After your baby is born, for women with type 1 diabetes
Managing diabetes after delivery
After your baby is born your diabetes team will review your diabetes management.
You are likely to need less insulin for the first few days after delivery and your target blood glucose levels will be higher (usually 5-10mmol/L).
At this stage when you have a new baby to care for, it is very important to try and avoid hypos.
Your diabetes in pregnancy team will discuss changes to your diabetes management plan with you.
After birth, your baby will be examined by a paediatrician, obstetrician or midwife.
If your blood glucose levels have been stable during your pregnancy and the birth, and your baby has no problems, your baby will go with you to your hospital room, where skin-to-skin contact and breastfeeding is encouraged.
If your baby is born very large, very small, prematurely or is having breathing problems or has low blood glucose levels, they may need to be observed in a special care nursery for a day or two.
Not all maternity hospitals are equipped with a high-level special care nursery, so in some circumstances, your baby may need to be transferred to another hospital.
Skin-to-skin contact between you and your baby will be encouraged at birth because it will help you to develop a close bond with your baby. It also allows your baby to suckle and helps keep their temperature more stable. Ask your midwife about skin-to-skin contact if you and your baby need to be separated.
Your baby’s blood glucose level
Your baby will be checked for low blood glucose levels for at least the first 24 hours after birth. This is done by heel prick—usually within 2 hours of birth or before your baby’s second feed. Blood glucose checks are done at regular intervals until the baby’s blood glucose levels are in range.
Heel prick blood glucose tests are done to check for low blood glucose levels; this is not to check if your baby has diabetes and does not mean that your baby will develop diabetes in the future.
If your baby’s blood glucose level is low (less than 2.6mmol/L), they may need to have supplementary feeds or some glucose. Talk to your midwife about using your breast milk for supplementary feeding.
Taking a new baby home is incredibly exciting, but it can also be a stressful time.
Some women with diabetes find it very hard to make their own health a priority and give their diabetes the attention it demands during this busy period.
Take advantage of any assistance your family and friends can offer. If you don’t have any support nearby, it may be a good idea to organise help with things like shopping, cooking and housework. It is best to start thinking about this and getting plans into place before the baby arrives.
When you first go home with a new baby, especially for the first few weeks, you will be kept busy looking after your baby. You may find that this new routine, along with disturbed sleep, means that you don’t manage your diabetes as well as you would like.
To make sure you and your baby stay healthy and safe remember the following:
- Don’t forget to take your insulin.
- Try to avoid hypos so that you are safe and fit to take care of yourself and your baby.
- Check your blood glucose levels at least four times a day, so you know whether your blood glucose levels are dropping, and to guide your insulin doses. Continuous glucose monitoring (CGM) or flash glucose monitoring (Flash GM) may be suggested in the first few months after your pregnancy. This can be very helpful in managing your blood glucose levels at this time. Access to CGM or Flash GM is available through the NDSS for a period of three months after your baby’s expected date of birth.
- Aim to keep most of your blood glucose levels between 5 and 10mmol/L.
- Make appointments with your diabetes health professionals, they can continue to help you manage your diabetes after your baby is born.
Contraception and future pregnancies
Make sure you are using an effective form of contraception to avoid having another pregnancy before you are ready. Remember that planning another pregnancy and having your diabetes well managed beforehand will help you to have a healthy baby.
If you decide not to have any more children, you may want to consider a tubal ligation or discuss a vasectomy with your partner. There are also a number of very effective long-term but reversible contraception options, including intra-uterine devices (IUDs) and hormone implants. Discuss the available options with your doctor.
Looking after your health
Once you are getting some more sleep and managing a new routine with your baby (usually 3–6 months after your baby is born), it is a good time to become more aware of your health needs again. Review your diabetes management with your diabetes health professionals to keep yourself healthy so you feel well, reduce the risk of long-term health problems and enjoy your new baby.