Sugar levels after childbirth. View full version What can you do if you have high blood sugar after childbirth?

Pregnancy. An amazing, wonderful and one of the most exciting periods in a woman’s life, which promises very important changes - the birth of a child. Of course, all mothers want the best for their baby - first of all, that he is healthy. The key to a baby’s health is, first of all, the health of his mother. But, unfortunately, it often happens that at the stage of pregnancy planning, or in the early stages of pregnancy, the gynecologist talks about the need to visit an endocrinologist, since an increase in blood sugar levels has been detected.

At the first visit to the gynecologist, all pregnant women are examined for glycemia (blood sugar - gr. glykys sweet + haima blood) on an empty stomach. At the same time, the expectant mother may hear: “Your blood sugar is 5.1 mmol/l, this is higher than normal.” How so? It seems that the indicator is “low”. But the thing is that glycemic targets are different for pregnant and non-pregnant women.

The normal level of venous blood plasma sugar in a pregnant woman on an empty stomach is strictly below 5.1 mmol/l.(it should be noted that before taking the test you can drink ONLY still water. Tea, coffee, etc. are prohibited).

If the venous blood plasma sugar level is ≥ 5.1 mmol/l, but below 7.0 mmol/l, a diagnosis is made gestational diabetes mellitus. In some cases, an oral glucose tolerance test (OGTT) is performed to confirm the diagnosis, but this is not mandatory .

Criteria for diagnosing gestational diabetes mellitus and its causes

• Gestational diabetes mellitus- when fasting blood sugar is equal to or more than 5.1 mmol/l and less than 7.0 mmol/l, 1 hour after the OGTT (oral glucose tolerance test) is equal to or more than 10.0 mmol/l, 2 hours after the OGTT is equal to or more than 8.5 mmol/l and less than 11.1 mmol/l.
• If the blood sugar level is higher than or equal to 7.0 mmol/l, blood is taken again from a vein on an empty stomach and 2 hours after a meal to determine glycemia. If blood sugar is again 7.0 mmol/l or higher, and two hours after eating 11.1 mmol/l or higher, a diagnosis is made manifest diabetes mellitus.

All studies should be carried out on venous blood plasma. When assessing indicators blood sugar from finger- data not informative!

So why does a healthy woman, whose blood sugar was always normal before, experience an increase?

In fact, high blood sugar (hyperglycemia) during pregnancy is now a common situation. According to statistics, about 14-17% of all pregnancies occur in conditions of hyperglycemia. Pregnancy is a state of physiological (with related to the physiology of the body, with its vital functions) insulin resistance (decreased tissue sensitivity to insulin).

Let's look at this term to make it clear. Glucose is a source of energy for the cells of our body. But glucose cannot enter cells from the blood on its own (with the exception of vascular and brain cells). And then insulin comes to her aid. Without this hormone, the cell “does not recognize” the useful and necessary glucose. In simple terms, insulin “opens the doors” of the cell for glucose to enter. The cell receives its energy, and the blood sugar level decreases. Thus, insulin ensures the maintenance of normal glycemic levels. Insulin resistance is a condition in which cells partially do not recognize insulin. As a result, the cells will not receive enough energy, and blood sugar levels will rise.

The hormones produced by the new organ of a pregnant woman, the placenta, are to blame for physiological insulin resistance. Due to this effect of hormones on cells, insulin production in the blood increases to “overcome” insulin resistance. Normally, this is sufficient, and when glucose enters the cells, the blood sugar level decreases. But in some pregnant women, despite increased insulin synthesis, insulin resistance is not overcome, and blood sugar remains elevated.

Overt diabetes mellitus- This is diabetes mellitus diagnosed for the first time during pregnancy, and its occurrence is not associated with physiological insulin resistance. This is the same diabetes that occurs outside of pregnancy - type 2 or type 1 diabetes.

When the mother's blood sugar level increases, glycemia and insulin levels in the blood of the fetus increase. As a result, this worsens the course of pregnancy and harms the health of the child.

Why is gestational diabetes mellitus dangerous?

