Women who have Type 1 or Type 2 diabetes or who are considered insulin
resistant or “pre-diabetic” can breastfeed and doing so is good for mother and baby.
Breastfeeding has a positive effect on a mother’s insulin response. For Type 1 diabetic mothers, this can decrease their need for insulin during the breastfeeding period. Mothers who have Type 2 diabetes may find they require less hypoglycemic medication while breastfeeding. Good control of your insulin levels is important while breastfeeding. You may need to do some additional monitoring and be in close contact with your health practitioner during the early weeks until your hormones and your milk productions stabilize.
Mothers who are diabetic are at an increased risk of pre-term birth and their babies may develop prolonged low blood sugar levels shortly after birth (a dip in blood sugar levels one to two hours after birth is normal with blood sugar levels starting to rise again within 2 to 4 hours). Planning ahead with your birth team to manage these potential events can be helpful so everyone is prepared and not making decisions in a stressful situation. If at all possible, plan to breastfeed within the first hour after birth and at least once an hour until the baby’s blood sugar levels stabilize. Skin-to-skin contact has been found to decrease the risk of hypoglycemia in newborns and it helps trigger the hormones that drive breastfeeding.
A mother who is diabetic or insulin resistant may find that it takes a bit longer for her milk volume to increase after giving birth. Colostrum is providing all the nutrients (vitamins, minerals and fats) that baby needs through the early days. Frequent effective feedings will speed up the body’s ability to increase the milk volume. In the event that supplementation is required during the first few days, human donor milk is the best option. A non-cow’s milk based formula is the next best option of donor milk is not available. Early introduction of cow’s milk is considered a risk factor for later development of diabetes. Talk to a La Leche League Leader or lactation professional if you have concerns about your milk supply.
Breastfeeding may make your blood glucose levels harder to predict. To prevent blood sugar dips:
* Plan to have a snack before or during nursing
* Drink enough fluids (plan to sip a glass of water or a caffeine-free drink while nursing)
* Keep something to treat low blood glucose nearby when you nurse, so you
* don’t have to stop your child’s feeding
* Developing a meal plan with your health care provider or dietitian will allow you to achieve stable blood sugar which will help you meet your breastfeeding goals.
Most medications used to treat diabetes or insulin resistance can be safely used during nursing, but be sure to check with your doctor. The insulin molecule itself is too large to pass from your blood stream into your breast milk and it would be digested in baby’s stomach if any did pass through. If you are considering taking herbs, like fenugreek, which may have an effect on blood sugar levels, discuss this with your health care provider. Mothers with diabetes have an increased risk of thrush and mastitis, which is why it is important for them to look after their nipples and drain their breasts regularly. Make sure that your baby is latched on properly and get help if you are experiencing sore nipples or sore breasts. When weaning, a diabetic mother should do so very gradually, so her body can adjust to the changing insulin requirement. Close monitoring and medication adjustment may be required at the end of breastfeeding as it was at the beginning.
For a detailed look at Insulin resistance and lactation insufficiency by Diana Cassar-Uhl, MPH, IBCLC check out this link.
For information and breastfeeding support if you are diabetic or insulin resistant or facing any other breastfeeding challenges please contact a La Leche League Leader.
If you need more information or have a breastfeeding problem or concern, you are strongly encouraged to talk directly to an accredited La Leche League Leader. In Canada, Leaders can be located by clicking http://www.lllc.ca/find-group or Internationally http://www.llli.org/.
If you have found this article helpful, La Leche League Canada would appreciate your support in the form of a donation at http://www.lllc.ca/join-lllc-friends so we can continue to help others breastfeed. Thank you!