Women who have diabetes prior to pregnancy and those who have gestational diabetes might wonder how diabetes can affect breastfeeding.
High blood sugar levels in pregnancy can affect your baby’s health and increase your risk of developing type 2 diabetes later in life.
The good news is that mothers with diabetes can breastfeed their babies. As well as the many incredible long term health benefits that breastfeeding offers, breastfed babies have a lower risk of diabetes later in life.
This article answers common questions about diabetes and breastfeeding, including: ‘Can diabetes potentially affect my milk supply?’
Does gestational diabetes affect breast milk supply?
Gestational diabetes mellitus is diabetes that is diagnosed for the first time during pregnancy. Hormonal changes in pregnancy can result in insulin resistance, or the body’s ability to process insulin effectively; this results in high blood sugar levels.
You can read more about this in BellyBelly’s article Gestational Diabetes | What You Need To Know.
Many mothers with diabetes have a delayed process of lactogenesis, or their breast milk ‘coming-in’ after giving birth. Milk production is considered to be delayed if a mother’s breast milk supply hasn’t come in 72 hours after giving birth.
Although there are many confounding factors that can lead to a delayed onset of lactogenesis, research has found that insulin resistance has a role in activating the onset of mature breast milk supply and production.
Can pre existing diabetes negatively affect breast milk supply?
As previously mentioned, insulin resistance has been found to affect early breastfeeding, due to the delayed onset of mature milk production. There are also other factors that lead to diabetic mothers experiencing problems with breastfeeding and breast milk supply.
Type 2 diabetes is associated with obesity. It is well established that obese mothers have a higher risk of delayed lactogenesis and shorter breastfeeding duration. Obesity and diabetes also increase the risk of having a premature birth or cesarean birth, two common complications that can negatively affect the early establishment of breastfeeding and breast milk supply.
Diabetes in the mother also increases a baby’s risk of hypoglycemia and early formula supplementation.
You can read more about this in BellyBelly’s article Low Blood Sugar After Birth – 5 Important Facts.
What is the best way to establish my milk supply if I have diabetes?
Sometimes babies of mothers with diabetes are born with low blood sugar (hypoglycemia). Expressing milk antenatally and storing the colostrum to use in the event your baby needs supplemental feeding can help avoid the early use of formula. Avoiding formula in the very early days after your baby’s birth helps establish breastfeeding.
Stored colostrum can also be given to babies who are separated from their mothers at birth for medical attention.
The DAME trial, a study on Diabetes and Antenatal Milk Expressing funded by the Australian National Health and Medical Research Centre, aimed to answer the question of whether it is worth advising women with diabetes to express breast milk antenatally. Results found that in mothers who had expressed colostrum during pregnancy, exclusive breastfeeding was more likely during their hospital stay.
Antenatal expressing is usually safe from 36 week gestation; you should, however, check with your health care team prior to commencing.
You can read more about this in BellyBelly’s article Expressing Colostrum During Pregnancy.
Aside from antenatal expressing, skin to skin contact as soon as possible after birth and frequent breastfeeding (about 8-12 times in 24 hours) are the most effective ways to establish breastfeeding once your baby has been born.
Seeing a lactation consultant prenatally is also a great way to put support systems in place before your baby arrives. It can also set you up for breastfeeding success.
How can I increase my milk supply if I have diabetes?
Breast milk production works on the principle of supply and demand. Put simply, the more milk that is removed from your breasts – either by breastfeeding your baby or expressing milk using a breast pump – the more milk your body will make.
You can read more about this in BellyBelly’s article How To Increase Milk Supply | Fast! 9 Best Things To Do.
Babies who are born early or with health problems might not be able to breastfeed directly. Using a hospital grade pump will help establish your supply until your baby is able to breastfeed directly.
For babies that are born at term, the following steps will help get breastfeeding off to the best possible start:
- Spend time skin to skin with your baby immediately after birth
- Allow your baby 1-2 hours to find the breast and have the first breastfeed after birth
- Follow your baby’s cues and breastfeed frequently throughout the day and at night. Newborn babies average 8-12 feeds, with periods of cluster feeding every 24 hours
- Keep glucose levels stable, as much as possible, by eating regularly and keeping snacks nearby, to raise blood sugar quickly, if necessary.
Does breastfeeding affect blood glucose levels?
It is important that women with diabetes who are breastfeeding maintain their blood sugar levels. When blood glucose levels are constantly fluctuating, the body’s hormonal balance can be affected. In the early days and weeks of your baby’s life, it might be necessary to monitor blood glucose levels before and after breastfeeding.
The good news is that research from the American Diabetes Association has found breastfeeding improves glucose metabolism and helps your body process insulin better. If you have had gestational diabetes, breastfeeding also lowers your risk of developing type 2 diabetes.
How can I control my diabetes and breastfeeding at the same time?
Women with diabetes should talk to their healthcare team or a registered dietician about their diabetes and breastfeeding. A dietician will help plan a healthy diet with the right balance of carbohydrates and insulin doses.
Most diabetes medications, including metformin, are safe to take while breastfeeding.
It’s also worthwhile to seek breastfeeding support from a registered lactation consultant, to manage any early infant feeding problems and make sure you are able to breastfeed successfully when you have diabetes.
