YBy Marsha Walker, RN, IBCLC

You may have just found out that you have diabetes. Or you may have had it for awhile.Happily, breastfeeding is possible. It is good for both you and your baby.

Before Your Baby Is BornTaking good care of yourself during pregnancycan help your baby to be healthy. You can alsoget ready for breastfeeding.

Talk with your baby’s doctor about how tomonitor your glucose levels after the birth.About half of babies of diabetic mothers mayhave low blood sugar soon after birth.If you have type 1 diabetes, discuss nighttimeinsulin dosages, calorie needs, and snacksbefore each breastfeeding.Contact a lactation consultant to talk aboutbreastfeeding. Learn how to express colostrumfrom your breasts in case breastfeeding isdelayed and/or your baby needs to besupplemented in the hospital.

After Your Baby Is BornYour baby may be taken to a special carenursery. If she needs to be supplemented, askthat she receive your colostrum or milk froma human milk bank instead of formula. Standardformula increases the risk for your baby gettingdiabetes. If formula must be used, ask that ahypoallergenic formula be given to your baby.Keep your baby skin to skin with you. Skin-to-skin contact immediately after birth keeps yourbaby warm and makes it easy to startbreastfeeding. It keeps her blood sugar levelsfrom dropping due to separation or crying.Breastfeed soon after birth and often [see box].This will stimulate milk production andstabilize your baby’s blood glucose level. If thereare times you cannot breastfeed, express yourmilk until you are able to put our baby tobreast.

22 April 2006

There are 3 basic types of diabetes [see box].Breastfeeding is helpful with all 3 types.When you breastfeed, it:Lowers your baby’s risk of getting diabetes.Helps you lose weight between pregnancies.Helps your body to use insulin in a better way.Lowers your need for insulin.Helps prevent obesity.

Type 1 diabetesThe pancreas does not produce enoughinsulinRequires insulin injection

Type 2 diabetesObesity and high blood pressure increasethe risk for this type of diabetesIs managed by diet or oral medicineA woman may be switched to insulin duringpregnancy and breastfeeding

Gestational diabetesOccurs during pregnancyUsually goes away after pregnancy, thoughit may re-occurWomen with gestational diabetes who donot breastfeed the baby from that pregnancyare twice as likely to develop type 2diabetes

Types of Diabetes

Breastfeeding With Diabetes: Yes You Can!

© 2006 International Lactation Consultant Association. ILCA’s INSIDE TRACK may be photocopied and distributed freely but not sold, either by, for, or to any person or profit, non-profit, public, or private entity. Questions? Call (919) 861-5577.

Put your baby to breast within 1 hourafter birthNurse once every hour for the next 3to 4 hoursNurse every 2 to 3 hours until 12 hoursof ageNurse at least 8 times each 24 hoursduring your hospital stay

Stimulating Milk Production andPreventing Hypoglycemia

Place baby skin to skin on your chestWatch for rapid eye movements under theeyelids (the baby will wake easily)Move baby to breast when baby showsfeeding cues

Sucking movements of the mouth andtongueHand-to-mouth movementsBody movementsSmall sounds

Feeding Your Sleepy Baby

Your Local Lactation Consultant

If your baby is a little slow nursing at first, youmay need to watch closely for feeding cues[see box].

Make sure you know how to tell when yourbaby is swallowing. Use alternate massage ifyour baby doesn’t swallow after every 1 to 3sucks.

Massage and squeeze the breast each timeshe stops between sucks.This helps get more colostrum into herand keeps her sucking longer.

Your blood glucose will be monitored in thehospital. Meal plans often have 3 meals and 3small snacks. Eating something before everybreastfeeding will help you remember to eatand keep your blood glucose steady. Ask alactation consultant to help you write a planof how you will feed your baby at home.

After You Go HomeDiabetes may delay the rapid increase in milkusually seen on day 3. It may take a day or twolonger for your milk to come in.

Breastfeed 10 to 12 times each day untilyour milk supply increases.

Check for at least 6 wet diapers and atleast 3 bowel movements every 24 hoursafter the first 3 days.

Take your baby to see her doctor for a weightcheck a day or two after you go home.Delay feeding cereal or other foods until yourbaby is 6 months old. This may help protecther from developing diabetes.Taking Care of YourselfMonitor your blood sugar closely.

Your blood sugar may fluctuate while youbreastfeed.Herbal products can affect your bloodglucose levels.

If you have type 1 diabetes, you may have lowblood sugar within an hour afterbreastfeeding.

Eat a snack with carbohydrate and proteinbefore or while nursing.Keep a snack, glucose tablets, or fast-actingsugars in places where you nurse in caseof an emergency.

Work with a lactation consultant to help avoidsore nipples as your baby learns to latch onand suck.Diabetic mothers with sore nipples are morelikely to develop a yeast infection or a breastinfection (mastitis).