Practice Quiz

Certified Midwife Exam Prep

Category - Antepartum

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A client at 20 weeks’ gestation asks the nurse midwife if she will be able to breastfeed her baby after birth. The client has a history of type 2 diabetes, which has been well-controlled before and during the pregnancy. The client has a BMI of 34. Which of the following statements by the nurse midwife is the most appropriate?
  1. “Whether or not you can breastfeed your baby will depend on your blood glucose levels after birth.”
  2. “Mothers with type 2 diabetes are encouraged to breastfeed their babies after birth. Breastfeeding may also lower your need for insulin.”
  3. “You may not breastfeed your baby after birth. Insulin can cross into the breast milk and may cause your baby to develop hypoglycemia. Your baby may be nourished with formula milk.”
  4. “Breastfeeding is encouraged for women with type 2 diabetes. However, you may need to increase your insulin when nursing.”
Explanation
Answer: B - The nurse should inform the client that mothers with type 2 diabetes are encouraged to breastfeed their babies after birth and that she may need less insulin while breastfeeding. Within hours after birth, the client’s need for insulin may abruptly drop. It is believed that the lowering effect of breastfeeding is caused by the process of milk production. Serum glucose is the main substance used in producing the breast milk and energy is much needed for milk production. The client may have to adjust her caloric levels, physical activity and insulin needs after birth to ensure the well-beings of both the mother and child during breastfeeding. Insulin does not cross into the breast milk.
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