Diabetes

Will having diabetes affect my milk supply?

Mothers with diabetes have lower breastfeeding rates and poorer breastfeeding outcomes. Studies suggest that diabetes can reduce milk supply and can cause the milk to come in late.  Mothers with diabetes may have other health problems that contribute to breastfeeding problems. Diabetes is not, however, a reason to avoid breastfeeding as breastfeeding benefits both mother and baby.

A) Describing diabetes

Diabetes is a disease that results in excess amounts of sugar in the blood. There are three main of types of diabetes:

  • Type 1: caused by the body attacking insulin-producing cells
  • Type 2: caused by resistance to insulin
  • Gestational diabetes: develops during pregnancy

Diabetes in a mother is not a reason to avoid breastfeeding. It has specific benefits for both diabetic mothers and their babies. Diabetes medication, including insulin, is generally safe for use by breastfeeding mothers.

Mothers with diabetes require careful monitoring during pregnancy and benefit from extra support after birth to establish breastfeeding. Their babies are at risk of low blood sugar levels after birth. 

B) Effect of diabetes on breastfeeding

Mothers with diabetes have lower breastfeeding rates and poorer breastfeeding outcomes (Finkelstein 2013; Verd 2016). 

The reason for this is unknown. Having diabetes may affect a mother's ability to breastfeed or there may be other factors related to diabetes that cause problems:  

  • Diabetes can cause the milk to come in late (Wu 2021).
  • Mothers are more likely to have a low milk supply (Riddle 2016).
  • Mothers with higher blood sugar levels have lower prolactin levels in their blood and milk (Ostrom 1993).
  • Some mothers are more likely to be obese.
  • Mothers with diabetes are more likely to require a Caesarean delivery.
  • Diabetes increases the risk of infection. 
  • The babies of diabetic mothers are more likely to have low blood sugar levels (hypoglycaemia) after birth, which may lead to supplementing with milk

References

Finkelstein SA, Keely E, Feig DS, et al. Breastfeeding in women with diabetes: lower rates despite greater rewards. A population-based study. Diabet Med. 2013 Sep;30(9):1094-101

Ostrom KM, Ferris AM. Prolactin concentrations in serum and milk of mothers with and without insulin-dependent diabetes mellitus. Am J Clin Nutr. 1993 Jul;58(1):49-53
 
Riddle SW, Nommsen-Rivers LA. A Case Control Study of Diabetes During Pregnancy and Low Milk Supply. Breastfeeding Medicine. 2016;11(2):80-85
 
Verd S, de Sotto D, Fernández C, et al. The Effects of Mild Gestational Hyperglycemia on Exclusive Breastfeeding Cessation. Nutrients. 2016 Nov 19;8(11). pii: E742

Wu JL, Pang SQ, Jiang XM, et al. Gestational Diabetes Mellitus and Risk of Delayed Onset of Lactogenesis: A Systematic Review and Meta-Analysis. Breastfeed Med. 2021 May;16(5):385-392