Mothers Aware: Breastfeed for Your OWN Health!

We often hear of the myriad of benefits a baby gets from breastfeeding and breastmilk. These range from the antibodies and immune enhancing properties provided by colostrum, the changing but tailored macronutrient composition of breastmilk as an infant grows, to the reduction of infant mortality and a quicker recovery during illness for infants exclusively breastfed.

But what about for mothers? The list of benefits is just as impressive. Although more studies are needed, current research is showing that mothers with gestational diabetes who breastfeed tend to have better blood glucose control, and likely longer term benefits such as a reduced risk of type 2 diabetes, a reduced risk of metabolic syndrome and more long-term continued function of the pancreas in insulin production. The improved glucose control seems to come via many routes such as better glucose utilization for milk production and increased insulin secretion and pancreatic beta cell mass caused by the hormone prolactin which increases through lactation. Other benefits of breastfeeding for mothers include better cardiometabolic profiles, improved blood pressure levels, quicker contraction of the uterus postpartum and reduced ovarian and breast cancer risks.

From personal experience, this seems to be true. For my first pregnancy I had more severe gestational diabetes, requiring blood glucose checks 4 times a day, and relatively strict diet control to maintain good blood glucose levels. However,  I subsequently breastfed my firstborn for 15 months. When it came time for my oral glucose tolerance test (OGTT) during my second pregnancy, I was pleasantly surprised to see the results showing I had only borderline gestational diabetes. The doctor advised me that I only needed to check my glucose level once every day or so! As a result I had a much more relaxing second pregnancy and did not need to monitor everything I ate so closely, as my blood glucose levels staying mostly within range.  So mothers, breastfeed for your own health!

(Sources:

  1. Kalra B, Gupta Y, Kalra S. Breast feeding: preventive therapy for type 2 diabetes. J Pak Med Assoc. 2015; 65(10):1134-6. http://jpma.org.pk/PdfDownload/7505.pdf. Accessed May 15, 2016.
  1. Breastfeeding. World Health Organization. http://www.who.int/maternal_child_adolescent/topics/child/nutrition/breastfeeding/en/ . Accessed May 15, 2016.
  1. Gunderson EP. Impact of breastfeeding on maternal metabolism: implications for women with gestational diabetes. Curr Diab Rep. 2014; 14(2):460. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146528/pdf/nihms558299.pdf. Accessed May 15, 2016.
  1. Rabin RC. Breast-Feeding Is Good for Mothers, Not Just Babies, Studies Suggest. The New York Times. http://well.blogs.nytimes.com/2015/11/23/breast-feeding-is-good-for-mothers-not-just-babies/. November 23, 2015. Accessed May 15, 2016.
  1. Much D, Beyerlein A, Roßbauer M, Hummel S, Ziegler AG. Beneficial effects of breastfeeding in women with gestational diabetes mellitus. Mol Metab. 2014; 3(3):284-292. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3986583/pdf/main.pdf. Accessed February 18, 2016.
  1. Ziegler AG, Wallner M, Kaiser I, Rossbauer M, Harsunen MH, Lachmann L, et al. Long-term protective effect of lactation on the development of type 2 diabetes in women with recent gestational diabetes mellitus. Diabetes.2012; 61:3167 – 3171. http://diabetes.diabetesjournals.org/content/61/12/3167.long. Accessed May 15, 2016.)

Qn of the Month: I Had Gestational Diabetes in Pregnancy. Can I Forget About Blood Sugars Now That Baby’s Out?

Not quite – let me explain why.

Like me, you may have had gestational diabetes (GDM) during pregnancy, or you are currently experiencing it. Regardless, no one likes it, but it’s something we endure for the sake of delivering a healthy baby. The worst part I found was not so much that I had to constantly watch what I ate, but because I had to poke my finger to check the blood glucose level at least four times a day. The best part though is post-delivery when blood glucose levels often quickly improve and you can enjoy high carbohydrate foods again. But before you sigh with relief, forget all about blood glucose checking and throw away your testing kit, there are still a few things you should know now that you have a history of GDM.

As you may already know, gestational diabetes carries risks for both the mother and the developing fetus within the womb, as well as to the post-natal infant immediately after delivery. Women who have gestational diabetes are also at a higher risk of developing type 2 diabetes later in life. I was given some differing bits of advice from different countries. When I was in the United Kingdom (UK), a midwife told me that after the baby was born, to check my blood glucose level every year on baby’s birthday. In Singapore, however, my OBGYN doctor told me to randomly check my blood glucose level once in a while after a high carbohydrate meal.

So what should really be done now that baby’s out? In the United States, the American Diabetes Association (ADA) provides some guidelines for post-partum women who have had a history of GDM. Recommendations call for women with a history of gestational diabetes to be tested at the 6-12 weeks post-partum check-up for persistent diabetes. This should be done using the oral glucose tolerance test (OGTT) involving a standard glucose load and comparing the results to non-pregnancy diagnostic criteria. The reason for this is because while most women’s blood glucose levels return to normal post-delivery, some women may continue to have high blood glucose levels.

It is also recommended that women with a history of GDM should have lifelong screening for the development of diabetes or prediabetes at least every 3 years. In those found subsequently to have prediabetes (i.e., results indicating they are on the borderline of being diagnosed with type 2 diabetes), ADA recommends these women to receive lifestyle interventions or the medication named metformin to prevent diabetes.

So if you’ve have a history of GDM, you can relax…but not too much. It is still important to take care of your health and body, and to a certain extent be somewhat mindful of what you are eating. This means being aware of and possibly limiting high carbohydrate nutrient poor foods, avoiding excessively large portion sizes, having regular spaced meals/snacks during the day and staying active. And you’ll still need to periodically have your blood glucose levels checked!

(Source: American Diabetes Association. Standards of Medical Care in Diabetes – 2014. Diabetes Care. Jan 2014; 37 Suppl 1: S14-S80. http://care.diabetesjournals.org/content/37/Supplement_1/S14.long#sec-22. Accessed May 30, 2014. Note that there is a correction published for one of the sections within this article at http://care.diabetesjournals.org/content/37/3/887.1)