Diabetes and Breastfeeding
There are three main types of diabetes. Type 1 is when the body doesn’t produce insulin. Type 2 is when the body’s response to insulin is impaired which in turn, affects blood sugar levels.The third type is called Gestational diabetes. This occurs in approximately 9 % of pregnancies. Most mom’s will go back to a normal non-diabetic state after delivery. It is important that diabetic moms breastfeed their babies.If they do, it does improve their glucose metabolism in the early days after giving birth. However there are some factors which mom should be aware of. It can delay the coming in of the milk (lactogenesis 2) by a day at least. Mom may need an extra snack at night.
Her baby will be monitored for his/her blood sugar following the birth. There may be a need for supplementation of the infant until the mom’s milk comes in. Early skin to skin and frequent breastfeeding of the infant is important If the baby can room in and his/her glucose levels can be monitored at the bedside. This is ideal. However, baby may be monitored for awhile in the N.I.C.U. until they feel all is stable. The colostrum is important to stabilize the infant blood sugar.
If mom is separated, start her expressing a.s.a.p. If mom is checking her urine, be aware that lactose is reabsorbed from the breast and excreted in the urine which can alter the test results. (do not use Clinitest). Mom could potentially express prior to delivery and store some colostrum for use in the newborn period. It is recommended to use a hydrolyzed formula if formula is required.
Often the babies of diabetic moms are larger than normal. Baby may then experience some birth injuries from a more difficult delivery. That may mean that the infant has extra adaptations to make following the birth. Sometimes the baby has such injuries as a broken collarbone, etc from birth. If mom requires insulin, this is not a problem as the medication doesn’t pass into the breastmilk. Mom is also at increased risk for mastitis ( a breast infection) and Thrush (yeast infection).
Because of the altered glucose levels, this can increase mom’s chance of developing both breast infections and yeast infections. She should dry her nipples after feeds, and be vigilant in latching correctly to prevent skin breakdown. She may need additional calories and as she is weaning, she will need to watch her insulin needs. These levels may decrease as milk production slowly weans off. Milk production overall may be affected by too much or too little insulin. She needs to be monitored for hypothyroidism as this too can affect her supply.
Mom should have her blood sugar checked at 6 weeks postpartum.
Moms can and should breastfeed their infants if they have any form of diabetes. It is good for them and their infant. They will need a heads up to prepare for a few possible deviations in the normal course of lactation, but overall, breastfeeding should be encouraged
References: Breastfeeding and Human Lactation, Enhanced 5th edition, Wambach,Karen, Riordan,Jan.Jones and Bartlett Learning,2016