The Sweetest Bond: Navigating Breastfeeding with Diabetes Without the Stress by Kate Rudduck
There’s a moment after birth that doesn’t get talked about enough.
A baby placed on your chest.
Skin-to-skin.
Warmth meeting warmth.
And underneath that moment, questions.
Will my milk come in?
Will my baby’s sugars be okay?
Am I already behind because of my diabetes?
As a Registered Midwife and Diabetes Educator, I see this question carried quietly by so many mothers.
So let me say this clearly, from the very beginning: You are not behind.
But you are often navigating a system that doesn’t fully explain the why behind your body’s rhythm.
And when you understand the “why,” everything feels different.
It’s Not Harder. It’s More Nuanced
Breastfeeding with diabetes isn’t a hurdle to be cleared. It’s just… different.
For some mothers, milk may transition a little later.
Not because your body isn’t working, but because insulin plays a role in the hormonal shift that triggers milk production.
Research shows that metabolic factors like insulin resistance and glucose variability can influence the timing of Lactogenesis II, the stage when milk becomes more abundant.
But here’s the part that matters most: Delayed doesn’t mean dysfunctional.
It means we plan for it.
We support it.
We don’t panic when things don’t happen instantly.
We trust the colostrum while the transition unfolds.
Because early breastfeeding isn’t about volume, it’s about connection, signalling, and repetition.
The First Hour Changes Everything
There is one moment that matters more than most, and it’s often underestimated in a medicalised birth.
Skin-to-skin immediately after birth.
The WHO/UNICEF Baby-Friendly Hospital Initiative calls this Step 4: uninterrupted contact between mother and baby.
In real life, it looks like this:
Your baby on your chest.
No rush.
No unnecessary interruption.
This moment is more than bonding; it is physiology.
It supports instinctive feeding behaviours and triggers the oxytocin cascade that helps milk production begin.
For babies of mothers with diabetes, who are often more closely monitored, this isn’t just “nice to have.” It is protective.
If there’s one thing to advocate for in your birth space, let it be this.
The Safety Net: “Liquid Gold”
Around 36 weeks, something small, but powerful, can shift the energy of your entire birth: Antenatal colostrum harvesting.
This is the gentle practice of expressing and storing colostrum before your baby arrives.
Not to “get ahead.”
Not to force your body.
But to remove the pressure of the what-if.
Because if your baby needs support with blood sugars in those early hours, you already have your own colostrum ready.
And that changes everything.
Research in women with diabetes shows that antenatal expression is safe when appropriately guided and may support earlier breastfeeding establishment.
Colostrum is small—but it is mighty.
The Early Days: Expectations vs Reality
This is where things often go wrong.
Not because of your body, but because of expectations.
I often meet mothers in the first 24 hours who whisper the same thing:
“I think I don’t have enough milk.”
And almost always, what they’re experiencing is not low supply.
It’s the very beginning, working exactly as it should.
Let’s gently reframe what’s normal: Colostrum comes in small amounts, teaspoons, not bottles, and it is perfectly designed for your newborn.
Frequent feeding (8–12+ times in 24 hours) is how your body receives the signal to build supply.
A slightly slower transition to fuller milk is a metabolic variation, not a failure of your body.
What feels like not enough is often just the beginning.
The WHO International Code of Marketing of Breast-milk Substitutes reminds us that formula should not be introduced without a clear medical indication, not because it is harmful, but because unnecessary supplementation can interrupt the system trying to establish itself.
This Was Never Meant to Be Done Alone
Breastfeeding with diabetes sits within collaborative care.
That means your care is not meant to sit on your shoulders alone.
Your midwife, diabetes team, and lactation support should work together, not separately.
Because this isn’t just about feeding.
It’s about:
glucose patterns
hormonal shifts
recovery
confidence
And when support is aligned, everything feels more manageable.
The Part No One Warns You About
Breastfeeding is metabolically active.
It lowers blood glucose, sometimes significantly.
You may notice:
– low blood sugars during or after feeds
– changing insulin requirements
– a sudden, urgent kind of hunger
And it can feel unexpected.
But this isn’t something going wrong.
This is your body working.
Breastfeeding is often described as a metabolic reset, improving insulin sensitivity and reducing long-term risk of Type 2 diabetes after gestational diabetes.
With the right support, this becomes something you move with, not something you fear.
A Different Definition of Success
It’s easy to look for numbers.
Millilitres.
Timing.
Schedules.
Glucose readings.
But breastfeeding isn’t built on numbers.
It’s built on:
repeated contact
responsive feeding
support when things feel uncertain
Especially with diabetes, success isn’t perfection.
It’s: Understanding + support + time
You Are Not Behind
If you take one thing from this, let it be this:
You are not behind.
Your body is not failing.
And this is not something you need to force into working.
Breastfeeding isn’t just feeding.
It is the bridge that allows you to transition from being a patient back to being a mother.
And your body already knows how to begin.
You just need the space and the support to let it unfold.
Kate Rudduck is an Australian Registered Midwife, Diabetes Educator, and Lactation Researcher dedicated to bridging the gap between clinical complexity and the magic of early motherhood. While she is an advocate for all breastfeeding journeys, Kate specialises in navigating the nuances of breastfeeding with diabetes, moving families away from "high-risk" fear and toward metabolic empowerment. Whether providing in-home support through Elara Lactation or conducting research, Kate desires to ensure every mother feels confident, nourished, and heard. Connect with her at elaralactation.com or on Instagram and Facebook.
For clinicians, midwives, and educators wanting to deepen their understanding of this space: Kate’s Professional Practice Course: Diabetes & Breastfeeding Care offers a structured, evidence-based framework to confidently support families navigating these intersecting needs without over-medicalising the experience.
References
Filardi, T., Bleve, E., Gorini, S., Caprio, M., & Morano, S. (2025). Is Breastfeeding an Effective Approach to Reduce Metabolic Risk After GDM in Mothers and Infants?. Journal of clinical medicine, 14(9), 3065. https://doi.org/10.3390/jcm14093065
Greenberg, V.R. (2025). Glycemic Patterns and Breastfeeding With Type 1 or Type 2 Diabetes. Diabetes Spectrum, [online] 38(4), pp.407–413. doi:https://doi.org/10.2337/dsi25-0012.
McMonagle, G., Mooney, E., Mallon, K., McCloat, A., Lydon, R., Cunningham, L., Kennedy, M., Lennon, R. and McLoone, M. (2025). Transforming Breastfeeding outcomes: the Power of Antenatal Breastmilk expression, a Retrospective Cohort Study in Ireland. Midwifery, 150, p.104625. doi:https://doi.org/10.1016/j.midw.2025.104625.
Wu, J.-L., Pang, S.-Q., Jiang, X.-M., Zheng, Q.-X., Han, X.-Q., Zhang, X.-Y. and Pan, Y.-Q. (2021). Gestational Diabetes Mellitus and Risk of Delayed Onset of Lactogenesis: A Systematic Review and Meta-Analysis. Breastfeeding Medicine, 16(5), pp.385–392. doi:https://doi.org/10.1089/bfm.2020.0356.