Can mothers with diabetes continue breastfeeding? Learn whether breastfeeding is safe with type 1, type 2 or gestational diabetes, along with potential benefits, blood sugar considerations and important precautions for new moms.
Diabetes during pregnancy is common. Some women develop gestational diabetes, which usually settles after delivery. Others already have type 1 or type 2 diabetes and continue to need treatment after childbirth. In some cases, diabetes first diagnosed during pregnancy does not go away after delivery.
This can leave new mothers wondering whether they can breastfeed safely. In most cases, they can. Diabetes itself is not a reason to avoid breastfeeding.
Breastfeeding and your baby
Breast milk provides the nutrients a baby needs in the early months and contains components that help protect against infections. Breastfeeding may also be linked with a lower risk of childhood obesity and some metabolic problems later in life.
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For you, breastfeeding increases energy use after delivery. It may support gradual weight loss and can have a positive effect on glucose metabolism. These effects vary from one woman to another, so breastfeeding should not be treated as a substitute for diabetes treatment or a specific weight-loss plan.
Managing diabetes while breastfeeding
After delivery, blood sugar levels often fall, especially in women who had gestational diabetes. If you have type 1 or type 2 diabetes, you may still need insulin or other medication.
Your medication needs to be reviewed before and after delivery. Insulin is compatible with breastfeeding. Metformin is also generally considered suitable because only very small amounts pass into breast milk.
Some newer diabetes medicines have less safety information during breastfeeding. SGLT2 inhibitors and several newer glucose-lowering medicines are generally avoided unless your doctor has a specific reason to prescribe them. Some sulfonylureas may be used in certain situations, but they can increase the risk of low blood sugar in the baby. Do not stop, restart, or change your diabetes medicine without speaking with your doctor.
Breastfeeding can lower your blood sugar because your body uses glucose to produce milk. This matters more if you use insulin or another medicine that can cause hypoglycaemia. Check your glucose as advised, eat regular meals and snacks, drink enough fluids, and keep a fast source of carbohydrate with you in case your blood sugar drops.
Breastfeeding problems can usually be managed. Sore or cracked nipples, breast engorgement, and mastitis do not usually mean you need to stop breastfeeding. Early treatment can prevent these problems from becoming more difficult. If feeding is painful or your baby is struggling to latch, a lactation consultant can help identify and correct the problem.
What matters most is keeping your diabetes under control while making sure you and your baby are getting enough nutrition and support.
If you have diabetes, breastfeeding is usually safe and is encouraged when there is no medical reason to avoid it. Your treatment may need to change after delivery, and your insulin or glucose-lowering medication should be reviewed with your healthcare team. With appropriate monitoring, food, fluids, medication and breastfeeding support, most women with diabetes can breastfeed successfully.
- This article is authored by Dr. Shrinath P Shetty, Consultant Endocrinology, KMC Hospital Mangalore
