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Is Insulin Safe During Breastfeeding

Thursday's Tip: Breastfeeding If You Are Diabetic Or Insulin Resistant

Thursday's Tip: Breastfeeding If You Are Diabetic Or Insulin Resistant

Women who have Type 1 or Type 2 diabetes or who are considered insulin resistant or “pre-diabetic” can breastfeed and doing so is good for mother and baby. For more about the role of breastfeeding in diabetes prevention for babies and insulin resistant women check out our Thursday’s Tip from last week Breastfeeding has a positive effect on a mother’s insulin response. For Type 1 diabetic mothers this can decrease their need for insulin during the breastfeeding period. Mothers who have Type 2 diabetes may find they require less hypoglycemic medication while breastfeeding. Good control of your insulin levels is important while breastfeeding. You may need to do some additional monitoring and be in close contact with your health practitioner during the early weeks until your hormones and your milk productions stabilize. Mothers who are diabetic are at an increased risk of pre-term birth and their babies may develop prolonged low blood sugar levels shortly after birth. (a dip in blood sugar levels one to two hours after birth is normal with blood sugar levels starting to rise again within 2 to 4 hours) Planning ahead with your birth team to manage these potential events can be helpful so everyone is prepared and not making decisions in a stressful situation. If at all possible plan to breastfeed within the first hour after birth and at least once an hour until the baby’s blood sugar levels stabilize. Skin-to-skin contact has been found to decrease the risk of hypoglycemia in newborns and it helps trigger the hormones that drive breastfeeding. A mother who is diabetic or insulin resistant may find that it takes a bit longer for her milk volume to increase after giving birth. Colostrum is providing all the nutrients, (vitamins, minerals and fats) that baby needs thro Continue reading >>

Is Insulin Safe For Pregnant Or Breastfeeding Women?

Is Insulin Safe For Pregnant Or Breastfeeding Women?

Depending on the type of insulin, the medication may or may not be safe to use while you are pregnant. Some forms, usually older insulin forms, are classified as pregnancy category B drugs, which means that it is not likely to be harmful if used during pregnancy. However, they have not had enough testing in pregnant women to prove that they are safe, so there may be some risk. Other, often newer, forms of insulin are classified as category C drugs, which means they have been shown to cause some harm in animal studies and may not be safe for use during pregnancy. Insulin is widely considered safe for women who are breastfeeding. However, it is always best to ask your doctor about the possible risks if you are breastfeeding, and about how breastfeeding will affect the amount and type of insulin you need. Continue reading >>

Use Of Hypoglycemic Drugs During Lactation

Use Of Hypoglycemic Drugs During Lactation

Use of hypoglycemic drugs during lactation Copyright the College of Family Physicians of Canada This article has been cited by other articles in PMC. QUESTION My patient was taking glipizide (an oral sulfonylurea) for type 2 diabetes. Now she is pregnant and taking insulin instead. She is very anxious to return to her previous treatment immediately after delivery because of the pain and hurdles associated with the administration of insulin. Can sulfonylureas cross into human milk and, if so, is it safe for her to breastfeed her infant? ANSWER The exposure of infants to second-generation sulfonylureas (eg, glipizide, glyburide) through breast milk is expected to be minimal, based on the limited data available. Women with type 2 diabetes treated with sulfonylureas should not be discouraged from breastfeeding. The benefits of breastfeeding greatly outweigh the risks of these medications, if any. The baby should, however, be monitored for signs of hypoglycemia. QUESTION Ma patiente prenait du glipizide (sulfonylure par voie orale) pour un diabte de type 2. Elle est maintenant enceinte et prend plutt de linsuline. Elle a bien hte de revenir son ancien traitement et veut le faire immdiatement aprs laccouchement cause de la douleur et des embarras associs ladministration dinsuline. Est-ce que les sulfonylures peuvent passer dans le lait maternel et, dans laffirmative, est-il scuritaire pour elle dallaiter son nourrisson? RPONSE Selon les donnes limites notre disposition, on pourrait sattendre ce que lexposition du nourrisson aux sulfonylures de deuxime gnration (p. ex., glipizide, glyburide) par lintermdiaire du lait maternel soit minimale. Il ne faudrait pas dcourager les femmes ayant un diabte de type 2 et traites aux sulfonylures dallaiter leur enfant. Les avantages de lal Continue reading >>

