Information for parents of a newborn when mother has diabetes (admission to the Neonatal Unit)

When you arrive at the Neonatal Ward, a neonatal nurse will welcome you. Your baby will be placed in an incubator so that we can keep an eye on its colour, breathing and general condition. Your baby will be weighed and measured, and we place electrodes on the body which are connected to electronic monitoring, allowing the nurses to read your baby’s heart and breathing rate. In addition to the risk of low blood sugar, babies who are born to mothers with diabetes also have a small risk of heart problems which is why the nursing staff closely monitor any changes in the baby 's breathing and heartbeat.

However, even though your baby is connected to the monitor, you may still lie or sit skin-to-skin with your baby. Skin-to-skin contact in the early days is important to reinforce parent- baby bonding. The nurse will help to lay your baby over with you, when it is time for your baby to eat and during other contact.

Babies born to mothers with insulin-dependent diabetes are more immature than other newborns, we estimate them to be a few weeks younger. This means that they are naturally more tired, and they are often a little lethargic to eat. It may therefore take longer to establish breastfeeding, and it is important to remember this so that you do not lose heart when the baby is tired at the breast, and we then feed them through their feeding tube. It is necessary that the baby is offered food immediately after birth to prevent low blood sugar, and that supplementary feeds continue to be given, even after the baby has suckled with the mother.

Your baby's nutrition will be planned in consultation with you, the paediatrician and the nurse. The planning of how often and how much the baby should eat depends on the baby's blood sugar, weight, and how well the baby is feeding. You will find that your baby can be offered food before they are naturally hungry which can cause a tendency for your baby to experience nausea and vomiting. It can be frustrating when you are teaching your baby to feed, but it is necessary because having a low blood sugar can affect your baby's brain.

Depending on how low your baby's blood sugar is, they will initially be offered extra food as treatment. If the baby continues to have low blood sugars, they will be given sugar water as a supplement to the food. The sugar water is given through a drip into a vein, the drip usually being placed on the back of the hand or foot, but occasionally it is placed in the umbilical cord. An electronic pump is set to provide the sugar water at the rate the baby needs. Some babies may also need medication to regulate their blood sugar.

When your baby’s blood sugar is stable and the baby is feeding sufficiently, they are phased out of the sugar water in the drip.

Since milk production depends on stimulation of the breast, it can often be necessary to express with a milking machine or by hand. You may need to express milk every 3 hours, and you will of course be guided in this by the staff. If the baby is too tired to feed, they are given the expressed breast milk through the feeding tube or cup.

The nutritional issues means that it can be difficult to predict the length of hospitalisation. If the baby’s blood sugars are stable from birth and remain stable with just a small supplement in a cup, you will be hospitalised for about 1 day in the Neonatal Unit, and then you can spend the days together at the maternity ward for further breastfeeding establishment. If blood sugar levels are low and unstable despite feeding tube supplementation and sugar supplements in a drip, the admission to the Neonatal Unit can extend over days and in some cases weeks. A conversation with the doctor and nurse at the beginning of the hospitalisation will make this clearer.

As mentioned, the mother is admitted to the maternity ward for the first day, and if the baby's hospitalization extends beyond this, the mother will be admitted to the neonatal unit together with the baby. If your baby's hospitalisation extends over several days, you will usually remain in the Neonatal Unit until you can be discharged directly to the home. In that case, you will not return to the Maternity Ward to establish breastfeeding but instead will receive help with this at the Neonatal Unit.

Your baby has had a high insulin production as a foetus due to its mother's diabetes and high blood sugar. When the baby is born, it still produces too much insulin and thus gets too low blood sugars. When the baby’s blood sugar is stable again, it is to be considered a healthy baby.

If you have any questions, you are welcome to contact us.