Hyperglycemia during pregnancy significantly increases the risk of:

• Preeclampsia (a form of late toxicosis - increased blood pressure above 140/90 mmHg, proteinuria (the appearance of protein in the urine), edema).
• Premature birth.
• Polyhydramnios.
• Urogenital infections.
• Development of placental insufficiency.
• High frequency of operative delivery.
• Thromboembolic disorders.
• Perinatal diseases of the newborn, perinatal mortality.
• Diabetic fetopathy of the newborn.
• Ischemic changes in the brain of a newborn.
• Lesions of the central nervous system of the newborn.
• Pneumonia of newborns.
• Fetal macrosomia (large fetus) is the main cause of birth injuries.

Who needs to be examined at the stage of pregnancy planning:

• Women who are obese.
• Women with ovarian dysfunction and infertility.
• Women with a burdened obstetric history, miscarriage.
• Women who had gestational diabetes mellitus in a previous pregnancy and are planning a pregnancy again.

So, the diagnosis of gestational diabetes mellitus has been made. Of course, an individual approach to the treatment of any disease is necessary, there are no exceptions. An individual treatment regimen can only be selected by an endocrinologist or gynecologist-endocrinologist at an appointment. For one patient, the endocrinologist will prescribe only a special diet for the entire gestation period, while another will need additional drug therapy. But the basis is the same for everyone. This is a special balanced diet and proper self-control of glycemia.

How to properly self-monitor glycemia

Self-monitoring of glycemia is carried out independently using a glucometer. At the pharmacy it is possible to purchase a glucometer, both the simplest and the more complex, which stores measurement values ​​and can build a glycemic curve.

But whatever the glucometer, it is best to start keeping a diary of self-monitoring of glycemia and a food diary. This is an ordinary notebook in which all blood sugar measurements are recorded on one page, indicating the dates and times of measurement (before meals, an hour after meals, before bed).

On another page they write the daily diet, indicating the time of food consumption (breakfast, lunch, dinner or snack) and the amount of product (required) + calorie content, protein, fat and carbohydrate content (desirable).

In case of gestational diabetes mellitus, at the stage of selecting and assessing the adequacy of treatment, glycemic measurements should be from 4 to 7 times a day. These are indicators on an empty stomach before breakfast, before lunch, before dinner and at night (required) + 1-1.5 hours after breakfast, after lunch (optional).

What are the goals of treatment for gestational diabetes?

• Fasting glycemia - strictly less than 5.1 mmol/l
• Glycemia 1-1.5 hours after eating is less than 7 mmol/l.

Features of the diet for gestational diabetes mellitus:

• Fasting and long breaks between meals are unacceptable.
• The last meal - an hour before bedtime (snack) - is protein (meat, fish, egg, cottage cheese) + complex carbohydrates (uncooked cereals, pasta, black, whole grain bread, vegetables, legumes). If you are obese, the last snack before bed is protein + vegetables.
• Minimize or completely avoid sweets (honey, sugar, sweet pastries, ice cream, chocolate, jam), sugary drinks (juices, fruit drinks, soda), boiled cereals/pasta, mashed potatoes, white bread, white rice.
• The frequency of meals is at least 6 times a day! (3 main + 3 snacks)
• Carbohydrate starvation should not be allowed; carbohydrates must be eaten, but the right ones! These are uncooked cereals, pasta, potatoes, black and whole grain bread, vegetables, legumes, liquid unsweetened dairy and fermented milk products. It is recommended to consume carbohydrates in small quantities every 3-4 hours.
• Physical activity is required - a walk in the morning and evening for 30 minutes.
• Increase your fiber intake - these are vegetables (except potatoes, avocados). If you are obese, include fiber in every main meal.
• Low-calorie diets are unacceptable. Consume at least 1600 kcal per day. (taking into account the actual body weight, the endocrinologist will select an individual norm).
• Fats for normal body weight should make up about 45% of the daily diet, for obesity - 25-30%.
• Protein food is required - at least 70 grams of protein per day.
• Eat fruits with a low glycemic index in small quantities (grapes, cherries, cherries, watermelon, melon, figs, persimmons, bananas are not recommended). It is better to combine with protein foods (for example, cottage cheese, cottage cheese casserole with fruit).
• Dried fruits - no more than 20 grams of dried fruits per serving in main meals. If it is a snack, combine it with protein (for example, cottage cheese). No more than 2 times a day.
• Chocolate - only bitter, no more than 3 slices (15 grams) per serving, no more than 2 times a day. In the main meal or in combination with protein (for example, cottage cheese).

