Lindsey Desoto is a licensed, registered dietitian and experienced medical writer.
Jonathan Jassey, DO, is a board-certified private pediatrician at Bellmore Merrick Medical in Bellmore, New York.
Mothers with diabetes are encouraged to breastfeed their babies whenever possible. Though it offers many benefits for both the baby and mother, diabetes can make breastfeeding more difficult by affecting milk supply and blood sugar levels.
This article will explore the benefits and potential challenges of breastfeeding if you have type 2 diabetes or gestational diabetes.
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Mothers who breastfeed reap many health benefits, including a decreased risk for certain cancers and health conditions, weight loss, and quicker recovery after delivery.
Though gestational diabetes often goes away after birth, half of the women diagnosed develop type 2 diabetes later in life. Breastfeeding can decrease your risk because it helps your body process insulin and glucose more efficiently.
The amount of time you breastfeed also impacts your odds of developing type 2 diabetes. One study found breastfeeding for more than two months may decrease the risk of developing type 2 diabetes by nearly half. Breastfeeding for over five months was associated with more than one-half reduction in risk.
Additionally, mothers with type 1 diabetes may require less insulin, and mothers with type 2 diabetes may experience better blood sugar control while breastfeeding.
Breastfeeding can help you lose weight and return to your pre-pregnancy weight more quickly. This is partly because breastfeeding can burn as much as 500 calories daily, the equivalent of running at a steady pace for about 45 minutes.
One study found women who exclusively breastfed for three months lost 3.2 more pounds in the first 12 months than those who did not.
Breastfeeding mothers trying to lose weight should consume at least 1,800 calories daily to maintain their breast milk supply. Losing 1 pound per week is considered safe.
Breastfeeding may help decrease a woman’s risk of breast and ovarian cancers. Breastfeeding women often experience hormonal changes that delay the return of their period. This reduces their lifetime exposure to certain hormones (estrogen) linked to an increased risk of these cancers.
Breastfeeding stimulates the release of hormones that help the uterus shrink to its normal size. This can reduce postpartum bleeding and help you recover from childbirth more quickly and easily.
In addition to supplying optimal amounts of nutrients and energy to support a baby's growth and development, breastfeeding can help protect babies against diabetes and other health problems later in life.
Breastfed babies have a lower risk of developing type 1 diabetes and obesity, a risk factor for type 2 diabetes.
A review of existing research found babies who were breastfed for at least six to 12 months were less likely to develop type 1 diabetes than those who were breastfed for a shorter duration.
Though research appears promising, we still need additional studies to clarify the role of nonexclusive and exclusive breastfeeding in developing type 1 diabetes.
Babies who are breastfed often have strong immune systems because breastmilk contains antibodies that have been passed down from the mother.
Research suggests breastfed babies have a lower risk of health concerns throughout life than those who are not breastfed. These include:
The American Diabetes Association, the American Academy of Pediatrics, and the World Health Organization recommend exclusive breastfeeding for six months. After six months, breastfeeding should continue along with the introduction of age-appropriate foods until 2. A longer duration of breastfeeding results in greater health benefits for the child and the mother.
When breastfeeding with diabetes, here are a few things to consider when managing your medications.
Medications, including Glucophage (metformin) and insulin, are considered safe while breastfeeding. More research is needed on the newer drugs used to treat diabetes.
There is insufficient data on the following medications:
Studies show that the insulin requirements for a mother with type 1 diabetes are approximately 21% lower than pre-pregnancy doses.
Additionally, breastfeeding burns calories and may aid in weight loss, lowering your need for insulin therapy. Your healthcare team can work with you to adjust your insulin and other medications during this time.
Though breastfeeding offers many benefits for both mom and baby, it comes with some challenges.
Good blood sugar control is important for lactation. Studies suggest that having gestational diabetes or preexisting type 1 or type 2 diabetes may be associated with a low milk supply.
Researchers found nursing mothers with a low milk supply were more likely to have a diabetes diagnosis during pregnancy than latch problems or nipple issues. Also noted, women with insulin resistance and a higher body mass index (BMI) are more likely to have low milk production.
Breastfeeding can increase the risk of low blood sugar (hypoglycemia) because your body will use sugar from your blood to make breast milk. Mothers should carefully monitor their blood sugar levels while breastfeeding.
You may find it helpful to eat a snack or meal before breastfeeding. Additionally, keeping 4 ounces (1/2 cup) of fruit juice or a tube of glucose gel on hand while breastfeeding can help raise your blood sugar if it becomes too low.
Women with diabetes are at greater risk for developing nipple thrush, a yeast infection that occurs on the nipples of breastfeeding women.
Symptoms of nipple thrush commonly include:
Treatment for nipple thrush often consists of topical antifungal medications and topical antibiotics.
As you navigate breastfeeding with diabetes, working closely with your healthcare provider and lactation consultant is important. A board-certified lactation consultant can help you prevent and manage common breastfeeding concerns.
Joining a breastfeeding support group is also an excellent way to discuss common concerns and connect with others who have breastfed with diabetes.
Though breastfeeding mothers with diabetes may face challenges, it offers many benefits, both for moms and babies. Breastfed babies have a lower risk of diabetes and other health conditions. Mothers with diabetes who breastfeed often have better blood sugar control and other benefits. If you are struggling with a low milk supply or any other nursing problem, a lactation consultant or your healthcare provider can help.
Every woman's breastfeeding journey is different. You may experience some problems or none at all. Though it's recommended to breastfeed for at least six months, any amount of breastmilk you can provide your baby with is beneficial. If you cannot breastfeed, formula is also a good choice and can provide the nutrients your baby needs to grow and thrive.
Yes, metformin and insulin are safe to use while breastfeeding.
Yes. Breastfeeding can help reduce the mother and the child's risk of type 2 diabetes later in life.
If your blood sugar is low during breastfeeding, eat or drink approximately 15 grams of carbohydrates (e.g., 4 ounces of juice, three to four glucose tablets, or 1 tablespoon of sugar, honey, or syrup). Always keep these foods on you while breastfeeding.
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Lindsey Desoto is a registered dietitian with experience working with clients to improve their diet for health-related reasons. She enjoys staying up to date on the latest research and translating nutrition science into practical eating advice to help others live healthier lives.
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