Key takeaways: Babies of parents with diabetes are more likely to have low blood sugar after birth, and are checked with heel sticks. Early skin-to-skin and frequent feeding help. Some babies are larger or have breathing or jaundice issues. Breastfeeding benefits both parent and baby.
Diabetes in pregnancy, whether gestational or pre-existing, affects how a baby grows and how their body handles blood sugar after birth. With good care, most babies do very well.
Why Babies Need Extra Monitoring
During pregnancy, extra glucose crosses the placenta. The baby’s pancreas responds by making more insulin. After birth, the glucose supply stops suddenly, but insulin levels may stay high for a while. This can cause low blood sugar (hypoglycemia) in the first hours to days.
What to Expect in the Hospital
- Blood sugar checks: heel sticks, often before feeds, for the first 12 to 24 hours or longer.
- Early feeding: ideally within the first hour.
- Skin-to-skin to help regulate temperature and blood sugar.
- Treatment if needed: extra feeds, dextrose gel, or IV glucose for persistent low levels.
From the author
From First Breath to First Birthday is my month-by-month guide to your baby’s first year, written as a NICU and postpartum nurse. Getting ready for baby? My book is a month-by-month companion for the whole first year: feeding, sleep, growth, development and the warning signs to know.
Other Possible Concerns
- Larger size (macrosomia): can increase the chance of a difficult birth.
- Breathing problems: lungs may mature later in some cases.
- Jaundice.
- Low calcium levels.
- Higher red blood cell counts.
- Babies of parents with poorly controlled pre-existing diabetes have a higher risk of certain birth defects, especially of the heart.
Antenatal Colostrum Expression
Some parents with diabetes collect colostrum by hand expression in the last weeks of pregnancy to have it ready for their baby. A large trial found that expressing colostrum from 36 weeks in low-risk pregnancies with diabetes didn’t increase NICU admissions. Talk with your provider before starting.
Breastfeeding
Breastfeeding helps stabilize a baby’s blood sugar and has benefits for the parent, including improved glucose control and, for people who had gestational diabetes, a lower future risk of type 2 diabetes. Milk may come in a little later for some parents with diabetes, so early, frequent feeding and expression help.
Long-Term Health
- For the parent: people who had gestational diabetes have a higher lifetime risk of type 2 diabetes. ACOG recommends glucose testing 4 to 12 weeks after birth and regular screening afterward.
- For the baby: some research suggests a higher risk of obesity and type 2 diabetes later in life. Healthy feeding, active play, and regular checkups help.
Call your baby’s doctor if your baby: is very sleepy, jittery, feeding poorly, or looks increasingly yellow.
The Bottom Line
Babies of parents with diabetes need close blood sugar monitoring at first, but most do very well. Early, frequent feeding helps, and follow-up care protects long-term health for both of you.
Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.
Related Articles
Sources
- Adamkin DH; Committee on Fetus and Newborn. Postnatal glucose homeostasis in late-preterm and term infants. Pediatrics. 2011;127(3):575-579.
- American College of Obstetricians and Gynecologists. Practice Bulletin No. 190: Gestational diabetes mellitus. Obstet Gynecol. 2018;131(2):e49-e64.
- Forster DA, Moorhead AM, Jacobs SE, et al. Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (DAME): a multicentre, unblinded, randomised controlled trial. Lancet. 2017;389(10085):2204-2213.
- Wight NE; Academy of Breastfeeding Medicine. ABM Clinical Protocol #1: Guidelines for glucose monitoring and treatment of hypoglycemia in term and late preterm neonates, revised 2021. Breastfeed Med. 2021;16(5):353-365.
- Gunderson EP, Lewis CE, Lin Y, et al. Lactation duration and progression to diabetes in women across the childbearing years: the 30-year CARDIA study. JAMA Intern Med. 2018;178(3):328-337.
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
