It is important to be aware of potential risks for feeding complications as early as possible. This way, you can be mentally prepared, and have support systems and strategies in place before you encounter possible issues.
Unfortunately, Insulin resistance and Diabetes (Type 1, Type 2, and Gestational) can be associated with low milk production for breastfeeding parents. If you fall into this category, fear not! Diabetes and insulin resistance are just one piece of the puzzle. Work with your doctor and an IBCLC to prevent and manage low supply.
People with diabetes can sometimes experience a delay in their milk “coming in”, as well as a lower overall production. People who take insulin (vs. those who manage through diet alone) are at a higher risk.
Why does this happen?
Insulin is required for overall blood sugar regulation. How that plays into milk supply, though, is super interesting.
Glucose is circulating in your body as “blood sugar”. This sugar gets delivered to cells to help them perform their basic functions. You can have too much of a good thing, however, and insulin helps keep blood sugar levels in check.
When you are breastfeeding, your milk-making cells (called lactocytes) have receptor sites for insulin. The presence of insulin on those cells helps attract and bring in glucose.
The glucose that is drawn into your lactocytes is then converted into lactose.
Not only is lactose the main carbohydrate/sugar in breastmilk, it is also needed to pull water into the breasts and to manufacture the proteins and fat necessary in breastmilk.
Ok, so what does this MEAN?
Research has found that the lactose levels during early milk production (those first few days) are lower in parents with insulin-dependent diabetes. Since lactose drives milk production, milk supply can suffer. Parents with diabetes during pregnancy are up to 2.6X more likely to experience low supply than parents without diabetes.
As an added kicker: higher cortisol (stress hormone) can further increase insulin sensitivity and further reduce lactose uptake. When milk is slow to come in and supply is low, it can be incredibly stressful. Adding stress on top of any underlying issues can exacerbate the problem even more.
What can I do?
This is why is it so important to get meaningful support when breastfeeding!! A prenatal breastfeeding class, prenatal phone consult with an IBCLC (I offer both services!) and postpartum support are crucial steps in your infant feeding journey!!
See my blog post: 3 Steps to Increase Milk Supply and take my Prenatal Breastfeeding Course to learn how you can best maximize your supply from Day 1 and reduce your risk of low supply!