Insulin as a proteohormone does not reach the mother's milk, and is not absorbed intestinally. Any effect on the infant can therefore be ruled out.
Neither glibenclamide nor glipizide were detected in the breast-milk of three mothers. Hypoglycemia was not observed in any of the children. In another eight women receiving a single dosage of gliben clamide, no substance was found in milk. A high protein-binding of 98% could explain these results (Feig 2005).
Only small amounts of metformin are found in mothers' milk; the weight-adjusted dose for a fully breastfed child is 0.1-0.7% (Briggs 2005, Gardiner 2003, Hale 2002). Hypoglycemia was not reported in breastfed infants. Metformin concentrations in breast milk remained stable over the time of observation. Growth, motor-social development, and illness requiring a pediatrician's visit were assessed in 61 nursing infants (21 male, 40 female) and 50 formula-fed infants (19 male, 31 female) born to 92 mothers with polycystic ovary syndrome (PCOS) taking a median of 2.55 g metformin per day throughout pregnancy and lactation. At 3 and 6 months of age, the weight, height, and motor-social development did not differ between breast- and formula-fed infants. No infants had retardation of growth, or of motor or social development. Intercurrent illnesses did not differ (Glueck 2006).
Up to 16.2% of the weight-related dosage of tolbutamide can pass into the milk (Moiel 1967).
There are no data on the other oral antidiabetics, acarbose, gli-bornuride, gliclazide, glimepiride, gliquidone, glisoxepide, miglitol, pioglitazone, repaglinide, and rosiglitazone.
There is also insufficient experience on the antihypoglycemics glucagon and diazoxide.
Recommendation, insulin and metformin are not problems during breastfeeding. Glibenclamide may also be taken; however, the infant should be observed for symptoms of hypoglycemia after the start of therapy. Other oral antidiabetic should not be taken, but single doses do not require any limitation of breastfeeding.
4.11.10 Estrogens, gestagens, and hormonal contraceptives
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Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...