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Diabetes and Breastfeeding – Why Breastfeed?

  1. The American Academy of Pediatrics recommends that all babies receive exclusive breastmilk for the first 6 months of life and extended to at least a year or beyond. This national standard is recommended because of all the wonderful benefits that breastmilk provides to the baby, the mother, the family unit, and to society.
  2. Breastmilk is the optimal choice of nutrition for all infants. The Healthy People 2010 national goals are to have 75% of all moms initiating breastfeeding after delivery, 50% exclusively breastfeeding at 6 months, and 25% still providing breastmilk for their children at 12 months of age. 
  3. A diabetic mother should be given the same opportunity to breastfeed her baby as a non-diabetic mother. Diabetes is not a contraindication for breastfeeding.
  4. There are over 300 components in human breastmilk which cannot be duplicated in formula, including hormonal factors that help control metabolism and appetite.   
  5. Breastmilk is easier to digest and has natural sugars.
  6. Research indicates breastfed children have a lower risk of diabetes, both Type I and Type II.
  7. Research has also established that breastfeeding helps prevent childhood and adult obesity, which are major risk factors for Type II diabetes.
  8. BENEFITS
    1. One of the benefits for a diabetic mother who successfully breastfeeds is lower daily blood sugar levels which requires less daily use of insulin. The reason for this finding is the sugars in her blood are transferred to the breastmilk to meet the infant’s needs.
    2. Diabetes is a genetic disorder. We cannot alter the genes we are born with, but we can alter our daily nutrition. Breastmilk is the optimal nutrition for all newborns. 
    3. Many diabetic mothers either do not choose to breastfeed or quit breastfeeding because of a lack of support and misinformation.
    4. Babies born to diabetic mothers have an increased risk of complications at the time of delivery due to babies being larger in size, unstable blood sugars, higher risk for cesarean surgical birth, and possibly being delivered before their expected date of birth. Breastfeeding or providing breastmilk for the baby may prove to be a challenge during the first few weeks or days after the delivery. Babies may be admitted to the neonatal intensive care unit (NICU) to be monitored more closely. This separates the mother and the baby. Baby-Friendly Hospitals will provide the support and education needed for mothers to provide breastmilk to their babies.
    5. Colostrum, the mother’s first milk, helps to stabilize a newborn’s blood sugar. Breastfeeding should be encouraged to start within the first hour after the delivery.
    6. Breastfeeding has a protective effect on the onset of diabetes in childhood. The World Health Organization published their findings after reviewing several studies and found “the prevalence of overweight/obesity and type-2 diabetes was lower for breastfed subjects” (Horta, 2007).
    7. Sadauskaite-Kuehne’s research study in 2004 showed that the longer exclusive breastfeeding protects against the development of type 1 diabetes mellitus in childhood.
    8. Stube’s research in 2005 suggested a correlation between the longer the duration of breastfeeding and the lower incidence of diabetes. The researchers stated that the women had a 14% to 15% decreased risk of diabetes for each additional year of lactation.
    9. Cordero’s research examined the clinical outcome of infants born to mothers with gestational diabetes and mothers with pre-existing type one diabetes while in the routine newborn nurseries. The study found that the breastfed babies had fewer complications and encouraged mothers to provide breastmilk for their babies.
    10. Wallensteen’s research found that formula fed infants produced more insulin in response to   feeding than breastfed infants did, yet their blood sugar was the same, implying that insulin resistance was occurring. This study showed that in this situation, formula-fed infants had to produce more insulin in order to get the same blood sugar reading, which might indicate the possible start of a pattern of developing insulin resistance, which could possibly have significant effects later in life.
    11. Breastfeeding, even for a short duration, improves the glucose metabolism of women with gestational diabetes and is a low cost intervention to reduce the chance of developing type one diabetes at a later time.
  9. STEPS TO TAKE TO ENSURE BREASTFEEDING SUCCESS
    1. Learn about breastfeeding and diabetes during your pregnancy.
    2. Take a minimum 2 hour breastfeeding class during the pregnancy.
    3. Discuss with your obstetrician and pediatrician about your choice to breastfeed.
    4. Consult with your endocrinologist about your choice to breastfeed.
    5. Know your community breastfeeding resources to consult when issues arise.
    6. Diabetic moms should have a light snack a light snack before or during nursing. Blood sugar levels should be checked before nursing. Careful adjustments of insulin and food intake should be done as mother’s insulin requirements change after the delivery. (ADA recommendations)
    7. Good control of the mother’s glucose status is important to maintain for mother’s well being. Uncontrolled blood sugars can delay the onset of breastmilk or cause a low milk supply. (Biancuzzo, 1999)
    8. Diabetic mothers are prone to infections and need to be taught how to prevent breast infections, the early signs of breast infections, and the proper treatment of breast infections. If managed appropriately breastfeeding should not have to be discontinued and milk supply will continue to be adequate.
    9. A baby-friendly hospital will encourage the breastfeeding relationship, help mothers to establish an adequate milk supply, and address any breastfeeding issues that may arise.
  10. SUMMARY
    1. Increasing the breastfeeding rates in the Coastal Bend through increased breastfeeding awareness, education and support would impact our local diabetes statistics by helping to prevent or delay the onset of the disease. A healthier family and community is the ultimate goal. Breastmilk can help us to attain those goals.

 

References:

Biancuzzo, M. (1999). Breastfeeding the Newborn: Clinical Strategies for Nurses, 2nd e edition. St. Louis: C.V. Mosby.

Cordero, L et al. Management of Infants of Diabetic Mothers. Arch Pediatr Adolesc Med.   March 1998. 152(3):249-254.

Horta, B.L., et al (2007). Evidence on the long-term effects of breastfeeding. WHO.

Ip, S., et al (2007). Breastfeeding and maternal health outcomes in developed countries. AHRQ Publication No. 07-E007. Rockville, MD: Agency for Healthcare    Research and Quality.

Lawrence, R. (2005). Breastfeeding: A guide for the medical profession, 6th edition. St. Louis: C.V.Mosby.
Preparing Pregnant Women with Diabetes for Special Breast-Feeding Challenges. Journal of the American Dietetic Association. June 1998. 98(6):648.

Sadauskaite-Kuehne, et al (2004). Longer breastfeeding is an independent protective    factor against development of type 1 diabetes mellitus in childhood. Diabetes Metab Res Rev 20(2): 150-7.

Stube, A. et al (2005). Duration of lactation and incidence of type 2 diabetes. JAMA,   294:2601-2610.

Sullivan, M. (2006). Lactation lowers maternal type 2 diabetes risk rate. Retrieved from Metabolic Disorders on January 1 from www.familypracticenews.com.
Wallensteen, M et al. Acute C-Peptide, Insulin, and Branched Chain Amino Acid R  Response to Feeding in Formula and Breast Fed Infants. Acta Paediatr Scand. F  February 1991. 80(2):143-148.