Lowdermilk Perry and Bobak 1997 Maternal and Neonatal Nursing Family
Centred Care  St Louis  Mosby

While this text covers diabetes mellitus, Insulin Dependent in depth  it
does discuss gestational diabetes (ie diabetes which arrives during
pregnancy whether Insulin dependent or not.)  Most gestational diabetics
return to normal following delivery and are not of serious consequence
however a few may progress to a chronic condition requiring Insulin.   The
prognosis for the baby of a gestational diabetic is better than  for the
baby of an insulin dependent diabetic woman.  However, all babies should be
breastfed regardless.  Women who are Insulin dependent find there dose of
Insulin reduces if breastfeeding and it is stated in Lawrence that the
colostrum has a high glucose content.

HOWEVER, higher levels of glucose in breastmilk does not mean that the baby
will be retuned to a normal state by breastfeeding alone.  True blood
sugars are continued until normoglycaemic.

Infants of gestational diabetics however very rarely need nursery care and
the women return to a normal pre-pregnant state with some monitoring and
nutritional management.

Jaundice for these IDM (Insulin Dependent or otherwise)  is not a specific
problem (or not specific to hypoglycaemia unless the hypoglycaemia persists
or a condition called polycythaemia (many red blood cells) exists.  It is
more likely that jaundice will occur if polycythemia exists.  Polycythamia
is rare these days with good diabetic control.  When polycythaamia does
occur it is a due to the presence of the baby's hyperinsulinaemia related
to the mother's large amount of circulating glucose..

Overall the outcome for the gestational diabetic woman and her baby is
better than that for pre-existing conditions.

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