Breast-feeding when you have diabetes

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Breast-feeding when you have diabetes

Even though you have diabetes, you can have the same success with breast-feeding as any other woman. Breast-feeding is recommended by the American Academy of Pediatrics and other medical specialist organizations because of the multitude of benefits it provides for both the mother and the infant. Make sure your diabetes care team and other members of the health care team know before the birth that you are planning to breast-feed.

Nutritional requirements of breast-feeding

Proper nutrition is one key to a healthy, successful breast-feeding experience. Breast-feeding requires an adjustment in your diabetes meal plan and possibly an adjustment in insulin dosages. Frequent monitoring of blood sugar levels is also necessary during the time you are breast-feeding. If you take a nighttime long-acting insulin (NPH), you may need to decrease the dose to prevent nighttime hypoglycemia, which could result from the increased energy expenditure of producing breast milk during the night. You may need to increase your daytime insulin dosages to cover the additional food intake required to support breast-feeding.

You need an additional 200 calories each day (above what you needed during the last two trimesters of your pregnancy) to meet the high energy requirements of breast milk production. Producing breast milk consumes about 500 to 1,000 calories a day. Some of these calories are supplied by the fat your body has stored during pregnancy, but the rest must be supplied through your diet.

Your calcium intake also should increase. While you are breast-feeding, you lose about to each day. Your health professional may recommend calcium supplements of to a day.

You should eat snacks and meals at regular intervals to prevent high or low blood sugar. Snacks should be scheduled for before or during nursing or before naps to prevent hypoglycemia. A registered dietitian can help you tailor your meal plan to meet your nutritional needs, your target blood sugar range, and your weight goals.

Some examples of healthy snacks include:

• Bagel with cream cheese.
• Meat sandwich.
• Dried fruit and nut mix.
• Crackers with cheese or cottage cheese.
• Hard-boiled egg and toast.
• Fruit salad.

Drink plenty of water and other sugar-free, noncaffeinated beverages. If you drink milk and juice to meet your fluid needs, be sure to count them in your meal plan.

Do not drink alcohol while you are breast-feeding, because it may interfere with your milk let-down reflex, increase your risk of hypoglycemia (if you take insulin), and prevent you from drinking more nutritious beverages. Also, alcohol passes from your breast milk into your baby.

The use of saccharin when you are breast-feeding is not recommended. Aspartame is considered safe, but do not use more than three servings a day. Women with phenylketonuria (PKU) should not use aspartame.

When breast-feeding is not recommended

In some circumstances, breast-feeding is not advised, such as:

• If diabetic complications inhibit your body's ability to handle the additional demands of breast-feeding.
• If you are using medicines or substances that are not compatible with breast-feeding. Oral diabetes medicines are not recommended for breast-feeding women.

For more general information, see the topic Breast-Feeding.

Credits

Last updated:	August 14, 2007
Author:	Caroline Rea, RN, BS, MS
Reviewed By:	Caroline S. Rhoads, MD - Internal Medicine, Matthew I. Kim, MD - Endocrinology & Metabolism
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC