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Breastfeeding and Diabetes - Type 1, Type 2 and Gestational diabetes

Mums with diabetes can reach their breastfeeding goals with the right information and support. 

pregnant mum

If you have Type 1 or Type 2 diabetes or you have been diagnosed with gestational diabetes during pregnancy, you may be worried about whether you will be able to breastfeed.

While mums with diabetes may have extra health concerns and closer monitoring during pregnancy and birth, with the right support and information, you will be more likely to reach your breastfeeding goals. Research can reassure you that you can successfully breastfeed and that common concerns that mums have usually relate to breastfeeding rather than diabetes.1   

There are 3 types of diabetes  

Type 1 diabetes (T1D) is an autoimmune condition in which the immune system is activated to destroy the cells in the pancreas which produce insulin. We don’t know why it happens and there isn’t a cure. People usually get T1D as children, so most T1D mothers have had the condition for at least 10 years.2 

Type 2 diabetes (T2D) is often a progressive condition in which your body becomes resistant to the normal effects of insulin and/or gradually loses the capacity to produce enough insulin in your pancreas. T2D develops over a long period of time and initially can often be managed with healthy eating and regular physical activity. Traditionally, T2D affected older people (over 45 years). However, rates are now increasing in younger people.2   

Gestational diabetes mellitus (GDM) is a form of diabetes which affects many pregnant women. It is caused by hormones from the placenta blocking the mother's insulin (hormone that moves sugar from our blood to our cells so it can be used to make energy). GDM usually occurs around weeks 24 to 28 and generally goes away after birth.  

Emotional impact of diabetes and breastfeeding 

If you have diabetes, you will know that managing it is complex and constant and that it is often an emotional burden to carry. You need to measure and maintain blood sugar levels and may, at times, fear for your own health and that of your baby. Mums with diabetes are often anxious which can interfere with oxytocin release essential for a healthy breastmilk supply.3 

You may have more complications and interventions during your pregnancy and birth which may add to your stress once baby arrives. However, breastfeeding may actually help with these.  

Breastfeeding has benefits for mothers with diabetes 
  • You may have improved metabolic function and greater insulin sensitivity.4 

  • Your body may use insulin more efficiently therefore your dose may be reduced.5 

  • You may lose weight, have better sleep and improved bonding with your baby as a result of breastfeeding. 
     

If you have had GDM, your risk of developing type 2 diabetes later in life is 7 times higher than someone who hasn’t had GDM.6 However: 

  • Breastfeeding for over 3 months will provide more protection against future diabetes.5 

  • Breastfeeding for a longer period of time lowers the incidence of diabetes.5 

  • Breastfeeding is a cost-effective way to reduce the risk of future diabetes. 

Breastfeeding has benefits for your baby too
  • Colostrum helps stabilise your baby's blood sugar levels after birth.  

  • Your baby is protected against under-nutrition and over-nutrition.3,4 

  • They will have a reduced risk of childhood obesity or being overweight.3,4

Breastfeeding may have some potential challenges 
  • Delay or decrease in mature milk coming in 3,5  

  • A mum may think her milk supply is low 5 

  • The need to breastfeed your baby often if they have experienced higher blood sugar levels in the womb 3

  • Preconception, pregnancy, birth, and post-birth difficulties 3,7

  • Medical complications with mum 3,8 

  • Medical complications with baby 3

Preparing to succeed with diabetes 

Understanding your diabetes and being prepared may help you to meet your breastfeeding goals.   
skin-to-skin first feed

During pregnancy

  • Attend an in-person ABA Breastfeeding Education Class near you or an online Breastfeeding Education Live. If you understand how breastfeeding works and how to position and attach your baby, you will have less new things to learn when your baby arrives. 

  • Speak to your doctor or midwife about expressing colostrum before your baby is born, from about 36 weeks. If you have diabetes during pregnancy your baby may be at risk of low blood sugar after birth. If you have extra colostrum available, this can help stabilise their blood sugar level.  

  • Discuss your desire to breastfeed with your health care providers and gain their support. You may need changes to your diabetes management during breastfeeding.  Download the ABA fact sheet for health professionals Gestational diabetes and breastfeeding to take to your appointments.    

After the birth

Skin-to-skin contact is important for all mums and babies but even more so when diabetes is involved. It: 

  • helps stabilise your baby’s blood sugar levels. 

  • encourages your baby to follow breastfeeding instincts to attach and feed. 

  • increases your oxytocin levels. This is important in establishing your breastmilk supply. 

Hold your baby skin-to-skin as much as possible during the first week. 

Getting started with breastfeeding

  • If possible, breastfeed within the first hour after birth and keep feeding frequently.  

  • Some mums with diabetes find it takes longer for their milk to ‘come in’.3,5 Insulin plays a central role in starting and maintaining breastfeeding. Keep feeding your baby as often as possible. 

  • If you aren’t able to breastfeed straight away, then express as much and as often as you can. This is when you can feed your baby the colostrum that you expressed antenatally. 

  • Keep water and a stash of snacks nearby for when you are breastfeeding. Seek information and support from the hospital dietician about any extra food you may need while breastfeeding.  

In the early weeks

  • Feed your baby as often and for as long as they need. You can establish and maintain a good milk supply by following your baby’s lead.  

  • Look out for your let-down reflex each time you breastfeed. If you are worried about your health and breastfeeding, there may be less oxytocin to help your milk flow. Read about ways to help your let-down.

  • Have confidence. With the right support it’s likely your body can provide all that your baby needs. 

Further resources 

Diabetes Australia 

 

By Gemma Macdonald, BSc (Hons), Cert IV in Breastfeeding Education (Counselling)

 

 

The information on this website does not replace advice from your health care provider.

© Australian Breastfeeding Association April 2022

References - open to view
  1. Fallon, A., Dunne, F. Breastfeeding practices that support women with diabetes to breastfeed. Diabetes Res Clin Pract. 2015;110(1):10–17.
  2. Diabetes Australia: www.diabetesaustralia.com.au
  3. Stuebe, A. Breastfeeding and diabetes - benefits and special needs. Diabetes Voice 2007; 52(1):26–29.
  4. Achong, N., Duncan, E.L., McIntyre, H.D., Callaway, L. The physiological and glycaemic changes in breastfeeding women with type 1 diabetes mellitus. Diabetes Res Clin Pract. 2018;135:93–101.
  5. Herskin, C.W., Stage, E., Barfred, C., Emmersen, P., Ladefoged Nichum, V., Damm, P., Mathiesen, E.R. Low prevalence of long-term breastfeeding among women with type 2 diabetes. J Matern Fetal Neonatal Med. 2016;29(15):2513–2518.
  6. Much, D., Beyerlein, A., Roßbauer, M., Hummel, S, Ziegler, Mol Metab A.G. Beneficial effects of breastfeeding in women with gestational diabetes mellitus.. 2014;3(3):284–292.
  7. Feldman, A.Z., Brown, F.M. Management of Type 1 Diabetes in Pregnancy. Curr Diab Rep. 2016;16(8):76.
  8. Achong, N., McIntyre, H.D., Callaway, L., Duncan E.L. Glycaemic behaviour during breastfeeding in women with Type 1 diabetes. Diabet Med. 2016;33(7):947–955.