“I was apprehensive about breastfeeding my first kid because of my diabetes and insulin shots,” says 30-year-old Beth Hawkins, a massage therapist from England in an online interaction with Happiest Health. Hawkins was diagnosed with type 1 diabetes at the age of nine.
“I was afraid whether my body would be able to secrete enough milk for my child,” she says.
Hawkins decided to explore further and started making better dietary choices to manage her diabetes more efficiently.
“I started to spread out my meals and adjust my insulin dosage accordingly. I went on to breast feed my first-born Sage till he turned one and will follow the same with my younger kid Jaigo,” she adds.
Breastfeeding anxieties of women with diabetes
One of the main anxieties among pregnant Type 1 diabetic women is any adverse impact of insulin dependency, leading to reduction in milk secretion. Numerous studies point that there could be a delay in milk secretion in mothers with gestational diabetes (diabetes developed during pregnancy) but it has been reiterated that it should not be a reason for them to worry about breastfeeding.
Dr Shweta Budyal, Consultant Endocrinologist & Diabetologist, Fortis Hospital, Mumbai, India explains that women have good capacity to produce quality breast milk with or without diabetes. She also points out that breast milk gets secreted due to prolactin production and oxytocin reflex (milk-ejection reflex) when the baby tries to suckle on the mother.
“As diabetic mothers come with a higher risk of assisted delivery or C-section which could keep the baby and mother apart, this could initially delay the stimulation and thereafter the milk secretion,” she adds. But this is soon normalised and breastfeeding should not be interrupted.
Breastfeeding and insulin shots
Another common query of mothers about insulin shots for diabetes management is whether excess insulin passes onto their child through breast milk. Dr Parimala V Thirumalesh, Sr Consultant- Neonatology & Pediatrics, Aster CMI Hospital, Bengaluru says that most of the insulin gets metabolised in the mother’s body and only 10% of mother’s insulin intake seeps through the breast milk to the baby.
“Insulin would adversely affect the baby only if the infant gets injected directly with insulin,” she adds.
Dr SM Fayaz, consultant-Internal Medicine, diabetology, Kinder Women’s Hospital and Fertility Centre, Bengaluru, India also says that insulin is safe during pregnancy and women should be more careful about regular oral medications which should be strictly taken as per doctor’s advice only.
How breastfeeding helps the baby
According to the Centers for Disease Control, breastfeeding is essential to ensure the health of the growing baby. One of the main reasons why breastmilk, especially the colostrum (thick milk secreted for the first time after childbirth), is considered the best nutrient for a new born baby is because it contains a high amount of antibodies that strengthen the overall immunity of the baby. This serves as the building blocks for a strong immune response against various inflammatory conditions in the infant.
It is recommended that babies should be breastfed for at least the first six months before introducing other food items slowly in their diet along with breast milk. This protects the baby from multiple conditions including:
- Asthma
- Obesity
- Type 1 Diabetes
- Severe Lower respiratory disease
- Ear Infections
- Sudden Infant Death Syndrome (SIDS)
- Gastrointestinal conditions
According to the American Diabetes Association, some infants born to women with diabetes including gestational diabetes might have low blood sugar immediately after delivery. This is due to the effect of high sugar and insulin levels of the mother on the baby and is generally normalised within a few days of regular breastfeeding.
Breastfeeding benefits for the mother
- Dr Budyal explains that breastfeeding is an energy-consuming process that mobilises the fat, thereby helping shed excess weight gained during pregnancy.
- Effective weight management reduces the risk of developing type 2 diabetes and cardiovascular risks for those diagnosed with gestational diabetes.
- Breastfeeding tends to lower the risk of breast cancer as lactation leads to lesser secretion of oestrogen.
- Dr Thirumalesh points out that excess milk is a good medium for bacterial growth leading to mastitis (inflammation of mammary glands usually due to bacterial infection). Diabetes increases the risk of infection manifold as blood sugar boosts bacterial growth and also slows the healing of the wound. Frequent breastfeeding prevents breast milk retention, thus avoiding mastitis.
Tips to manage blood sugar levels during breastfeeding
Dr Ankita Chandna, Associate Director- Obstetrics & Gynaecology, Max Super Specialty Hospital, Delhi, India provides following tips to manage sugar levels for nursing diabetic mothers
- Consistently monitor blood sugar levels (both before and after nursing)
- Eat a snack either before or after breastfeeding (as per doctor’s advice)
- Stay hydrated
- Get enough sleep.
Takeaways
Breastfeeding improves glucose metabolism and insulin sensitivity in both mother and baby. It also lowers risk of developing Type 2 diabetes in women diagnosed with gestational diabetes. Women with diabetes (especially Type 1) should consult their doctor, prepare a healthy diet plan and adjust their insulin dosage as per the requirement. Experts point out that breast milk strengthens immunity in infants.
