Your baby after birth when you have gestational diabetes
Your baby gets a blood sugar check with a small heel prick in the first hours after birth, because babies of mothers with diabetes are more likely to have low blood sugar for a short time. Feeding soon after birth, and then often, is the first way to keep it up. If it stays low, the team gives extra feeds, a sugar gel or a drip.
Why a baby's blood sugar can drop
Before birth, the baby got more sugar than it needed and made extra insulin to handle it. After birth that extra sugar stops, but the extra insulin does not stop at once, so the baby's blood sugar can fall. It can take a few days for the baby's insulin to adjust.1
The checks
- NICE advises a routine blood sugar test 2 to 4 hours after birth for babies of mothers with diabetes.2
- The test is a heel prick. Babies at risk are tested often until their level stays normal for about 12 to 24 hours.3
- Low blood sugar can have no signs at all, which is why the nurses check even when the baby seems fine.3
Feeding is the first step
NICE advises feeding the baby as soon as possible after birth, within 30 minutes, and then every 2 to 3 hours until the baby's blood sugar before feeds stays at 2.0 mmol/L (36 mg/dL) or more.2 NICE also advises that the baby stays with you, unless there are problems that need special care.2
If the blood sugar stays low
| Step | What it is |
|---|---|
| Extra feeds | More breast milk or formula. Some breastfed babies get extra formula if there is not yet enough milk; hand expression can help.3 |
| Sugar gel | A gel given by mouth for a short time when there is not enough milk.3 |
| A drip | Sugar through a vein, if the baby cannot feed, or feeding does not bring the level up.3 |
The outlook is good for babies who have no symptoms or who respond well to treatment.3
Signs to tell a nurse about
Poor feeding or vomiting, a baby who is very sleepy or very fussy, floppy muscles, trouble keeping warm, or shaking, sweating or seizures.3 Tell the nurse at once; do not wait for the next check.
Other things the team watches
Babies of mothers with diabetes are also more likely to have breathing trouble from less mature lungs, newborn jaundice and a high red blood cell count.1 The team checks for these when there are signs.2
And you
NICE advises stopping blood sugar medicine for gestational diabetes right after the birth.2 The ADA recommends breastfeeding after gestational diabetes, partly because it lowers your own risk of type 2 diabetes later.4 You will get a follow-up blood sugar test some weeks after the birth (see does gestational diabetes go away).
Questions
Why does my baby need a heel prick?
Babies of mothers with diabetes are more likely to have low blood sugar for a short time after birth, and it can have no signs. The heel prick measures it.
How long do the checks go on?
Until the baby's level stays normal for about 12 to 24 hours.
Will my baby go to the NICU?
Not usually. NICE advises that the baby stays with you unless there are problems that need special care. Some babies with low blood sugar need extra monitoring.
Will my baby have diabetes?
Not at birth. The ADA says high blood sugar before birth raises the child's later risk of obesity, high blood pressure and type 2 diabetes, which is one reason treatment during pregnancy matters.
Sources
- MedlinePlus (US National Library of Medicine). Infant of diabetic mother. https://medlineplus.gov/ency/article/001597.htm
- NICE guideline NG3. Diabetes in pregnancy: management from preconception to the postnatal period (recommendations). https://www.nice.org.uk/guidance/ng3/chapter/Recommendations
- MedlinePlus (US National Library of Medicine). Neonatal hypoglycemia. https://medlineplus.gov/ency/article/007306.htm
- American Diabetes Association. 15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes—2026. Diabetes Care 2026;49(Suppl. 1):S321. https://pmc.ncbi.nlm.nih.gov/articles/PMC12690181/
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