The benefits of breastfeeding for both mother and baby are well-documented. However, breastfeeding is not naturally easy for every woman. More and more factors that lead to difficulties with lactation are being discovered.  General doctors and health care professionals involved in mother and child care should be well-informed about these factors.

It is already known that obesity in women appears to lead to difficulties with lactation. Now, it seems that maternal glucose intolerance as well may make breastfeeding more challenging. Research has shown that it can take longer for mothers with diabetes to start breastfeeding, possibly because of the role played by insulin lactation. In addition, breastfeeding can lower the need for insulin by up to 25%, because breast milk contains lactose, which is a sugar. For the mother, breastfeeding results in a loss of sugar, and thereby, a fall in blood glucose levels. Mothers with diabetes who do breastfeeding should be aware of the changing blood sugar levels to prevent hypoglycaemia.

In a study led by Dr. Riddle, three groups of mothers were compared, namely, mothers with diabetes, mothers with low milk supply, and mothers who were experiencing other breastfeeding problems. The results showed that nearly 15% of those with low milk supply had diabetes during pregnancy. Just over 6% of the mothers who had lactation problems unrelated to milk supply had maternal diabetes. A possible explanation could be that the abnormal insulin action/glucose metabolism may cause difficulties in establishing and sustaining robust milk production. However, more research is necessary to confirm a cause. Right now, a small randomized controlled trial is ongoing to investigate the effect of metformin on low milk supply.

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