p. 541-543 of the 2nd ed. Of Breastfeeding and Human Lactation by Riordan
and Auerbach provides excellent (and very well referenced) information on
diabetic mothers nursing their babies after giving birth. Breastfeeding
ameliorates the symptoms of diabetes. To summarize:

1. The initiation of breastfeeding is delayed by about one day. Women with
insulin-dependent diabetes mellitus (IDDM) have lower prolactin levels than
women without diabetes; so they need additional attention if they are to
establish lactation. Pumping to stimulate the milk supply is advised. Donor
milk can be used until a sufficient milk supply is established.
2. Blood-glucose meters enable a mother to self-monitor day-to-day changes
in blood-glucose levels.
3. Because fasting plasma-glucose levels during the exclusive breastfeeding
period are significantly lower than are the glucose levels of women with
IDDM who have stopped breastfeeding or who have never breastfed (even in
the face of higher caloric intake), less insulin is needed. One study
showed the need for a 27% reduction in prepregnancy insulin to avoid
hypoglycemic reactions.
4. Sudden drops in blood glucose appear to affect milk production (i.e.,
lowers it) but milk supply can be rebuilt.
5. Mothers with diabetes may have a higher risk of mastitis--especially if
their blood-glucose is not well controlled--and for candidiasis--if
blood-glucose levels are elevated. All of which can be helped with careful
monitoring and teaching about breast care.
6. Weaning requires adjustments in diet and insulin--gradual weaning is
best.

Cynthia Good Mojab, MS
Ammawell
Email: [log in to unmask]
Web site: http://ammawell.homepage.com

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