By Joyce Teo, The Straits Times

Gestational diabetes increases the risk of mothers and their children developing Type 2 diabetes after pregnancy.

One way of reducing such risks is to breastfeed the baby, studies have shown.

"A mother who has (gestational diabetes) increases the risk that her child will become obese during childhood," said Professor Tan Kok Hian, the head and senior consultant of the perinatal audit and epidemiology unit at KK Women's and Children's Hospital.

"However, breastfeeding a baby for at least six months reduces that risk."

Feeding with infant formula can lead to excessive weight gain in babies, he said.

Breastfeeding has many advantages for the newborns, including decreased risks of high respiratory infections, high blood pressure, asthma, allergies and diabetes.

For the mother, breastfeeding helps to boost her metabolism, burn calories and reduce her weight, said Prof Tan.

Mothers who breastfeed also decrease their risks of heart disease and Type 2 diabetes, he said."

The longer the mother breastfeeds, the lower her risks will be."

Breastfeeding can also help lower blood glucose levels in the period soon after birth, he said.

Prof Tan added that mothers with gestational diabetes should not deliberately try to lose weight too quickly. "It is important that the mother obtains optimal amounts of fluids, protein, vitamins and minerals while breastfeeding," he said.

"Develop a meal plan with the doctor or dietitian that can allow for gradual weight loss and still achieve successful breastfeeding."

If a mother has diabetes, she can still breastfeed as diabetes does not change the composition of the mother's milk, which is the most beneficial source of nutrition for infants, Prof Tan pointed out.

However, she has to take note that when she is not breastfeeding, low blood sugar levels (hypoglycemia) might occur, he said.

To prevent this, she can:
• Monitor her blood sugar levels closely.
• Have a snack before or during breastfeeding.
• Drink sufficient fluids (try sipping a glass of water while nursing).
• Keep a snack at hand, which she can eat if she feels giddy due to low blood sugar levels. This way, she can still continue to breastfeed her child.

Manage your gestational diabetes

You can reduce the risk of developing gestational diabetes by having a healthy pre-pregnancy weight, diet and exercise regimen.

But if you do get it, control it by changing your diet.

Gestational diabetes is controlled via diet and rarely, with insulin, said Dr Tan Kai Lit, an obstetrician and gynaecologist at Thomson Women's Clinic (Toa Payoh).

Here are his tips:
• Eat less carbohydrates - such as rice, bread and noodles - and more protein and fibre. Also, aim for no sugar in beverages.
• Avoid fast food.
• Exercise regularly. For instance, aim to do so two to three times a week and for about half an hour each time.
• Walk for about 20 minutes after each meal to help control post-meal blood sugar levels.
• Avoid excessive weight gain in pregnancy.

In September last year, the National University Hospital (NUH) started the Smart-GDM trial to test the efficacy of an app in preventing excessive weight gain among women with gestational diabetes.  
As of last week, it has recruited 240 patients for the trial, said Dr Yew Tong Wei, a consultant at NUH's endocrinology division. 
The app provides patient education, helps track the weight and blood glucose levels of pregnant women with gestational diabetes, and has an interactive messaging platform.
Gestational diabetes that is managed with diet changes, or controlled with blood glucose-lowering therapy, usually is resolved with the delivery of the child, said Dr Tan.
But for blood glucose-lowering therapy, women should discontinue the medication immediately after birth, he said.
"Continuing the medication could cause low blood sugar levels, which may be harmful to the mother." 
He advises mothers with gestational diabetes to get a fasting blood sugar level test done between six and 13 weeks after delivery to make sure the condition has resolved.