Infant of diabetic mother
An infant of a diabetic mother is a baby who is born to a mother with diabetes. The baby's mother had high blood sugar (glucose) levels throughout her pregnancy.
High blood sugar level in a pregnant woman can affect the infant after birth.
- Infants who are born to mothers with diabetes are often larger than other babies. Organs such as the liver, adrenal glands, and heart are likely to be enlarged.
- These infants may have periods of low blood sugar (hypoglycemia) shortly after birth because of increased insulin level in their blood. Insulin is a substance that moves sugar (glucose) from the blood into body tissues. The infant's blood sugar level will need to be closely monitored in the first 12 to 24 hours of life.
Mothers with poorly controlled diabetes are also more likely to have a miscarriage or stillborn
child. The delivery may be difficult if the baby is large. This can increase the risk for brachial plexus injuries and other trauma during birth.
If the mother had diabetes before her pregnancy, her infant has an increased risk of birth defects if the disease was not well controlled.
The infant is often large for gestational age
. Other symptoms may include:
- Blue or patchy (mottled) skin color, rapid heart rate, rapid breathing (signs of immature lungs or heart failure)
- Newborn jaundice
- Poor feeding, lethargy, weak cry (signs of severe low blood sugar)
- Puffy face
- Reddish appearance
- Tremors or shaking shortly after birth
Exams and Tests
Before the baby is born:
- Ultrasound performed on the mother in the last few months of pregnancy to assess the baby’s development will show that the baby is large for gestational age.
- Lung maturity testing may be done on the amniotic fluid if the baby is going to be delivered more than a week before the due date.
After the baby is born:
- Tests may show that the infant has low blood sugar and low blood calcium.
- An echocardiogram may show an abnormally large heart, which can occur with heart failure.
All infants who are born to mothers with diabetes should be tested for low blood sugar (hypoglycemia), even if they have no symptoms.
If an infant had one episode of low blood sugar, tests to check blood sugar level will be done over several days. Testing will be continued until the infant's blood sugar remains stable with normal feedings.
Feeding soon after birth may prevent low blood sugar in mild cases. Low blood sugar that does not go away is treated with sugar (glucose) and water given through a vein.
Rarely, the infant may need breathing support or medicines to treat other effects of diabetes. High bilirubin levels are treated with light therapy (phototherapy). Rarely, the baby's blood will be replaced with blood from a donor (exchange transfusion) for this problem.
Often, an infant's symptoms go away within a few weeks. However, an enlarged heart may take several months to get better.
- Congenital heart defects
- Heart failure
- High bilirubin level (hyperbilirubinemia) -- may cause permanent brain damage if it is not treated
- Immature lungs
- Neonatal polycythemia
(more red blood cells than normal) -- this may cause a blockage in the blood vessels or hyperbilirubinemia
- Severe low blood sugar - may cause permanent brain damage
- Small left colon syndrome - causes symptoms of intestinal blockage
When to Contact a Medical Professional
If you are pregnant and receiving regular prenatal care, routine testing will show if you develop gestational diabetes.
If you are pregnant and have diabetes that is not under control, call your doctor right away.
If you are pregnant and are not receiving prenatal care, call your health care provider for an appointment. You can also call the State Board of Health for instructions on how to obtain state-assisted prenatal care.
Women with diabetes need special care during pregnancy to prevent complications. Controlling blood sugar and getting diagnosed with gestational diabetes early can prevent many problems.
Lung maturity testing may help prevent breathing complications that can occur if the baby is being delivered more than a week before the due date.
Carefully monitoring the infant in the first hours after birth may prevent complications due to low blood sugar. Monitoring and treatment in the first few days may prevent complications due to high bilirubin level.
Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.