Infant With a Diabetic Mother

An infant of a diabetic mother with illness that was poorly controlled throughout the pregnancy is typically larger and heavier compared to other babies. The baby will also have a greater chance of developing a congenital irregularity such as cardiac irregularity, as if hyperglycemia were teratogenetic to the quickly developing of fetus.

Most of the babies have fat and puffy appearance; they tend to be limp on the first few days of their lives as the result of hyperglycemia. Macrosomia (longer and heavier baby) results from the over stimulation of the pituitary hormones and extra deposited fats resulting from the high levels of insulin at the time of pregnancy.

The large size of an infant is deceptive although these babies are usually immature. High fetal insulin secretion throughout pregnancy can counteract hyperglycemia that may interfere with the cortisol release. This reaction can block the lecithin formation that may prevent the maturity of the lungs. The term that is usually used with these infants is "fragile giants".

The infants of diabetic mothers lose greater proportion of weight during the first days of their lives compared to those average newborn because they loss extra fluid accumulation.

Complications:

The macrosomic infants have the greater chances of birth injury more especially with neck and shoulders injury. Ceasarian delivery might be necessary to avoid the cephalo-pelvic distortion. Right after birth, the infants tend to be hyperglycemic because the mom was a little hyperglycemic during the pregnancy and the pancreas responds to the high glucose level from the islet cell hypertrophy that results to the higher insulin levels.

After the birth, the baby's glucose level starts to fall due to the mother's circulation are not supplying glucose anymore, over production of insulin will then cause the development of the severe hyperglycemia.

Management:

Hypoglycemia is the serum glucose level of less than 40 mg/dL in the newborn babies. To avoid the serum glucose level from falling too low, the infant of a diabetic mother should be fed early on with it formula or administer the continuous infusion of the glucose. Some infants with a diabetic mother have smaller left colon due to the effect of the intrauterine hyperglycemia that limits the amount of the oral feedings which limits the quantity of oral feeding as they take during the first days of life.