Breastfeeding With Diabetes: What You Need To Know

Breastfeeding With Diabetes: What You Need To Know

The benefits of breastfeeding for the mother and child are well-established and breastfeeding their newborn is an important goal for many women. There is much to learn about breastfeeding, and women with diabetes may wonder if there are specific diabetes-related considerations. Here, I address some common questions and challenges for women with diabetes who choose to breastfeed. Some women with diabetes wonder “Can I breastfeed?” In a word, the answer is a resounding “Yes!” Unfortunately, some physicians are not well-informed about breastfeeding with diabetes, and some women have actually been discouraged from doing so, likely because breastfeeding is associated with a higher likelihood of low blood glucose. However, armed with knowledge and support, and with some planning, there is absolutely no reason that a woman with diabetes should not breastfeed if that is what she wants to do! The challenges faced will undoubtedly vary between individuals, but it is very useful to have a clear picture of the most common ones ahead of time. Here are some ways to prepare: Learn the Basics Before I became a mom, I did not realize how much goes into breastfeeding. I always assumed that it was a straightforward process and was unaware of the challenges that can arise. In fact, there is a lot to learn and it is quite likely that the upcoming challenges may be completely unrelated to diabetes. Although this study describes that women with type 1 diabetes are less likely to breastfeed long-term compared to nondiabetics, the authors concluded that type 1 diabetes was not the direct cause of this after accounting for all the variables. Instead, it was found that the mother’s level of education, breastfeeding at the time of hospital discharge, and the gestational age of the newbor Continue reading >>

Insulin's Role In Making Breast Milk

Insulin's Role In Making Breast Milk

The reason so many women have trouble making enough breast milk to feed their newborn is partly because a large proportion of them are prediabetic - insulin dysregulation undermines their milk supply, researchers from Cincinnati Children's Hospital Medical Center and the University of California Davis suggested in PLoS ONE. In a new study, which adds to their previous one, the scientists explain that insulin plays a major role in lactation success. Lactation is the secretion of milk by the mammary glands. During lactation the human mammary gland (woman's breast) becomes extremely sensitive to insulin. This is the first study to describe how this occurs, the authors wrote. They added that theirs is also the first study to show specifically which genes are switched on in a woman's breast during breastfeeding. Study leader, Laurie Nommsen-Rivers, Ph.D., explained that RNA sequencing revealed "in exquisite detail" the blueprint for making milk in the human mammary gland. Dr. Nommsen-Rivers had demonstrated in a previous study that mothers with markers of sub-optimal glucose metabolism took longer for their milk to come down, suggesting that insulin plays a major role in lactation. Examples of sub-optimal glucose metabolism include being obese, having a very heavy newborn, and being at an advanced maternal age. This latest study shows how a woman's breasts become sensitive to insulin during lactation. The milk-making cells in the human breast do not need insulin to take in glucose, which led most experts to believe that insulin played no direct role in lactation. It is now evident that insulin does a great deal more than simply facilitate the uptake of sugars. Dr. Nommsen-Rivers said: This new study shows a dramatic switching on of the insulin receptor and its downstream sig Continue reading >>

Analysis Of Insulin In Human Breast Milk In Mothers With Type 1 And Type 2 Diabetes Mellitus

Analysis Of Insulin In Human Breast Milk In Mothers With Type 1 And Type 2 Diabetes Mellitus

