It is usually encouraged for most women with diabetes to breastfeed their infants. Breastfeeding has many benefits including reducing the risks of pre-menopausal cancer and the metabolic syndrome for the mom and protection from both type 1 and type 2 diabetes for the infant. (1) What are the special concerns that a woman with diabetes may have about breastfeeding? What are concerns that every woman might have before breastfeeding for the first time?
A pregnant woman with diabetes should start asking questions about breastfeeding way in advance of her due date. Having diabetes is a risk factor for having a preterm (less than 37 weeks) birth. (2) Although this may not happen to you, it is always less stressful to be prepared.
Questions to ask your healthcare team and steps to take to prepare yourself for breastfeeding:
What medication will be advisable for me to take for my diabetes while breastfeeding? Some medications for diabetes are not advisable to take during this time. To help you with information on medications, diabetes and breastfeeding go to http://toxnet.nlm.nih.gov/. At this site (provided by the United States National Library of Medicine) put in a request (example: insulin and breastfeeding or metformin and breastfeeding). This will give you information so you can prepare questions to ask your doctor.
How often should I need to test my blood glucose and do I need a snack? This will depend on the type of medication you need to take and if you need to take a medication. Your blood glucose levels may drop during breastfeeding. This makes a lot of sense, as your body is providing the nutrients your baby needs including carbohydrates. It may be advised to have a snack before or during breastfeeding to prevent lows. Ask your healthcare team for advice on when to test your blood glucose levels (before feeding, during, after) and if you will need a snack with carbohydrates before or during feeding and how much. The amount may vary as your baby grows. Remember you may need to test at night and also have a snack in the middle of the night. Ask if this is needed and what kinds of snacks to have on your night table.
Call the hospital where you will deliver your baby and ask to speak to the lactation consultant or specialist. Tell her you will deliver at her hospital and ask if you can have a consultation with her before the birth. Is there is anything special she can give you ahead of time to read about to prepare for breastfeeding? In some states, your local health department or Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program) can also provide you with good resources for breastfeeding with diabetes. Ask about nursing bras. Where can you purchase them and what size should you bring to the hospital? What type of supplies does the hospital give you to get you started in breastfeeding (example nursing pads)? What should you do to prepare your breasts for breastfeeding?
Be prepared to drink enough fluids to support breastfeeding. This is for everyone not just for those with diabetes. Ask what the amount should be for you and because you have diabetes, what fluids are best.
Think about and purchase necessary supplies and research special equipment. Do your homework. If you are in the WIC program, is there a breast pump loan program that you can use? Call your insurance program if you are not on WIC. Does it cover the cost of a breast pump loan or purchase? What supplies will you need if you use a pump? Examples are breast shields, tubing, bottles etc. Ask your doctor what cream you should use for you nipples if they get sore. Buy a tube of the cream to have it when you get home from the hospital. Other equipment and supplies that you may consider include a nursing pillow and clothes that are easy to breast-feed in. Ask friends that are breastfeeding if they can save their special clothes they used. You can also look in consignment shops to save money on clothes wear during this time. Do you have a rocking chair or comfortable place to sit? If not can a family member give you one on loan you one?
Preparation is key to a less stressful time of breastfeeding. Use resources in your community to help you. Ask the breastfeeding consultant at the hospital what resources are available to help you after delivery. Above all, enjoy every minute of time you have bonding with your baby!