Breastfeeding and beyond
Breastfeeding is not easy for most people - diabetes or not! It would seem that it “should” be, as it is the most natural thing in the world. However, both you and your baby must learn the techniques of breastfeeding, as well as how to make milk supply increase and suit you and your baby. Whether you have just recently learned that you have diabetes or you’ve had it for quite some time now, do not believe the myths that claim that you can’t breastfeed your baby. It is good for both of you.
Here are some facts about diabetes and breastfeeding.
- may lower your baby’s risk of getting type 2 diabetes
- lowers your baby’s risk of other infections and illness
- is best for baby’s brain and overall development
- is portable and cheap!
- helps you lose weight/prevent obesity
- helps your body use insulin in a positive way
- lowers your insulin need
The Australian Breastfeeding Association is a wonderful resource to explore before and after the birth of your baby.
During the pregnancy you can prepare yourself for breastfeeding by speaking with a lactation consultant or breastfeeding expert. Many hospital ante natal classes will cover breastfeeding. With diabetes there are particular things to consider such as the fact that it can take longer for your milk to come in and perseverence is needed, so seeking additional advice from your health care team is also useful Don’t presume you will just know what to do! It is something that needs to be practiced in terms of technique.
Involve your partner and loved ones in discussions about how you want to proceed with breastfeeding and ask for their support to ensure you can manage. You will need people to take over other tasks when you return home with your new baby, so you can focus on yourself and your baby. Your diabetes control will be all over the place for a time and your body will be trying to get back to balance. In addition your emotions are likely to be all over the place.
So look after yourself and remember you are dealing with diabetes AS WELL as a new baby.
As soon as possible (even after a c-section you can do this in recovery if baby and you are up to it), hold your baby skin-to-skin to keep him/her warm and to interest him/her in breastfeeding. If baby needs to go to special care nursery that is fine and you can visit as soon as you are up to it and have as much contact with your baby as is possible. Makes sure you have someone alongside to advocate for you and what you want.
A breastfeeding plan is just as important as a birth plan.
In particular, if breastfeeding is delayed and/or the baby needs to be supplemented in the hospital, it is important that you start expressing the colostrum from your breasts as soon as possible after the delivery, to encourage your body to start producing milk and to have this available for you baby, to be used as part of the supplement.
A lactation consultant or midwife can help with this and can also help you plan how you will feed your baby once you go home from the hospital. You can hand express yourself even if restricted to bed. If you are unable to do this for whatever reason, try not to stress and just start as soon as you are physically able.
You want to begin to stimulate your milk supply and keep your baby’s blood glucose levels stable.
If, for some reason, you are not able to breastfeed, make sure to express or pump every 2 to 3 hours until you are able to feed the baby so that you are stimulating your production and simulating what the baby would typically be doing.
Many women with type 1 diabetes in particular find they have low blood glucose levels within an hour after breastfeeding, so eating something with a good balance of carbohydrates and protein just before, or during, breastfeeding, is important.
Helpful tip - have a basket with glucose tablets, lollies, crackers and fruit, a water bottle, mobile phone, blood glucose monitor and the remote for the t.v (as breastfeeding in the early days can take a long time!!). and have it with you when breastfeeding at home. Always keep a proper snack in your bag when you go out, as well as hypo foods.
It is very important to breastfeed as often as possible in the early days. You can not feed too much when establishing supply. You also need to take care of yourself, but if you can establish a good supply at the outset, you will have more chances of keeping on with breastfeeding.
Rest, nutrition and water are all important in helping your body to produce milk. Some babies are sleepy or reluctant to feed and/or may have trouble learning too – remember they are also learning a new skill! Work together with your baby and your midwife or lactation consultant and keep with it. A wet flannel can be handy to keep a sleepy baby alert.
A mun with type 1 recalls her experiences with breastfeeding 3 babies
“my first baby was not brought to the breast for 2 days before we had a chance to try breastfeeding ( and I did not know better) and for many reasons including his own health, I was unable to breastfeed him past 8 weeks, after doing everything possible to make this work.
My second son was also in the special care nursery and had supplemental feeds due to low blood glucose, but I requested he have this via a gavage ( tube in his nose into his tummy) which is very gentle – so that he would not have to learn to suck a bottle at the time he needed to learn how to suckle at the breast, as they are very differemt actions.
I was able to feed him for 14 months. My third baby had a go at a feed in the delivery room, did not need special care or supplementary feeds and roomed in with me within hours. He was reluctant to suckle as my supply was slow to start, but a smart nurse used a syringe to squirt a small amount of sterile water into his mouth whilst he attached to the breast and it encouraged him to start sucking and off we went! I stuck by feeding him a LOT in the first few days, on about days 3 – 5 this was increased significantly, and here we are 3 years later trying to get him off the breast!”
If the baby is having a rough start at breastfeeding, just remember to observe for hunger cues and stay relaxed and focused. He/she will learn. Remember to observe the sucking and swallowing pattern (suck-suck-swallow-pause…) of your baby to make sure everything is going well. Although it is recommended to feed one breast entirely before offering the other, it may be necessary to switch breasts often to ensure she is getting an adequate amount of colostrum (Often called “super-switch nursing” — where the baby is taken off the breast when he starts to slow down and put on the other…sometimes multiple times in a feeding period.)
You need to watch your blood glucose levels very carefully in the hospital to ensure that they are steady. You may need to eat more frequently than what is offered — some hospitals only serve breakfast, lunch, and dinner, with sometimes a very small snack. Ask to speak with a hospital dietician who can arrange to give you at least 3 other snacks during each day of your stay. If not, ask a support person to bring something to you.
Don’t be surprised if your milk has not come in by Day 3 as having diabetes may slow milk production slightly. It is fair to say that you can expect to see your milk come in by Day 4 or 5 if you are breastfeeding at least 10 times a day. Sometimes it can also come in slowly, not all at once like you see in the movies! You will know the baby is doing well if he is having at least 6 wet nappies and 3 bowel movements every day after the first 3 days. The peadiatrician will also want the baby to have a weight check within the first few days to make sure everything is on the right track. if you have had a c-section you will probably be in hospital for about 5 days.
Remember – you can breastfeed. It may be overwhelming to think about breastfeeding with diabetes, but with proper preparation and monitoring, you and your baby will both benefit and really enjoy it!