susan,
 
yes, it is kind of frustrating with a 'borderline' diagnosis of gestational diabetes!  the routine is to do blood sugars on the baby and each hospital has it's own protocols.  the best thing to do is to put baby to breast and get some colostrum in.  colostrum is the best blood sugar stabilizer ever!  if baby won't latch for whatever reason then pump/hand express as much colostrum as possible and get it into your baby.  supplementing is only necessary if the blood sugar is critically low, again, according to hospital protocols.
 
it's my personal experience that moms diagnosed and poorly controlled or with type 1 diabetes have issues with delayed establishment of supply.  if you are well controlled and bf early and often you should be fine. :-)
 
as far as future risks, that's hard to say.  i was diagnosed with gestational diabetes with baby # 4 and immediately put on insulin.  when he was about 10 months old i was diagnosed with type 1 diabetes.  the usual precaution would be to check your blood sugar for a few weeks pp and with yearly exams in the future.  hopefully you will be blessed with a healthy future without diabetes!
 
blessings to you!
 
Angie Gleason RN, IBCLC, RLC
Texas Children's Hospital
6621 Fannin Street
MC 1-1410
Houston, Texas  77030-2399
832-826-6176 

________________________________

From: Lactation Information and Discussion on behalf of [log in to unmask]
Sent: Wed 1/2/2008 4:38 PM
To: [log in to unmask]
Subject: gestational diabetes: breastfeeding issues



Hello all, 

I'm currently 32 weeks pregnant and was diagnosed with gestational diabetes 
at 28 weeks.  I seem to have a mild case (if there is such a thing) because 
I'm able to control my blood glucose with minor diet modifications mostly at 
breakfast time.  I did not have GD with my first pregnancy and frankly am 
reeling a bit from this diagnosis because I don't feel like I fit the risk 
profile.  My weight gain has been about 17 pounds so far.  My  total weight gain
with my first pregnancy was 24 pounds.  I'm  delivering at a well-known U.S.
hospital with a midwife.   

My question is this...what do I need to be on guard about immediately 
following the birth of this baby?  I've searched through the LactNet  archives (and
elsewhere) and here's what I've come up with:

a) Baby's blood glucose may be low after birth prompting hospital staff to 
suggest supplementing with formula or sugar water.  I understand that  putting
baby to the breast should be tried first, but when is  supplementation really
warranted?

b) My milk may be delayed in coming in.  My 3-year old daughter  self-weaned
12 weeks into this pregnancy so I'm thinking that perhaps this would  be less
of an issue for me than say a first-time mom?

c) My risk for future diabetes will be lower because I'm going to  breastfeed
this child. 


I'm asking because I want to be prepared to rebut (or accept) advice  that
hospital personnel might make.  Am I missing anything that might  be thrown our
way?  I greatly appreciate the collective wisdom of this  group.

Thanks very much. 

Susan  




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