November is not only about raising awareness for prematurity; it’s also Pregnancy and Diabetes Awareness Month. This dual focus shines a spotlight on how diabetes during pregnancy—both pre-existing and gestational diabetes—can impact maternal and infant health. For South African Certified Lactation Consultants (SACLC), this is a critical time to support mothers in managing the challenges of diabetes while fostering successful breastfeeding journeys.
The Link Between Diabetes and Breastfeeding
Pregnancy complicated by diabetes, whether type 1, type 2, or gestational diabetes (GDM), introduces unique challenges. High blood sugar levels can affect foetal development and result in complications such as premature birth, large-for-gestational-age babies, and difficulty stabilising a newborn’s blood sugar levels postpartum.
However, breastfeeding offers remarkable benefits for both mother and baby in the context of diabetes:
For Mothers
Helps regulate postpartum blood sugar levels.
Reduces the risk of developing type 2 diabetes after gestational diabetes.
Promotes quicker weight loss, which can improve insulin sensitivity.
For Babies
Stabilises their blood sugar levels.
Reduces the risk of obesity and diabetes later in life.
Strengthens their immune system through the protective qualities of breast milk.
Challenges in Breastfeeding with Diabetes
Despite its benefits, breastfeeding while managing diabetes can pose challenges, such as:
Delayed Lactogenesis: Mothers with diabetes may experience a delay in the onset of milk production due to hormonal imbalances.
Hypoglycemia in Mothers: Breastfeeding can lower blood sugar levels, increasing the risk of hypoglycemia in mothers, particularly those managing insulin-dependent diabetes.
Baby’s Blood Sugar Stability: Babies born to diabetic mothers might struggle with low blood sugar (neonatal hypoglycemia), requiring close monitoring.
Colostrum Harvesting: A Backup Plan for Breastfeeding Success
Colostrum harvesting, or antenatal milk expression, involves hand-expressing small amounts of colostrum during the 37th–39th weeks of pregnancy and storing it for use after birth. This practice is particularly beneficial for diabetic mothers, as colostrum’s high fat and protein content helps stabilise newborn blood glucose levels and prevent hypoglycemia. It also supports early milk production, increases the likelihood of exclusive breastfeeding, and reduces the need for formula supplementation. While initiating breastfeeding within the first one to two hours after birth is ideal, colostrum harvesting provides a valuable backup for mothers at risk of delayed lactogenesis or low milk supply. It is important to consult with your Certified Lactation Consultant before starting the process or to find out how to harvest colostrum.
How SACLC Can Support Mothers with Diabetes
As SACLC professionals, we are uniquely positioned to guide mothers with diabetes through a successful breastfeeding journey. Here’s how we can help:
Educating Mothers During Pregnancy
Educate expectant mothers about the benefits of breastfeeding and its role in managing diabetes.
Collaborate with healthcare providers, such as endocrinologists and obstetricians, to integrate breastfeeding into the mother’s diabetes care plan.
Managing Delayed Milk Production
Provide practical tips to stimulate milk production, such as frequent hand expression, breast massage, and early initiation of breastfeeding or pumping.
Encourage skin-to-skin contact, which can promote milk let-down and bonding.
Preventing and Managing Hypoglycemia
Help mothers plan for breastfeeding sessions by teaching them to monitor their blood sugar levels and have snacks on hand to prevent hypoglycemia.
Educate on recognizing early signs of low blood sugar and how to respond quickly and effectively.
Supporting Infants’ Blood Sugar Stability
Guide mothers on frequent, small feedings to help stabilise their baby’s blood sugar levels.
Encourage supplemental feeding methods using expressed breast milk if needed, while avoiding practices that might interfere with breastfeeding.
Providing Emotional Support
Pregnancy and diabetes can be overwhelming, and mothers may feel added pressure when breastfeeding doesn’t go as planned. SACLCs offer empathetic support and evidence-based solutions to alleviate stress and build confidence.
Long-Term Benefits Advocacy
Advocate for continued breastfeeding as part of a long-term health strategy for both mother and baby, emphasising its role in reducing risks associated with diabetes.
A Message of Hope and Empowerment
For mothers managing diabetes during pregnancy, the journey may seem daunting, but with the right support, breastfeeding can become a rewarding and beneficial experience. As SACLCs, our role is to equip mothers with the knowledge, tools, and encouragement they need to overcome challenges and embrace the profound benefits of breastfeeding for themselves and their babies.
This Pregnancy and Diabetes Awareness Month, let’s join hands to empower mothers to take charge of their health and their breastfeeding journey. Together, we can foster healthier families and a brighter future.
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