International Journal of Endocrinology Volume 2012 (2012), Article ID 296368, 9 pages 1Biochemistry and Molecular Biology, School of Biomedical and Chemical Sciences, Faculty of Life and Physical Sciences, The University of Western Australia, UWA M310, 35 Stirling Highway, Crawley, WA 6009, Australia 2Clinical Services, Royal Perth Hospital, GPO Box X2213, Perth, WA 6001, Australia 3Obstetrics and Gynaecology, School of Women’s and Infant’s Health, The University of Western Australia, King Edward Memorial Hospital, Subiaco, WA 6008, Australia Academic Editor: Stuart Tobet Copyright © 2012 T. J. Whitmore et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Despite the important role that insulin plays in the human body, very little is known about its presence in human milk. Levels rapidly decrease during the first few days of lactation and then, unlike other serum proteins of similar size, achieve comparable levels to those in serum. Despite this, current guides for medical treatment suggest that insulin does not pass into milk, raising the question of where the insulin in milk originates. Five mothers without diabetes, 4 mothers with type 1, and 5 mothers with type 2 diabetes collected milk samples over a 24-hour period. Samples were analysed for total and endogenous insulin content and for c-peptide content. All of the insulin present in the milk of type 1 mothers was artificial, and c-peptide levels were 100x lower than in serum. This demonstrates that insulin is transported into human milk at comparable concentration to serum, suggesting an active transport mechanism. The role of insu Continue reading >>

Diabetes And Breastfeeding

Diabetes And Breastfeeding

Breastfeeding is the normal and natural way to feed and nurture a baby. If you have diabetes you may be concerned about whether you can breastfeed. The answer is yes. All mothers experience metabolic and hormonal changes after giving birth. A mother with diabetes who breastfeeds has an advantage as breastfeeding reduces the impact of these changes. When you breastfeed, your body continues to support you and your baby, making your diabetes easier to manage in the days after birth. Later on, gradual weaning helps you to maintain control of your diabetes. Gestational diabetes Benefits of breastfeeding What about medications? Be prepared Blood glucose control Babies can have a hypo after birth Antenatal expression of colostrum Get breastfeeding off to a good start Looking after yourself Adjusting your diet Gestational diabetes It can be a shock if you are diagnosed with gestational diabetes during your pregnancy. This is usually a temporary condition in which your body fails to produce enough insulin to meet your extra needs while you are pregnant. It is usually diagnosed from the fourth month of pregnancy. Just like mothers who are on long-term treatment for diabetes, good control of blood glucose levels will minimise any problems for you and your baby. You may not need any extra medical care during labour and delivery. Diabetes treatment is usually unnecessary once you have given birth. Benefits of breastfeeding For you as a mum with diabetes • It is easier to control your blood glucose levels as your body adjusts after the birth of your baby. • Depending on the type of diabetes you have, you may need less insulin or other medications. • Breastfeeding suppresses your periods and monthly hormonal changes. • Oxytocin and prolactin hormones are calming and help to re Continue reading >>

Diabetes Medications During Pregnancy And Breastfeeding

Diabetes Medications During Pregnancy And Breastfeeding

In the past, women with diabetes were at high risk for complications during pregnancy. Today, with advancements in treatment and good blood glucose control, women with diabetes can have a safe pregnancy and delivery similar to that of a woman without diabetes. (Please note: this article focuses on pre-existing diabetes, which refers to women who have diabetes before becoming pregnant. This is different than gestational diabetes, which occurs during pregnancy.) Planning your pregnancy For women who have diabetes, obtaining preconception (‘before pregnancy’) care is associated with better birth outcomes. By discussing pregnancy with your healthcare team prior to conception, they can help you reach your blood glucose targets, start folic acid supplementation and discontinue potentially harmful medications to lay the groundwork for a healthy pregnancy. Blood glucose targets It is important that woman who are planning a pregnancy get their preconception A1C levels to less than 7%, or as close to normal as can be achieved safely. This will decrease the risk of spontaneous abortion, birth defects and pregnancy-induced high blood pressure (this is known as ‘preeclampsia’). Good blood glucose control in pregnancy is important, because high blood glucose levels can cause the baby’s size and weight to be larger than average and increase the risk of complications during and after delivery. Women should speak to their healthcare team, as blood glucose targets change in pregnancy; hence, more frequent blood glucose monitoring is recommended to ensure these goals are being met. Hypoglycemia can be more common in the first trimester of pregnancy; therefore, monitoring and adjustment of insulin doses, as needed, are both very important during this time. The risk of hypoglycemi Continue reading >>

