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Breastfeeding and Oral Diabetic Meds
By Jane Squires, RN, IBCLC

Janes SquiresQ. I found out at 7 1/2 weeks that I had diabetes. My first pregnancy was fine. I immediately went on insulin. After I delivered, my sugars were checked and found to be normal. No more insulin, but I still followed a diabetic diet. For 6 months I checked my bloodsugars and everything was normal.

Today, I went to my family doctor to see if I had a UTI, and they found lots of sugar in my urine. The PA recommended that I go on Acot, an oral diabetic med. It is not recommended for breastfeeding. The PA wants me to immediately stop breastfeeding and take the meds. My mom is a diabetic educator, and she said my sugar is not high enough to rule out lowering by diet and exercise. My question is, do you know of any medication other than injectable insulin that a person can take to control their sugars without it interfering with breastfeeding? My son is 13 months old, but we are not ready to wean yet.

A. I do know quite a bit about breastfeeding and diabetes. I know that when the baby is born you kind of go into a honeymoon phase with the diabetes. Hence the more normal blood sugars. I have not known that you could not breastfeed with insulin. Your mother sounds like a smart woman.

Dr. Thomas W. Hale says in his book that the peptide of insulin, which is basically the particle that has to pass into the breastmilk to get to the baby, is too big. He goes on to say that if it does get into the breast milk, it will be destroyed in the baby's GI tract leading to minimal or no absorption. He further states that for pediatric concerns, none are reported via milk.

He does not say anything about oral hypoglycemic agents. I would contact him at http://www.iBreastfeeding.com and ask him the same question. Then you will be armed with information. You should not have to give up breastfeeding at the mountain of ignorance. Most people know so very little about breastfeeding, that they would rather tell you to quit, than to look into it, because looking into it takes time, but the answers are out there. There are so few drugs that are contraindicated while breastfeeding.

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