My nine-year-old daughter has had type 1 diabetes for almost eight years. She has been pumping for almost seven years. Her father and I are divorced and are both remarried. Until recently, we have all been on the same page about her care. However, during Spring Break of this year, our daughter started sneaking high carbohydrate/high sugar foods while in her stepmother’s care. We finally convinced her to stop sneaking foods, but now the stepmom gives the child “treats” like ice cream, cookies, and cake on a consistent basis claiming that if she doesn’t, then the child will just sneak them anyway. I have asked the father and stepmom repeatedly to speak with a dietician. They finally called the Diabetes Nurse Educator who explained to them about meal planning and gave us all some specifics about her control, care, and meals. Even with this information, the stepmom has refused to abide and continues to make poor choices in meal planning, depriving the child of ALL foods when she is higher than the target range at meals times, and not changing her pump out when there are messages such as “no delivery” alarms. What else can I do to get proper care for my daughter while she is at their house? Is this medical neglect?

Yikes–what a mess. First, I agree that the behavior you allege is intolerable and may constitute child abuse. I assume that the court awarded each parent joint custody and the child/children split their time between the parents as per an agreement. Where is the biological dad in all this? Does he go along with the dangerous feeding by his wife? You might get your daughter’s physician involved; he could write a letter to dad advising him of the risk to your daughter’s health by the feeding you allege. At the same time, begin a log of the type of feeding you allege to be able to document it. If Dad does not take heed, or you think the danger is severe at this time, you can contact the child welfare authorities in the community in which this taking place. Hopefully, you can find a sympathetic and knowledgeable case worker who can help protect your daughter. You can also go back to your attorney who handled your original divorce/custody matter (or any other attorney you feel comfortable with) or represent yourself to petition to the domestic relations/family court seeking court supervision of the visitation with the father so that his wife does not have the ability to endanger your daughter. What you cannot do is interfere with the child’s visitation with her dad without permission of the court.

DSH