It is recommended to follow the “plate rule”. This rule is that at each main meal you need to eat foods rich in fiber (vegetables), proteins, fats and carbohydrates. At the same time, most of the plate (1/2) should be occupied by vegetables.

Recommendations are general. If, when consuming a particular product, blood sugar rises above the target values, it is recommended to limit its consumption or reduce the amount of the product. All questions regarding the preparation of an individual nutrition plan must be resolved at an appointment with an endocrinologist.

Need to know during pregnancy It is prohibited to take tableted glucose-lowering drugs, since their safety during pregnancy has not been proven.

If the diet fails to achieve glycemic targets, the doctor prescribes insulin. You shouldn't be afraid of this. Insulin does not cause any harm to either the mother or the fetus. Popular myths about insulin are nothing more than myths. After delivery, in 99% of cases, insulin is discontinued. Do not forget that the main thing in the treatment of gestational diabetes mellitus is achieving stable glycemic targets.

Gestational diabetes mellitus:postpartum period and lactation

As noted earlier, most often after childbirth, blood sugars return to normal. But sometimes there are exceptions. In the first three days after birth, an examination is necessary, which is carried out in order to identify the possible persistence of impaired carbohydrate metabolism - fasting glycemia is monitored.

Lactation and breastfeeding are the prevention of diabetes mellitus for women who have had gestational diabetes mellitus. If a woman continues to have an increase in glycemia, and during diet therapy, blood sugars do not return to normal, the endocrinologist prescribes insulin therapy for the entire period of breastfeeding. Taking tableted glucose-lowering drugs during lactation is prohibited.

Let's sum it up

• Gestational diabetes mellitus is characterized by a systematic increase in glycemia in the absence of treatment.
• Even the slightest increase in glycemia in a pregnant woman ultimately leads to adverse consequences.
• When the mother’s blood sugar increases, the baby’s blood glucose and insulin levels increase, which ultimately leads to the serious complications described above.
• During pregnancy, it is better to come to the endocrinologist once again if you are worried about this or that issue, than not to come.
• The basics of treating gestational diabetes mellitus: proper self-control + diet therapy + drug therapy (if prescribed by an endocrinologist). Goals are stable glycemic targets.

Dear mothers, take care of yourself. Take your health and the health of your baby seriously. Have an easy pregnancy and healthy babies!

Endocrinologist Galina Aleksandrovna Akmaeva

Very often a nursing mother wants to eat something sweet. It could be just tea with sugar or a delicious cake. This desire for something tasty can be easily explained: when breastfeeding, a lot of energy is expended. However, often the mother is in a state of stress and anxiety. Sleepless nights and breastfeeding also take away the strength of the nursing mother.

With the help of sugar or another sweet product, you can lift your mood and saturate the body with carbohydrates, which give the body strength and energy.

Beneficial features

If you eat a product that contains a lot of carbohydrates, you can increase the level of the hormone serotonin. Thanks to this substance:

• the general tone of the body is normalized;
• the state of fatigue goes away;
• insomnia is eliminated;
• pain is relieved.

If a nursing woman does not have enough serotonin in her body, her mood may deteriorate. This makes you want to eat something tasty and sweet. Using regular sugar, you can also activate the production of the hormone endorphin, which is also called the “hormone of joy.” This is why you often want to treat yourself to something tasty.

It's hard to imagine that sugar can be harmful to humans. Especially considering that both adults and children love sweets. How can you harm your body with sugar, which helps lift your mood and gives you strength and energy? However, it is worth considering whether it benefits the body during breastfeeding?

One nursing mother thinks that there is nothing wrong with the baby receiving carbohydrates through milk, which will give him more energy. And other women are sure that this sweet product should not be consumed while breastfeeding, as it can cause allergies and colic in the infant.