Insulin Use While Breastfeeding

Insulin Use While Breastfeeding

Insulin Levels and Effects while Breastfeeding Summary of Use during Lactation Mothers with diabetes using insulin may nurse their infants.[1] Exogenous insulin is excreted into breastmilk, including newer biosynthetic insulins (i.e., aspart, detemir, glargine glulisine, lispro). Insulin is a normal component of breastmilk and may decrease the risk of type 1 diabetes in breastfed infants.[2][3][4] Pasteurization of milk by the Holder method reduces the concentration of insulin in milk by about half.[5] Insulin requirements are reduced postpartum in women with type 1 diabetes.[1][6] In one study, insulin requirements were lower than prepregnancy dosage only during the first week postpartum: 54% of prepregnancy dosage on day 2 and 73% on day 3 postpartum. On day 7 postpartum, insulin dosage returned to prepregnancy requirements.[7] Another study found that dosage requirements did not return to normal for up to 6 weeks in some mothers.[8] A third study found that at 4 months postpartum, patients with type 1 diabetes who exclusively breastfed had an average of 13% lower (range -52% to +40%) insulin requirement than their prepregnancy requirement.[9] A retrospective case-control study found a 34% decrease in postpartum insulin requirement compare to preconception values. There was a nonsignificant trend towards lower requirements in exclusively breastfeeding mothers compared to partial or full formula feeding.[6] Breastfeeding appears to improve glucose postpartum glucose tolerance in mothers with gestational diabetes mellitus[10][11] and in normal women.[12] A small, well-controlled study of women with type 1 diabetes mellitus using continuous subcutaneous insulin found that the average basal insulin requirement in women with type 1 diabetes who breastfed was 0.21 units/kg Continue reading >>

Is It Ok To Take Insulin For Gestational Diabetes?

Is It Ok To Take Insulin For Gestational Diabetes?

Eating healthy foods and getting plenty of exercise may be all you need to control your blood sugar levels during your pregnancy. But when that's not enough, you may need to take insulin, too. Insulin is a hormone that helps your cells take in and use glucose. Your pancreas makes insulin, but the kind you take is made in a lab. Your doctor may prescribe it when your body doesn't make enough on its own to keep your blood sugar levels in a normal range. That will help prevent problems for you and your baby. Insulin doesn't cross the placenta, which means it can't get to your baby, so it's safe to use as prescribed. Taking Insulin You inject it under your skin with a syringe or insulin pen. You can't take insulin as a pill or drink it. How much you'll need and how often you'll need it will probably change during your pregnancy. Some kinds of insulin work in just a few minutes; others work more slowly but last longer. You take fast-acting insulin with a meal, so it goes to work right away to help your body use the glucose from the food you ate. Your doctor will probably prescribe this type, along with one that lasts about 12 hours or overnight. Longer-acting (24-hour) insulin hasn't been studied with pregnant women. What to Watch For You might get sore and have hard lumps where you inject the insulin. To prevent this, try not to give yourself the shot in the same place every time. Insulin can also cause low blood sugar (hypoglycemia) when there's not enough glucose in your blood for your body to work right. You're more likely to have this if you skip a meal or use too much insulin. Be sure you know the warning signs: dizziness, sweating, shaking, and blurry vision. The best treatment is a quick-sugar food like raisins, honey, or glucose tablets or gel. Low blood sugar can b Continue reading >>

