so it should tend help the kids sleep, except for the fact that they have to drink it—but…

  • we use a hermetically sealed cup with a straw. We gently rotate his face sideways to the pillow, put the straw in his mouth, and 90% of the time he just sips it without waking up. We will occasionally say “drink” if he stops…

  • if we are worried about his waking up, we warm the milk to lukewarm.

  • I make sure to insert the straw inside the ring of teeth, so as to minimize the impact on tooth decay as much as possible (@docslotnick, do you agree?).

We frequently have to use more than one drinking session. For us, each one is 4-6 ounces of skim milk, i.e. about 6-8 carbs. Occasionally, this may be much higher or much lower.

If I know that I will need A LOT OF CARBS, I reinforce the milk with chocolate milk powder, so that the boy won’t have to drink gallons. I will typically add 1x to 2x the carb load of the milk with chocolate milk powder, I always warm it up to lukewarm when I do that, so that to allow for a better mix for the powder (otherwise it remains gritty). For instance, a 6 oz glass of milk can go to 22-24 carbs that way.


By the way, here is an illustration of my treating the boy at night (…), from a past thread:

(Diabetes night watchman strikes at midnight)


Ditto, Liam drinks from a juice box w/o waking up following the steps you’ve outlined. He also chews glucose tablets and eats cheese crackers during his sleep. He never wakes up these days from treatments.


@Michel, Tooth decay from baby bottle syndrome is a lot different from an isolated instance of exposure to a small amount of milk or juice at night.

The problem comes from a constant long exposure, like when a child suckles on a bottle all night long.

I would just strongly recommend that @Kaelan brush his teeth first thing in the morning, especially after the nighttime milk treatment.

@ClaudnDaye, same thing goes for Liam. If brushing first thing in the morning is tough for the little guy, then a rinse with plain water would be next best.


WE use syringes to inject honey into Samson’s mouth. Of course, 4 g of carbs requires 5 mL , so if you have to correct with 15 or 20 g of carbs that could be cumbersome. He never wakes up when we use this method.
He does wake up if he eats stuff like glucose tabs.

1 Like

We tend to treat overnight lows just with glucose tabs and follow up with some cheese. But this is becasue he will wake up when low and be alter enough

@docslotnick we have (what we think is) an unscientific belief that cheese cleans teeth - is there any science behind that?

1 Like

I always gently wake my child up and have her sit up in bed for eating or drinking anything at night. I both want to ensure that whatever it is gets swallowed and there are no choking issues.

The wakeup / go back to sleep - is fast enough that there ends up being no memory the following day that anything even happened.

Many nights this is not required at all as our current basal seems to be working quite well overnight. When this is required, typically only a single event is all it takes for a “bump up”.

In my previous post which the initial post in this thread referred to - which mentioned “cup after cup” - that certainly not typical. Which actually was the reason for the mention.

1 Like