Whether you can eat sugar or not, everyone decides for themselves. After all, everyone’s body is individual. Someone can indulge themselves with sweets and not have any troubles, while others limit themselves even to sweet tea so as not to cause problems with the well-being of the newborn.

What does sugar consist of?

Before answering the question whether you can or cannot consume sugar during breastfeeding and why, you need to find out what it is.

Is it possible or not?

But why then does the question arise, is it possible to eat sugar while breastfeeding? There are many processing steps involved during the production of this product. As a result, there are almost no beneficial substances left in sugar. And the body spends a lot of effort to digest the carbohydrates received. This can disrupt the endocrine and immune systems.

But you can’t immediately give up sweets during lactation. Sugar perfectly replenishes lost strength, and glucose, which is part of it, activates the work of the brain.

A nursing woman can eat fruits and vegetables, which contain glucose and fructose necessary for the body. Cane sugar is an excellent alternative to regular sugar. It is much healthier and contains a large amount of vitamins and minerals.

When breastfeeding, it is better to limit yourself to eating sweet buns, cakes, chocolate, candies and other similar foods. They can trigger the fermentation process in the intestines. But this may not be the case for everyone.

So that a nursing mother does not deprive herself of the pleasure of eating sweets, she can please herself with the following products:

• marshmallows;
• cake with yogurt and cottage cheese;
• marmalade made from natural ingredients;
• paste;
• baked apples;
• candied fruit;

These products contain much less heavy carbohydrates, which can negatively affect the baby's body. Therefore, it is better to replace familiar sweets with less harmful ones. Also, you should not use them every day, especially in the first month after childbirth.

Previously, doctors allowed condensed milk during breastfeeding. But in recent years they do not recommend it, since modern production uses substances that are harmful to a fragile child’s body.

When breastfeeding, each woman decides for herself what and how much she can eat, and what she should refuse. Through trial and error, new mothers try out many dishes every day that they loved to eat before the baby was born. After all, some of them can negatively affect the well-being of the newborn. But a nursing mother should not completely give up sweets. A few goodies can please the mother and not harm the child. The received dose of carbohydrates will help lift the mood and replenish the expended energy of a tired woman, and this is very important for the emotional state of not only the nursing mother, but also her baby.

The birth of a child is a new stage in a woman’s life. Now she needs to get used to a new way of life - a daily routine, a sense of responsibility and, of course, dietary habits. At least for the first time after childbirth, mothers who are breastfeeding their babies should follow a diet. This point is especially difficult for many girls. After all, many foods are prohibited, especially sugar during breastfeeding. What should young mothers with a sweet tooth do?

Can a nursing mother have sugar? Of course, we are not talking about completely excluding this product from the menu. After all, sugar has a number of beneficial properties:

However, despite the advantages, sugar has many more negative properties that cannot be ignored during lactation:

Is it possible to drink tea with sugar during lactation? If you really want to, then you can. With one caveat: the number of spoons of sugar should not exceed one or two.

Some mothers prefer to eat cane sugar. In terms of calorie content, it is not much different from ordinary beetroot and at the same time contains a certain amount of useful substances (for example, vitamins). However, the cane version is just as harmful as the regular one. In particular, it is prohibited for people with diabetes.

What does Dr. Komarovsky say about this?

The famous children's doctor, author of various books and television programs, Dr. Komarovsky, allows moderate consumption of sweets by a nursing mother. After all, if the mother is full and satisfied, lactation improves. But the key word here is moderate. In addition, according to the doctor, the mother should carefully monitor the baby’s reaction to the administered product. If the mother’s diet does not harm the baby in any way, then it is quite possible to continue to pamper yourself a little.

Permitted rate

So, you can eat sugar while breastfeeding. How to calculate the permissible norm for breastfeeding? Determining the exact amount in teaspoons is quite difficult. The norm is individual. A nursing mother should consume sugar taking into account the peculiarities of the reaction of the baby’s and mother’s body.

