Breastfeeding tips for mothers and infants with diabetes

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Being a new mother is exhilarating. Your happiness has no limits and you want to give your baby the best. This can be confusing at times as there is a plethora of advice out there and a lot of it is contradictory. And if the mother has any pre-existing medical conditions, then confusion and anxiety is inevitable.

One of those extremely common medical conditions is diabetes. It is a chronic metabolic disorder of impaired carbohydrate metabolism, where the body is unable to properly use glucose.

There are two categories of pregnant women with diabetes mellitus:

Pre-pregnancy diabetes which can be type 1 or type 2

· Gestational Diabetes that develops during pregnancy

The most common dilemma a mother with diabetes faces is:

Should she breastfeed?

Yes, she should. Breastfeeding offers countless health benefits for both baby and mother, even more so for babies of mothers with diabetes. Therefore, she should definitely breastfeed.

Would insulin or another diabetes medicine affect the baby?

Insulin or other diabetes medications can affect the mother’s blood sugar. Most of them do not enter breast milk and therefore do not affect the baby.

Will I be able to make enough milk for the baby?

Insulin plays an important role in the production of breast milk. In diabetes, either insulin is not produced (type 1) or the response to insulin is impaired (type 2). There may be some delay in stage 2 lactogenesis when breast milk production increases. This can be managed by early skin-to-skin contact with the baby, early and frequent breastfeeding, and careful monitoring of the infant.

Benefits of breastfeeding for the mother

Breast-feeding improves glucose metabolism in the early postpartum period and helps maintain normal blood sugar levels and early remission of gestational diabetes.

Breast-feeding reduces the need for insulin or oral anti-diabetic medicines.

· Breastfeeding reduces the risk of developing type 2 diabetes in gestational diabetes by seven times.

· Breastfeeding helps you lose weight. Almost 500 calories per day are burned by exclusive breastfeeding and thus contribute to better blood sugar control.

Breastfeeding reduces the risk of breast cancer and ovarian cancer.

· Breastfeeding helps reduce postpartum blood loss, delays menstruation.

· Breastfeeding releases the hormone oxytocin, which is known to improve mood and reduce stress.

Benefits of breastfeeding for the baby:

· Helps reduce obesity which is a great risk of developing diabetes and other metabolic diseases.

· Reduces the chances of developing type 2 diabetes by 33 percent.

· Protects against diarrhea, respiratory infections, ear infections.

· Protects against certain childhood cancers such as leukemia, lymphoma.

· Helps in better brain development. Breastfed babies have an IQ 6 points higher than non-breastfed babies.

Challenges faced by mothers with diabetes

Increased risk of developing hypoglycaemia in babies born to mothers with diabetes.

· Mother-baby separation, as newborns are often kept in neonatal intensive care units because they have a high risk of developing low blood sugar. This can delay the onset of breastfeeding.

Excessive use of infant formula or higher milk in newborns due to the risk of hypoglycaemia.

Insulin is very important for breast milk production and therefore diabetes can affect milk production initially.

High blood sugar in the mother may put her at risk of developing a bacterial infection of the breast, such as mastitis or fungal infection of the breast or thrush.

– Fluctuation of blood sugar in the mother and risk of hypoglycemia or hypoglycemia.

Practical advice for mothers

Give the baby plenty of skin-to-skin contact, which helps maintain the newborn’s temperature, blood pressure, and heart rate. It reduces the stress of childbirth and helps stabilize the infant’s blood sugar. Start breastfeeding as early as possible as this will help get a better latch and maintain sugar levels. Offer expressed colostrum to the baby if direct attachment is not possible.

Regular monitoring of blood sugar levels in mothers is recommended. Breastfeeding is known to improve glucose metabolism and therefore the need for insulin or other oral drugs decreases with breastfeeding, so determine the dose modification of insulin and other oral drugs Consequently.

Regular monitoring of the baby in the first days after birth. Keep an account of urine output, activity level. Observe the effective latching and transfer of milk. Supplement with expressed breast milk if latching is suboptimal. Monitoring the blood sugar level in the baby.

Also, be sure to eat healthy, low-carb meals at regular intervals. Keep some healthy snacks by your bedside.

(The author is MD Pediatrics, CLEC (Calif.), IBCLC.)


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