Breastfeeding is helpful to you whether you have Type 1 or Type 2 diabetes, are insulin resistant or “pre-diabetic”, or have gestational diabetes. Breastfeeding is also helpful to your child. (For the impact of breastfeeding on the prevention of diabetes in children, please see Diabetes Prevention and Breastfeeding.)
Gestational diabetes occurs during pregnancy. After giving birth, it usually goes away. If you have had gestational diabetes, you are at increased risk of developing Type 2 diabetes later in life. Breastfeeding reduces this risk. It is recommended that you get tested at six to twelve weeks after birth to make sure you no longer have diabetes.
If you are diabetic (with any type of diabetes), you are at an increased risk of having a preterm birth. Skin-to-skin contact can help your baby adapt to being outside the womb. It will also encourage your baby to latch and feed at the breast. Some preterm babies need extra care and are taken to an NICU (Neonatal Intensive Care Unit). If you are separated from your baby, start expressing your milk as soon as you are able.
With any type of diabetes, your baby may develop hypoglycemia or low blood sugar shortly after birth. This is different from the normal dip in blood sugar levels. A baby’s blood sugar level usually drops at one to two hours after birth and rises again within 2 to 4 hours after birth. With hypoglycemia, the blood sugar level doesn’t rise. The baby needs your milk to bring their blood sugar level back to normal. It can be helpful to plan ahead with your birth team to manage these potential events. If at all possible, plan to breastfeed, or feed your expressed colostrum, within the first 3o minutes after birth and at least once an hour until your baby’s blood sugar levels are stable. Skin-to-skin contact has been found to decrease the risk of hypoglycemia in newborns. It also helps trigger the hormones that support breastfeeding. See Skin-to-Skin Care.
If you have diabetes, you may find that it takes a bit longer for your milk volume to increase after giving birth. Colostrum (the first milk) provides all the nutrients your baby needs in the early days. Frequent effective feedings will help your body establish reliable milk production. You may want to express some of your colostrum during the last few weeks of pregnancy (see Prenatal Colostrum Expression). You can take this colostrum to your baby’s birth. If your baby requires supplementation in the early days, this expressed colostrum can be given. If your expressed colostrum is not available, donor human milk may be given. The early introduction of cow’s milk formula may, or may not, be a risk factor for later development of diabetes. The research is not clear on this topic and more is needed. For more information see Establishing Your Milk Supply and How to Know Your Baby is Getting Enough Milk.
It is important to discuss your medications with your healthcare provider before the birth. Most medications used to treat diabetes or insulin resistance can be safely used when nursing. The insulin molecule itself is too large to pass from your blood into your milk. If you are considering using herbs, like fenugreek, discuss taking them with your healthcare provider. They may have an effect on blood sugar levels.
Nursing parents with diabetes have an increased risk of thrush and mastitis. For that reason it is important to protect your nipples from damage and drain your breasts effectively. Make sure that your baby is latched properly with a good, deep latch. See Positioning and Latching.
When it comes time to completely wean your baby, it is important to do so very gradually. This allows your body to adjust to the change in your insulin requirements. Discuss the dose of your medication with your healthcare provider. It may need to be adjusted.
If you have any breastfeeding questions or concerns, contact your local La Leche League Canada Leader who can provide you with support and information.
References
Knip, M., Åkerblom, H. K., Al Taji, E., Becker, D., Bruining, J., Castano, L., ... & Writing Group for the TRIGR Study Group. (2018). Effect of hydrolyzed infant formula vs conventional formula on risk of type 1 diabetes: the TRIGR randomized clinical trial. JAMA, 319(1), 38-48.
Mohrbacher, Nancy. (2020). Breastfeeding Answers: A Guide for Helping Families, Second Edition. Nancy Mohrbacher Solutions, Inc.
Updated July 2023