Breastfeeding in women with pre-existing diabetes

Breastfeeding should be encouraged for all women because it has multiple benefits for mother and child. Using formula does not increase the risk of a child developing diabetes.

Insulin is safe to use during breastfeeding. Metformin is generally considered safe to use during breastfeeding, but the decision as to when to restart metformin should be made on an individual basis after discussion with the woman and the treating specialist. Other noninsulin antihyperglycaemic drugs are usually not given while the woman is breastfeeding. See General information on drug use in breastfeeding for more information about the safety of antihyperglycaemic drugs in breastfeeding women.

Breastfeeding women with diabetes need approximately 20% less insulin than before they were pregnant. The possibility of hypoglycaemia should be anticipated and avoided by timely meals and snacks; fast-acting carbohydrate (eg fruit juice, jelly beans) should be within reach while breastfeeding (see Hypoglycaemia in patients with diabetes). Women with diabetes should be advised to check their blood glucose concentration before feeding or bathing their baby, and before driving.

When women with type 2 diabetes stop breastfeeding, their antihyperglycaemic drug treatment should be adjusted according to their individual needs.