Breastfeeding for diabetics

Q I am 35 this year and pregnant with my first baby - due next month. I was told that I had diabetes prior to my pregnancy. Now I am on insulin twice a day. My doctor said that after birth, I would still need to be on medication.

I would like to find out if I would be able to breastfeed my baby. What are the chances of my baby having diabetes?

If my baby can't take my breast milk, will formula milk be as nutritious?

A Breastfeeding is strongly advised for diabetic mothers because there are clear benefits to both mother and baby. Breastfeeding mothers return to pre-pregnancy weight faster and maintain a healthy weight which is particularly important for diabetics.They also have better control of their sugar levels. Studies have shown that breastfeeding reduces type 2 diabetes in infants.

If you continue to need insulin after delivery, there is no concern whatsoever with breastfeeding. It is safe for the baby as it is not excreted in breastmilk. Other diabetic medications compatible with breastfeeding include glipzide and metformin. There are many options available to you.

Your breastmilk will definitely affect the baby in a positive way. Breastfed babies are less likely to have infections, require admissions to hospital or be obese. Breastmilk may even reduce short-sightedness. It is also a unique bonding experience between mother and baby.

Diabetes is caused by a combination of genetic and environmental factors. Although being diabetic puts your baby at risk of being diabetic, it is not a certainty. Breast-feeding is a good start to reduce the possibility of diabetes in your child.

Breastmilk has been perfected by evolution to meet the complete needs of your baby. Although the various components of milk in human milk may be present in formula milk, it may not be in the right proportion and the most digestible form for your baby. The most important advantage of breastfeeding is the immunities it confers and how it strengthens your baby's immune system, something which formula can never do. For optimal growth and development, breastfeeding is best.

Breastfeeding can be challenging for a diabetic mother - it would not be uncommon for your baby to be separated from you as there may be concerns about low blood sugar in your baby. Making sure you achieve optimal sugar control during pregnancy, and starting breastfeeding as soon and as frequently as possible after delivery, will help minimise that risk. It is important that you discuss your intentions to breastfeed with your obstetrician, diabetes doctor and paediatrician so that you can give your baby the best start in life. If you need help, try talking to a lactation consultant.

Some useful Internet resources:
>>The American Academy of Paediatrics' Policy Statement on Breastfeeding(www.aap.org/policy/re9729.html)
>>Association of Breastfeeding Advocacy, Singapore (www.abas.com.sg)
>>Laleche League ( http://www.lalecheleague.org)

DR YONG TZE TEIN, CONSULTANT, DEPARTMENT OF GYNAECOLOGY & OBSTETRICS, SINGAPORE GENERAL HOSPITAL

For an appointment at SGH, call 6321-4377