Consumption of sweets should be reduced to a minimum (or completely abandoned) if:

• the child has severe allergies and/or colic;
• a nursing mother has a tendency to increase blood glucose (for example, there were bad tests during pregnancy);
• mother has close relatives with insulin-dependent diabetes;
• Mom wants to lose weight.

It is most convenient to keep a food diary, which will reflect the number of sweets eaten. This way the mother will control her diet, while simultaneously observing the baby’s reaction. Keep in mind that you need to take into account not only the pure product, but also white bread, candy, cookies and other products where sugar is added.

According to medical standards, a woman can consume no more than 30 grams of sugar per day in total. This is approximately 6 teaspoons. For breastfeeding, you can adhere to these standards or adjust the amount downward.

The mother's nutrition for the first month after the birth of the baby should be as correct as possible. It is worth giving up all allergenic foods, including sweets.

How to replace it

A nursing mother is unlikely to be able to completely eliminate sugar from her diet. But replacing sugar with other sweet-tasting foods is quite possible.

Fructose

It has been proven that fructose is less harmful during breastfeeding, since it is a natural product extracted from fruits or honey. Its value is as follows:

• strengthening immunity;
• fructose in small quantities can be consumed even by mothers with diabetes;
• fructose can be used as an ingredient for preparing various dishes (as an alternative to granulated sugar).

Although fructose is a natural product, you should not abuse it either. It carries all the same risks as regular granulated sugar. An excess of fructose will negate all attempts of a nursing mother to lose excess weight. Since this component does not cause a feeling of satiety, it is not recommended to indulge in foods containing fructose.

Healthy sweets

It’s not just sugar that can be sweet, no matter how banal it may sound. And the restriction on candy, baked goods and other sweets is not the biggest sorrow. After all, you always have complete natural sweet foods on hand, filled with a fair amount of vitamins and minerals.

So, if the baby does not have allergic reactions, you can replace sugar with honey (of course, in moderation, because honey contains pollen - a strong allergen). Seasonal fruits will also bring mom a lot of taste pleasures, and most importantly, benefits.

It is worth giving preference to fruits that grow in the area where the young mother lives. It is better to put off exotic fruits and citrus fruits and introduce them into the diet as the child grows older.

Fruits and berries are natural sources of fructose.

Bakery

Tasty, aromatic, fresh homemade baked goods are undoubtedly much healthier than store-bought sweets. Made with soul, such a work of culinary art will charge the young mother and other family members with positivity and provide the necessary energy. During the baking process, you can adjust the amount of sugar in the recipe so that the product does not turn out too cloying.

You can use fructose for home baking. In such cases, the baking temperature should be slightly lower than for products with sugar.

Artificial sugar substitutes: a definite no

During lactation, the use of chemical sweeteners is unacceptable.

The most common artificial sweeteners are Cyclomate, Aspartame, and Sorbitol. It is strictly unacceptable to use them during breastfeeding. The components of any such sugar substitute easily penetrate the baby’s body through milk and negatively affect the gastrointestinal tract of the mother and baby. Moms should pay attention to more gentle natural options. The optimal sugar substitute for feeding is glucose or a stevia-based alternative.

The sweetener Cyclomat is prohibited for distribution in the European Union. Aspartame is no less dangerous to health. This sweetener is processed into methyl alcohol and, accordingly, is poisonous for adults and children. Some scientists believe that these sweeteners can even cause cancer.

So, for mothers who love to treat themselves to tasty foods, there is good news - you don’t have to give up all sweets. It is only important to dose the amount of sugar entering the body. In addition, there are many natural substitutes that will saturate the body and satisfy the sweet needs of a young mother.

Consumption of sugar in large quantities is harmful not only for nursing mothers, but also for other people. But in small doses it is even useful. After all, it lifts your mood and relieves fatigue, helps with depression and insomnia, and improves the overall tone of the body. The main thing is not to overeat sweets and not use chemical sweeteners when breastfeeding.

The benefits of sugar for nursing

Regular sugar or sucrose contains a large amount of carbohydrates. This is a valuable nutritious product that saturates the body with energy and increases the level of serotonin or the so-called happiness hormone.