Insulin And Breastfeeding

Insulin And Breastfeeding

Tweet Save Before taking insulin, women who are breastfeeding should talk to their healthcare providers about the benefits and potential risks. Although it is not known if insulin passes through breast milk, it is likely that the medication would be destroyed in the digestive tract of the infant even if it does pass through the milk. In general, most healthcare providers consider breastfeeding and insulin to be compatible. Insulin and Breastfeeding: An Overview It is not clear if insulin passes through breast milk. However, insulin is not expected to cause problems when used during breastfeeding. Most healthcare providers consider insulin safe for women who are breastfeeding and their infants. You should talk with your healthcare provider before taking insulin if you are breastfeeding or plan to start breastfeeding, as it may affect your insulin requirements. You need to have a clear plan in place for how to deal with the challenges of safely controlling your blood sugar levels while breastfeeding. Can I Take Insulin While Breastfeeding? There is conflicting information available about whether insulin passes through breast milk. However, even if it does pass through breast milk, it would be destroyed in the digestive tract of the infant. Insulin is a protein that is digested and inactivated when taken by mouth. This is why insulin must be taken by injection. It is not expected that taking insulin while breastfeeding would having any negative effects on the breastfed infant. When using insulin, the most significant risk to a woman who is breastfeeding (or to anyone, for that matter) is the risk of dangerously low blood sugar levels. Make sure to check your blood sugar levels often, and be sure you know exactly what to do if you experience low blood sugar levels. It is im Continue reading >>

Diabetes And Breastfeeding

Diabetes And Breastfeeding

Tweet Breastfeeding is widely considered to be the best way of feeding your new born baby and this applies to mothers with diabetes as well. We’ve taken a look at some of the common questions that get asked about diabetes and breastfeeding, and provide the answers you need to know. Is it healthy for people with diabetes to breastfeed their baby? Breastfeeding is considered to offer the best nutrition for your baby and diabetes need not override this advice. Will diabetes affect the quality of my milk? Your own blood sugar levels can affect your milk but if your blood glucose is well controlled, this should not be a problem. Is it more difficult to produce milk with diabetes? Insulin plays a part in milk production and so diabetes can affect your ability to produce milk. You may find that diabetes causes your milk to be produced a little more slowly but again, well controlled diabetes should reduce this problem. Will breastfeeding affect my blood glucose levels? To produce the milk, your body will use glucose from your blood so whilst you are breastfeeding, your blood glucose levels may be affected. People taking insulin may find that their insulin requirements are reduced whilst they are producing milk. Mothers taking glucose lowering medication should be aware of the signs of hypoglycemia. Will the medication I take affect my baby? Whilst your sugar levels can influence the lactose in your milk, the diabetic medication you take such as insulin, metformin and sulphonylureas should not directly affect your baby. If you are taking other medication, check the patient information leaflet of the medication and ask your doctor if you are at all unsure. Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the Continue reading >>

Breastfeeding And Diabetes

Breastfeeding And Diabetes

The Advantages of Continued Nursing Should you be breastfeeding while diabetic? What about breastfeeding and type 2 diabetes? Yes, a diabetic mother can continue to breastfeed her baby. Whether you have type 1, 2 or gestational diabetes, you can and should continue to breastfeed. Diabetic mothers are advised to breastfeed their babies exclusively for 6 months or longer. ~ Breastfeeding and diabetes ~ Does insulin pass through my breast milk? No, the insulin molecule is too large to pass through into your breast milk. Why is it Important to Breastfeed if You have Diabetes? It lowers your baby’s risk of developing diabetes. It helps the mother lose weight. It helps the body utilize insulin more efficiently. It lowers the need for insulin. Oxytocin released whilst breastfeeding will help a mother feel better physically and emotionally. Stress can aggravate diabetes, so this is a big huge advantage. Other basic benefits of breastfeeding ~ Breastfeeding and diabetes ~ Solid foods should be introduced only after 6 months of life, especially if there is a risk for diabetes. Tips for Breastfeeding with Diabetes Diabetic mothers should always eat something that contains a combination of protein and carbs before a breastfeeding session. Mothers who breastfeed will need to increase their calories daily, diabetic mothers who breastfeed need to increase their calories by an extra 500 (spread out through the day). A diabetic mother's milk might take longer to "come in" after her baby's birth. If her baby needs to be supplemented within those first few days, while her milk is coming in, she should try to get donor breast milk if possible. A Hypoallergenic formula can be given, if no donor breast milk is available. During those first few days, while you are waiting for your milk to " Continue reading >>

