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Is it safe for a diabetic mother to breastfeed?

By Vision Reporter

Added 15th August 2011 03:00 AM

NASIMU Nansubuga, a diabetic mother, wants to breastfeed her baby, but wonders if nursing will worsen the symptoms or harm her baby.

NASIMU Nansubuga, a diabetic mother, wants to breastfeed her baby, but wonders if nursing will worsen the symptoms or harm her baby.

BREAST FEEDING WEEK

By Halima Shaban


NASIMU Nansubuga, a diabetic mother, wants to breastfeed her baby, but wonders if nursing will worsen the symptoms or harm her baby.

“I was told that if I breastfed my baby, I would transmit the disease to her. I breastfeed her, but I’m scared that I may be giving her the disease,” Nansubuga says.

But according to Prof. Andrew Otim of Kampala Diabetic Centre, diabetic mothers can successfully breastfeed, and breast milk gives babies increased protection against diabetes.

Otim says during labour, diabetic mothers should be handled by a qualified health professional to monitor both the mother’s and baby’s sugar levels, to avoid complications.

“We have lost many babies because these mothers are attended to by nurses, who are not trained in handling diabetic mothers. We are also in the process of training nurses on how to handle diabetic mothers during labour,” Otim says.

When a diabetic mother gives birth, there is a sudden fall in the blood sugar levels because her hormones are delivered from her body and the placenta.
“There is a placenta hormone that antagonises insulin before birth, so diabetic mothers need more insulin before birth. After delivery when the placenta is out, the hormone in the placenta is removed, causing a more powerful effect of lowering the blood sugar,” he says.

Charles Mukisa, a doctor, says mothers who have type 1 or 2 diabetes, or who develop gestational diabetes during pregnancy, should not worry that breastfeeding could worsen their symptoms.

Mukisa says it is safe to take insulin while breastfeeding. “The insulin will not enter your baby’s body because it cannot be absorbed in the breast milk. However, if you have type 2 diabetes and are taking medication, talk to your doctor about the treatment that is healthiest for both you and your baby,” he says.
Some breastfeeding mothers find it easier to manage diabetes because their glucose levels stay more constant, and they have fewer symptoms, while breastfeeding.

Mothers on medication

Otim advises mothers taking oral medication to seek alternatives. “Oral drugs that lower blood sugar must be avoided because many are passed on in the milk, if needed then insulin given by injection because it is not passed on in the breast milk.

He says diabetics face a condition in which the quantity of glucose in the blood is too elevated (hyperglycemia). This is because the body produces none or not enough insulin, or has cells that do not respond properly to the insulin the pancreas produces. This results in excess glucose, eventually passes out of the body in urine. So, even though the blood has plenty of glucose, the cells are not getting it for their essential energy and growth requirements.

According to the World Health Organisation, about 98,000 Ugandans were diabetic in 2000. However, the number has risen to 1.5 million of the 30 million Ugandans. Statistics of diabetic mothers are not known, says Otim, also the chairman of the Uganda Diabetes Association.

Fatuma Kagoya, a diabetic mother of two, says: “I was not told that breastfeeding was something people with diabetes could do. I found out later that stopping breastfeeding early could contribute to my son developing diabetes.”

Otim says type 1 and 2 diabetes develop when the body is unable to move sugar out of the blood and into the cells for use. Symptoms may include intense thirst, blurred vision, fatigue and a constant need to urinate. If left untreated, diabetes may lead to heart disease, stroke, kidney disease and blindness.
Gestational diabetes, on the other hand, affects only pregnant women. Although the condition generally disappears after delivery, studies show that about 40% of women who get gestational diabetes develop type 2 diabetes in the next 15 years.

Dr. Robert Kasirye, the in-charge of Mukono Health Centre 1V, advises mothers to monitor their diet so as to regulate their condition. Some women report better health — and less of a need for insulin — during lactation, possibly because of their body’s natural adjustment to physical and metabolic changes after delivery,”

A diabetic’s need for insulin drops abruptly within hours after birth. The stress-bursting hormone oxytocin that a woman’s body releases during breastfeeding can also help a diabetic mother feel better physically and emotionally.

The foetus will produce excessive insulin to balance the high glucose levels. At birth, the extra insulin can result in a rapid drop in blood sugar in newborns. Therefore, babies are watched carefully and are checked at intervals. On their own, many newborns quickly adjust.

When a mother is diabetic, it is common practice in some hospitals to supplement breast milk with formula so as to ensure against low blood glucose.

Otim says when a diabetic mother delivers, there is need for the baby to have more sugar than a normal baby or else it will die as a result of low sugar.

Nutrition
Breastfeeding means that you have to be extra careful with your nutrition, so be sure to see your doctor or dietitian to create a meal plan that will work for you.

Otim says it is important to eat regular snacks when breastfeeding because you want to keep your blood sugar levels constant.

“You will need to increase your caloric intake by about 500 calories a day to meet your baby’s nutritional needs. You can do this simply by drinking a glass of milk each time you breastfeed, which will keep you both hydrated and full of vitamins,” he says.

In some circumstances, breastfeeding is not advised, such as:
  • If diabetic complications inhibit your body’s ability to handle the additional demands of breastfeeding.

  • If you are using medicines that are not compatible with breast-feeding. Oral diabetes medicines are not recommended for breast-feeding women
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    Is it safe for a diabetic mother to breastfeed?

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