Preparing for breastfeeding your baby: information for women with diabetes in pregnancy

Monitoring your baby’s blood glucose levels after birth

After birth, your baby’s blood glucose levels will be closely monitored as they adjust to glucose levels that may be different from those they have experienced in the womb. During this time, babies are more at risk of developing low blood sugars- hypoglycaemia.

Receiving regular, small feeds will help your baby to maintain their glucose levels more easily. Skin to skin contact with your baby until their first feed, or for as long as you want to, also helps your baby to regulate their glucose levels by helping keep your baby warm and calm and helps promote early feeding.

What sort of milk should I give my baby after birth?

Breastfeeding has many health benefits for mums and babies.

When you have diabetes, giving your baby breast milk will help them to maintain glucose levels at a stable level. Colostrum (the early milk) that is present in your breasts in your pregnancy and the first few days after birth is perfect for all babies. This is because it is extra concentrated milk that is rich in carbohydrate. Your baby has a small stomach after birth, about the size of a raspberry, so little and often is best in the early days.

Colostrum also contains antibodies, which help provide additional immunity for your baby.

Exclusive breastfeeding, i.e. not providing any formula milk for your baby has also been shown to reduce the risk of your baby developing diabetes and obesity as they get older. Breastfeeding also reduces your own risk of developing Type 2 diabetes.

The midwives in the Pregnancy Diabetes clinic will talk to you about the option of expressing your colostrum by hand at the end of your pregnancy. This can then be saved so it is ready to give to your baby via a syringe for their first feed if baby is not ready to feed right away.

By giving your baby colostrum you can know you’re giving your baby the best start in life. Every feed matters and the longer you continue to give breast milk, the greater the benefits for baby and you.

What is hand expressing?

This is the method of removing milk from the breast using your hands.

It is more effective to use your hand, rather than a pump, for expressing colostrum as you will just get a few drops to start with. This will gradually build up to a few millilitres, which can be drawn into a syringe, then stored.

You can hand express from 36 weeks of pregnancy, but please discuss with your midwives if you are at risk of going into labour early. We would not recommend hand expression if you have had vaginal bleeding and with caution if you have a twin pregnancy. The midwives will show you how to express the colostrum, using a knitted breast to demonstrate.

There are more resources available on the UNICEF Website (opens in a new tab).

Some tips to hand express most effectively

• If you are warm and relaxed, it helps.

• You can express in the shower or bath if it’s easier to start with.

• Wash your hands.

• Stroke your breasts gently first to begin with to encourage your hormones and help the milk to flow.

• Hand express from each breast. It should not be painful or uncomfortable.

• Express your milk directly into a sterile cup or syringe.

• You can express up to three times a day.

There is a picture guide in the NHS Mothers and Others Guide on page 21, which will be given to you.

It is a really useful skill to be able to hand express. This is something that you can continue to do after your baby is born, as you need or want to.

How should I store my breast milk?

• We will provide you with an expressing pack. This contains some sterile syringes and caps to use, also an information sheet with guidance on how often to express and what times are best.

• You can express up to three times a day into the same cup or syringe.

• You will need an expressing label which will be provided.

• Store your breast milk at the back of the fridge for up to 5 days 0-4 degrees or place it in the freezer for later use (6 months).

• Double label your milk with your name, date and time and a telephone number.

• Store your samples together in a sealed bag or plastic container.

• Please remember to bring your colostrum with you when you come to have your baby in a cool pack with ice-block. Please hand this to the midwifery team as soon as you arrive– it should be stored in the neonatal milk freezer.

• If you have any unused milk at the end of your stay it will be discarded by the neonatal unit after a few weeks. If you would like to take it home with you, please ask the midwifery staff

More information:

We hope this information is helpful to you.

There are some further information on these links:

• CUH Gestational diabetes page
• La Leche.org Website (opens in a new tab)

Please ask for further support or information as you need to.