Insulin During Pregnancy And Breastfeeding

Insulin During Pregnancy And Breastfeeding

Generic Name: Insulin Indications: Treatment of diabetes FDA Drug Category: B Summary Recommendations: Insulin is commonly given to patients to treat diabetes in order to lower blood sugar glucose. Controlling diabetes during pregnancy and lowering blood glucose sugar can reduce the risk of pregnancy complications and increased fetal weight. Your insulin dose may change during pregnancy. You should always keep prenatal appointments and track blood glucose levels daily. General Precautions: Diabetes can be a dangerous health condition during pregnancy. You should always maintain diabetes care and good blood sugar control during pregnancy and after birth. Diabetes care can be extremely specialized so your obstetrician will likely leave care to your primary care physician for medication and alternative treatment options. Various types of insulin exist, including short-acting, intermediate-acting, long-acting and fast-acting. Effect While Trying to Conceive: While insulin is not directly associated with infertility, diabetes, especially when it is uncontrolled can affect fertility in both men and women.Treating diabetes and lowering blood sugar glucose may improve fertility. If diabetes is found during medical testing, insulin treatment may help resolve the hormone imbalance, leading to more balanced fertility hormones and improved fertility. Effects on Pregnancy: Insulin is the drug of choice for treatment of diabetes during pregnancy. Insulin does not cross the placenta, and it does not go to the fetus. However, sugar glucose in the mother does cross the placenta and go to the fetus and can adversely affect the fetus. That is why taking insulin is important so the elevated sugar in the mother's blood does not adversely affect the feus. Doctors also use the drug to treat g Continue reading >>

Can You Breastfeed If You Have Diabetes?

Can You Breastfeed If You Have Diabetes?

Approximately 81.1% of mothers breastfeed their babies when they are born. About half of those are still breastfeeding 6 months later. There are many benefits for breastfeeding moms and babies if they are able to stick with it for at least 6 months. For moms with diabetes, there are even more benefits. However along with the benefits, there may also be some challenges as well. The following article provides information about the advantages of breastfeeding for all moms and babies as well as the things to look out for which are unique for nursing mothers with diabetes. The perks of breastfeeding Breastfeeding is very beneficial for the nursing mother as well as the baby. It provides lifelong benefits and can decrease the risk of developing diseases and problems later in life for both of them. For mothers who have diabetes, it can also help them manage their disease and prevent further complications. Benefits for all breastfeeding moms Breastfeeding reduces the risk of several diseases for mothers that nurse for 6 months or longer. These include: Heart disease Diabetes Mellitus Obesity Osteoporosis Rheumatoid Arthritis Ovarian Cancer Breast Cancer Uterine Cancer The risk of developing these diseases can be reduced up to 86%! Breastfeeding also releases a hormone that is called Oxytocin. This hormone is responsible for decreasing stress and increasing mood, which can be very helpful to new mothers that need more rest and a boost of confidence. One study found that for every 6 months that a mother breastfeeds, her BMI (body mass index) is decreased by 1% after she hits menopause. This is wonderful because an increased BMI can lead to many problems including heart disease and diabetes. Breastfeeding also burns calories, and it can help the new mother lose the extra weight th Continue reading >>

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