Diabetes: A Newborn’s Concern, Too

Babies born to mothers with diabetes aren’t destined to develop the condition. But they do face a high risk for complications after birth. A newborn infant of a mother with diabetes may develop one, or more, of the following:

• Low blood sugar: Hypoglycemia refers to low blood glucose in the baby immediately after delivery. This problem can occur if your baby had a high level of insulin in his circulation because your blood glucose levels were consistently high during pregnancy. After delivery, your baby’s blood glucose becomes very low because he no longer receives glucose from you.

• Larger body size: Macrosomia refers to a baby that is considerably larger than normal. All the nutrients your baby receives come directly from your blood. If your blood has too much glucose, the pancreas of your baby senses the high glucose levels and produces more insulin in an attempt to use this glucose. Your baby’s body converts the extra glucose to fat. Even if you have gestational diabetes, the fetus is able to produce all the insulin it needs. The combination of high blood glucose levels from you and high insulin levels in your baby can result in large deposits of fat and a larger than normal baby size. The baby’s size can lead to a hard delivery and possible birth injury.

• Difficulty breathing: Too much insulin in a baby's system due to diabetes can delay surfactant production which helps lungs mature.

Mother Plays Role in Treatment Decisions

The treatment your doctor recommends will depend on how your diabetes was controlled during the last part of your pregnancy and labor. It also depends on:

• Your baby’s gestational age, overall health, and medical history

• Extent of the condition

• His tolerance for specific medications, procedures, or therapies

• Expectations for the course of the condition

• Your opinion or preference

Immediate Care Can Protect Baby’s Health

If your baby develops any complications from diabetes, your doctor will take quick actions to protect his health:

• Your doctor will check for any signs of birth defects or birth injury and begin necessary care. For example, if your baby has breathing difficulties, your doctor may recommend oxygen therapy or a breathing machine.

• Your new baby’s blood glucose levels will also require careful monitoring. Blood may be drawn from a needle or through a tube placed in his umbilical cord. If your baby’s blood glucose level is too low after birth, he may need a quick source of glucose. This may be as simple as giving a glucose/water mixture as an early feeding. Or your baby may need glucose given intravenously.

Follow-Up Care Just as Important

After treatment, make sure to work closely with your child’s doctor. Your baby may need his blood glucose levels to monitored to see if hypoglycemia to occur again. Your baby also may require other future tests and treatment.