E-Newsletter

Featured articles edition 5

Pregnancy planning… men’s health matters!

As a couple prepares for pregnancy, the focus is most often on the health of the mum to be. While there’s plenty for a woman to do to get ready for pregnancy, new research tells us that the health of the father is also important!

A weighty issue

Men who are carrying too much weight are at increased risk of poor fertility, reducing the chances of a successful pregnancy. Obesity in fathers can also make a difference to the long-term health of the baby. This is because obesity affects the environment where sperm mature and can change how certain genes are passed on to the child at conception.  

The good news is that a healthy lifestyle can have benefits for both mums and dads to be. Lifestyle changes such as healthy eating and regular physical activity can also be easier with the support of a partner or loved one, so preparing for pregnancy together is the best way to give your baby the best start. 

Smoking fathers

Although the dangers of smoking are well known, almost 20% of adult men in Australia continue to smoke cigarettes. The harmful chemical in cigarettes can cause damage to all parts of the body, including sperm. This can affect the long term health of the baby with research showing an increased risk of certain childhood cancers when fathers smoke before pregnancy. What’s more, a mum’s exposure to passive smoke also increases the risk of low birth weight and other health problems for the baby. 

Planning for a baby is a great reason to try and quit smoking. Quitting isn’t easy, but help is available – talk to a doctor or call the Quitline on 137 848.

Lifestyle choices

Making nutritious food choices, limiting alcohol and trying to reduce exposure to chemicals and toxins in your environment are important healthy lifestyle changes for dads to be. Getting started early also makes it easier to have a healthy family lifestyle once baby comes along!

Pregnancy planning checklist for dads to be

  • Aim for a healthy weight (or some weight loss towards the healthy weight range) before trying for a baby
  • Choose at least 2 pieces of fruit and 5 serves of vegetables each day
  • Limit takeaways and fast foods
  • Choose water as your everyday drink and limit drinks high in sugar
  • Try to include at least 30 minutes of physical activity each day – if you haven’t exercised for a while or have other health problems talk to you doctor first
  • Limit alcohol to no more than 2 standard drinks a day, try to include some alcohol free days each week
  • If you smoke, try to quit before you start trying for a baby. Talk to a doctor or call the Quitline 137 848.
  • Try to reduce exposure to chemicals and toxins in your home and work environment (where possible).   

If you’re thinking about starting a family, remember that both mums and dads to be need to be in the best possible health to give your baby the best start in life. Talk to your doctor for more information and advice.

Find out more about men's health and fertility here.

Pregnancy and your emotional health

During the pregnancy journey, all women will experience an array of feelings and emotions. From the moment you find out you are growing a new little person, to the day you hold your baby in your arms, your feelings may range from excitement, happiness and joy, to worry, anxiety and fear, and back again. 

Common Feelings and Emotions

All feelings are valid and important, but if difficult feelings are taking over your life, it’s important to seek the support you need. Those more difficult emotions such as anger, guilt, fear and sadness, are there for a reason. It is essential you are able to identify your feelings and emotions – both the wonderful ones and the hard ones - and share them with someone who can support you. 

The best way through difficult emotions, is to face them head on, understand them, and share them. If you find that any feelings are causing ongoing distress in your life, there are counselling services available to help.

Along with the thoughts and worries that run through your mind, remember that pregnancy hormones can play a major part in your emotions, as do your general health and energy levels. Depending on what else is happening in your life, your past experiences of pregnancy and parenting, the amount of support you have, your mental and physical health, and the course of your pregnancy, you may find some feelings and emotions easier to handle than others.

When it comes to diabetes, this can also be affected by your emotions – both positive and negative. Excitement, worry and stress, all have the potential to raise or lower your blood glucose levels. Having an awareness of how your body responds to your feelings and emotions, and practising mindfulness and relaxation, can help you to manage this.

Some of the difficult feelings and emotions women with diabetes have spoken about which you may experience, include:

  • Diabetes burnout and exhaustion from the extraordinary effort required from pre-pregnancy through to motherhood
  • Sadness and depression
  • Worry, anxiety and fear about your baby 
  • Guilt and feeling like a failure, especially if you compare yourself with other women
  • Feeling anxious about the birth
  • Worries about breastfeeding
  • Loss from not being able to have the pregnancy or birth you dreamt about
  • A sense of being out of control, helplessness
  • If you experience post-natal depression you may feel disconnected from your baby and those around you

Some of the wonderful feelings and emotions women with diabetes have spoken about which you may experience, include:

  • Joy at your ability to grow a new life despite having diabetes
  • Excitement and anticipation
  • Happiness and peace
  • Focus on managing your diabetes and a sense you can do this!
  • Utter love for your baby
  • A sense of achievement, being proud
  • Being grounded by your baby/child and the importance of caring for yourself in order to care for them, despite it being hard to manage diabetes when you are a new mum

If you are experiencing any feelings or emotions that are difficult and you need support, talk to your GP who can refer you to counselling services in your area.

