Antidiabetic agents and lactation.

Abstract

If the dose of insulin and adequate carbohydrate intake is ensured, most diabetic mothers taking insulin will be able to breastfeed satisfactorily. Compared to the dose before pregnancy, the required insulin dose probably will be substantially reduced during breastfeeding. The American Academy of Pediatrics recommends tolbutamide as the preferred oral hypoglycemic agent during the breastfeeding period; however, the infant should be monitored closely for signs of jaundice. The mother should be monitored using a method specific for glucose, since lacturia may interfere with nonspecific methods of urine glucose measurement. It is important to monitor for ketones in the mother because acetone is excreted in breastmilk and may adversely affect the infant's liver.