Quality care for postpartum gestational diabetes is extremely important for both mother and baby.
If a woman has already had gestational diabetes with an earlier pregnancy, she will be at risk of it developing again with future pregnancies. She will also be at risk of developing Type-2 diabetes which is one of the permanent types of diabetes. The best way to prevent this is exercise and to maintain a healthy weight during pregnancy.
Insulin levels should return to normal after delivery but it is important for mothers who were on insulin therapy during pregnancy to have their physicians monitor blood glucose levels before the mother and baby are released from the hospital. In most cases, blood sugar levels will return to pre-pregnancy levels but in some cases the mother could develop Type-2 diabetes.
If the mother was on oral therapy before pregnancy and changed to insulin therapy during pregnancy, insulin therapy may need to be continued while breast feeding. The mothers’ doctor will advise her of this.
For those mothers with diabetes, they can still breast feed the baby. The mother’s calorie needs need to be monitored and carefully adjusted if needed. About 500 calories every day will need to be added to the mother’s pre-pregnancy diet to provide the energy needed for the production of milk.
For mothers with diabetes a careful record of blood glucose levels need to be kept as diabetics who breast feed are prone to hypoglycemia especially in the night hours between bedtime and before breakfast. Often a snack will need to be added before the nighttime feeding.
If a woman has had gestational diabetes she should avoid any medications that increase her resistance to insulin. Examples of these are nicotinic acid and glucocorticoid (prednisone and dexamethasone). It is advised to avoid progestin only birth control pills as they can raise the risk of developing Type-2 diabetes. Birth control pills that contain low dose combination of estrogen and progestin do not have the added increase risk of Type-2 diabetes.
A child born to a woman who has gestational diabetes is at a greater risk of being overweight and developing Type-2 diabetes. Breast-feeding the baby can lower the risk to the baby of becoming overweight. As the child grows older, it is up to the mother to teach and encourage the child to eat healthily and to get regular exercise to prevent Type-2 diabetes. Children who are overweight, who do not eat well and who get little or no exercise are setting themselves up for an early diagnosis of diabetes.
Quality care for postpartum gestational diabetes is extremely important for both mother and child. There are many changes occurring after giving birth and returning to normal activities so mothers may experience a roll-a-coaster of emotions as hormone levels return to normal pre-pregnancy levels.
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