In addition, it performs the following useful functions:

• Gives vigor and energy. Restores strength during physical and emotional stress;
• Improves mood and helps fight depression;
• Relieves fatigue, spasms and pain;
• Normalizes sleep and helps with insomnia;
• Protects the liver from the negative effects of toxins;
• Improves the absorption of vitamin B, iron and calcium;
• Participates in the formation of the brain and stimulates brain activity.

Sugar contains glucose, lactose and fructose. The listed substances are necessary for the full growth and development of the baby, as well as for the speedy recovery of the mother after childbirth. Sugar should not be excluded from the diet when breastfeeding, as it provides the necessary energy for both the baby and the mother.

Many mothers experience severe physical and emotional stress after childbirth and while breastfeeding. Lack of rest and sleep, loss of strength and nervous exhaustion often plague women. Then sweets come to the rescue. They lift your spirits, give you vigor and strength. In this case, sugar is not only possible, but also necessary to be consumed. But, of course, in limited quantities. Read what else will help a nursing mother cope with depression.

Harm of sugar for mother and baby

Consuming sugar in small quantities will not harm either mother or baby. Therefore, when breastfeeding, you can allow one or two cups of tea with one teaspoon of sugar per day and even a small piece of chocolate or other sweets. A nursing mother is not recommended to eat sweets, milk and white chocolate, cakes and other “heavy” flour products. You can't drink carbonated drinks!

A nursing mother can consume the following sweets:

• White marshmallow;
• Oriental delicacies (lokum, halva, kozinaki, pastila);
• Dark natural chocolate;
• Unleavened and oatmeal cookies;
• Dried fruits (prunes, dried apricots, raisins, dates are especially useful);
• (bananas, apples and pears are safest when breastfeeding);
• Natural compotes and juices;
• Homemade jam and marmalade.

But you shouldn’t abuse sugar and sweets while breastfeeding! An excess of this product leads to many negative consequences, including disruption of the endocrine and immune systems, deterioration of teeth, the appearance of caries and diathesis, weight gain and the risk of diabetes.

A large amount of sugar takes a long time to digest and is difficult to digest, which negatively affects the infant’s still fragile digestion. As a result, the baby's colic increases, gas formation increases, and stomach pain appears.

The most common reaction of infants to excess sugar is an allergy. A rash and redness, itching and swelling appear on the child’s skin. This especially often occurs due to overeating confectionery products. Oriental sweets in excess cause heaviness and pain in the stomach, bloating and other digestive problems.

How to replace sugar

Many mothers are interested in whether it is possible to replace sugar with anything during lactation. First of all, you need to include in your diet a large amount of fruits and vegetables, which contain fructose and glucose. These beneficial substances perform all the necessary functions of sugar.

Cane sugar is an excellent alternative. This is a healthy product with a large amount of vitamins and minerals, including potassium, calcium and magnesium, iron and phosphorus. It contains less heavy carbohydrates than regular one. It is easily digestible and does not affect the baby's digestion.

Cane sugar is called a harmless source of energy and is used as a sweetener. It increases volume, improves the consistency and taste of the product.

People with diabetes replace sugar with fructose. Fructose is a natural sugar that is extracted from fruits. This is a low-calorie product that does not contribute to excess weight and does not affect the condition of teeth. Fructose is suitable for active people, nursing mothers and diabetics.

Interestingly, fructose is much sweeter than regular sugar. Therefore, the consumption of such a product will be less. It quickly saturates and tones the body, does not cause changes in blood sugar levels and strengthens the immune system, minimizing the risk of an allergic reaction.

However, you should not take more than 30 grams of fructose per day! An excess of this substance causes problems with the heart and blood vessels.

It is better to obtain fructose naturally from honey and fruits, rather than buying a ready-made product in a store. In addition, while breastfeeding, you should not consume modern sugar substitutes that are manufactured industrially! These are very harmful products that will negatively affect the well-being of the baby and mother. They negatively affect the digestion of mother and baby, cause an allergic reaction and severe poisoning.

When breastfeeding, you should never consume Aspartame, Sorbitol, Saccharin and other chemical sweeteners!