There is also information and support available online:

PANDA have support and information on Perinatal Anxiety and Depression 

Beyondblue provides information about emotional health during pregnancy including links to support services 

You can also look for support via the online diabetes community to share all of your emotions – the wonderful and the tough, including places like:

*Diabetes Can’t Stop Me 

*The Type 1 diabetes network 

*Pregnancy groups on Facebook such as  facebook.com/groups/mydiabetespregnancy

*Note: these are external links and the content is not endorsed and approved by Diabetes Australia. 

Contact Diabetes Australia in your state for more information about locally available services. 

This article was written by Helen Edwards, Diabetes Blogger, Advocate & Consultant

Expressing breast milk in late pregnancy 

The practice of expressing and storing breast milk during late pregnancy is becoming more common among women with diabetes. Expressing breast milk before the baby is born provides a ready supply which can be used if the baby has low blood glucose levels after birth. However, the pros and cons of this have not been well researched to date. 

The DAME study is new Australian research which examined the outcomes of this practice among women with type 1, type 2 and gestational diabetes. Researchers compared those women who did and those who did not express breast milk after 36 weeks of pregnancy.  

The aim was to see if there were any differences in the outcomes for mothers and babies.  Only women at low risk of pregnancy and birth complications were included in this study. 

The researchers found that there were no differences in the number of babies admitted to neonatal intensive care or the number of babies born early among those who did and didn’t express. They also found some evidence of benefits of expressing breast milk in late pregnancy, with an increase in the number of babies of first time mums being exclusively breastfed in the first 24 hours after birth.

The researchers concluded that there is no harm in advising women with diabetes in pregnancy at low risk of complications to express breast milk from 36 weeks’ gestation. However, they also noted that advice to do so from health professionals should come with clear guidelines and instructions. 

Advice from our experts…

Although this study included some women with type 1 and type 2 diabetes, most of the participants in this study had gestational diabetes. The study also only included participants at low risk of pregnancy complications. Further research is needed to find out whether this practice is safe for women with type 1 or type 2 diabetes.

Women with diabetes who are considering expressing breast milk during late pregnancy should seek the advice of their diabetes in pregnancy team. It is also a good idea for women with diabetes to see a lactation consultant during pregnancy to find out as much as they can about breastfeeding and the support available to help with successful breastfeeding.

Source: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31373-9/abstract

ENDIA Regional Research Program 

The ENDIA (Environmental Determinants of Islet Autoimmunity) Study is the only study in the world to follow babies from the pregnancy through childhood to identify the factors which protect or trigger the development of type 1 diabetes.

ENDIA is an observational follow-up study; there are no interventions and participation is low risk.

For more information about who can participate go to www.endia.org.au.  

ENDIA Regional Program 

The study has been going since 2013 at hospitals and health centres in Adelaide, Brisbane, Geelong, Melbourne, Newcastle, Perth and Sydney. However, as much as we’d like to, we can’t be everywhere! In 2016 ENDIA introduced a Regional Participation Program to ensure eligible people from anywhere in Australia could contribute to this important research into the causes of type 1 diabetes. 

The Regional Program is coordinated from Adelaide by a Research Nurse, Sarah Beresford, who has over 25 years’ experience in type 1 diabetes research and paediatric nursing. Participation in the Regional Program is from the comfort of your own home. Depending on when you join the study (from the early stages of pregnancy up to 6 months postnatal), Sarah will send out information and study materials roughly every six (6) months, and she is always on the end of the phone or email if you have any questions or need to talk it through.

Living with type 1 diabetes can feel isolating; this may feel magnified when you live in the country. ENDIA offers regular contact and follow-up to see how you and your baby are doing. ENDIA is also on Facebook: https://www.facebook.com/endiastudy, so you can join us online to become part of the wider ENDIA community across Australia. So far we have 815 babies and families enrolled; we need 1400 in total.

If you, your partner or child have type 1 diabetes and are about to welcome a new baby to your home, please consider finding out more about the ENDIA Study. We’d love to hear from you. Email the team at endia@adelaide.edu.au or contact Sarah directly on (08) 8161 8655. Thank you!

FAQS

Does diabetes increase my chances of having a large baby?

Women with diabetes are at higher risk of having a large baby than women without diabetes. Part of the reason for this is that the higher glucose levels in the mother during pregnancy lead to more glucose passing through the placenta to the baby who then produces extra insulin. This can contribute to making the baby grow too big.

Women who have blood glucose levels above the target range during pregnancy are at greatest risk of having a large baby. Some women with diabetes who have blood glucose levels close to the target range will also have large babies. One probable reason for this is that the baby of a woman with diabetes is still exposed to more variable levels of glucose throughout the pregnancy than a woman without diabetes.

There are however a number of other factors that increase the chances of having a large baby. These include being overweight before pregnancy and/or gaining too much weight during pregnancy.

Your diabetes in pregnancy team will provide guidance on blood glucose and weight gain targets for pregnancy and closely monitor your baby’s growth during pregnancy. If they have any concerns about your baby’s growth, they will review your diabetes management, closely monitor your pregnancy and discuss with you a plan for your labour and birth.