During your pregnancy you will have the opportunity to discuss your chosen feeding method with your diabetes specialist and your obstetrician. We will support your choice of feeding, bit we would like you to be aware that breastfeeding offers special advantages to mothers with diabetes.
- Since type 1 diabetes is partially inherited, it is particularly beneficial for the baby of an insulin depended mother to be breastfed. Studies indicate that breastfeeding may reduce your baby’s risk of developing diabetes in later life.
- It has been suggested that women with recent gestational diabetes can delay or reduce the onset of type 2 diabetes in later life.
- The hormone released during breastfeeding and the extra energy used during milk production may decrease the amount of insulin the mother needs.
- Many mothers with diabetes report increased feelings of health and well-being while they are breastfeeding.
- The breastfed baby is statistically healthier with fewer ear infections, digestive problems and allergies.
- Certain things have been found to improve your chances of breastfeeding successfully. These are:
Hand expressing your breasts during late pregnancy.
- It can be helpful for you to practice expressing by hand frοm the 37th week of pregnancy. This has been shown to make mothers skilled in the technique of hand expressing. If your baby does not feed in the early postnatal period, then you are able to hand express colostrum and give this to them.
- Hand expressing will also help you to produce more colostrum before your baby is born. You can store the expressed colostrum in your freezer at home for later use.
- Stimulating your breasts releases the hormone oxytocin, which can cause ripening of your cervix and can help labour to start. If your labour needs to ne induced, it should be easier and more successful if the cervix is ripe.
Having early skin-to-skin contact with your baby.
- This means quite simply you and your baby having close skin contact with each other. Immediate skin-to-skin contact, and early feeding are both associated with breastfeeding success and duration.
- Babies maintain their temperature better if kept in skin-to-skin contact. For babies of mothers of diabetes, this is especially important as your baby is less likely to use its precious energy stores if kept warm.
- The first hour after delivery is a valuable time when both you and your baby are alert and in tune with each other. Skin-to-skin contact as soon as possible after delivery can encourage breastfeeding.
Looking after yourself both day and night
For women with type 1 and 2 diabetes- it is important that you take care of yourself. You may need to monitor your blood glucose levels in the night and have snacks close to hand.
Making sure your baby’s blood glucose levels are stable
After your baby is born, it may have a temporary period of low blood glucose levels. This is because high Circulating glucose levels have encouraged your baby’s pancreas to produce lots of extra insulin. Ensuring that your baby receives regular feeds, or hand expressed colostrum, will prevent low blood glucose levels.
- The first test for blood glucose levels will be performed by a ‘heel prick’ four hours after your baby is born and three hourly thereafter (if they remain at 2.5mmol or above).
- If at any time the blood glucose levels are less that 2.5 mmol you will be asked to breastfeed your baby and a ‘top up’ of your colostrum and/or formula milk will be given. Hopefully this will be a colostrum and/or formula milk will be given. Hopefully this will be the only supplement your baby will need.
- If the blood glucose level are a persistent problem, your baby will be admitted to the neonatal unit until his or her blood sugars are stable.
- If your baby is admitted to the neonatal unit you will be encouraged to continue to exclusively breastfeed your baby on demand, and express your milk if necessary. The staff on the postnatal ward and the neonatal unit will provide you with equipment and demonstrate its usage and the safe storage of your breast milk.
Adjust your diet
- For mothers with diabetes, it is important that you close monitor blood glucose levels until you feel they are stable.
- You may need to make some diet changes while breastfeeding to meet the additional energy requirements of lactation. It may be that you need to increase calories in accordance with your glucose levels.
- As a mother with diabetes, it is important that you eat at regular intervals to prevent hypoglycaemia. Some mothers in the early postnatal period find their appetite is poor. You may find that eating frequent small healthy snacks help.
Exclusive Breastfeeding
It is recommended by World Health Organisation and Department of Health that you exclusively breastfeed your baby for the first 6 months. It is also recommended that all babies be breastfed for at lease one year (and as long thereafter as mutually desired). There is significant evidence of the tremendous health benefits of long-term breastfeeding.
Dr Efterpi Tingi
Consultant Obstetrician and Gynaecologist
