Breastfeeding and Gestational Diabetes

I’m breastfeeding my eight-month-old. He is a very attached, cosleeping baby. He still nurses at night and is not on any sort of feeding schedule.

I’m also ten weeks pregnant. I am high risk due to gestational diabetes. I want to nurse throughout the pregnancy (my doctor is fine with this). Is this safe for the three of us? My concern at this point is that I’m on a carbohydrate-restricted diet, and I’m hungry between meals. I would grab a snack, but my diet doesn’t allow that. What effect does breastfeeding have on my blood sugar? Is there anything else I should know?

It’s great to have the support of your doctor in continuing to breastfeed through your new pregnancy.

Very often during lactation, the insulin requirement for mothers goes down, so in that sense lactation is a plus for diabetic mothers. If you have had gestational diabetes, your doctor is going to be monitoring you pretty closely. You may want to have a chat with your doctor and/or a nutritionist about your diet now that you are pregnant again. Diabetic women—and I realize you may only fall into that category during some part of your pregnancy—usually need to take in more food than nondiabetic women while they are nursing [on average 2,500 calories instead of 2,000]. Even if you need to restrict your carbs, there are other foods that might be appropriate for snacks, especially in the protein, veggie, and (some) fruit categories. It should not be necessary to feel hungry all the time but you probably do want some professional advice from a specialist familiar both with nutrition for diabetics and with breastfeeding. The La Leche League website (www.llli.org) has links to many articles on breastfeeding and diabetes, including an annotated bibliography.