Last update Feb. 1, 2025

Insulin

Compatible

Safe product and/or breastfeeding is the best option.

Insulin is a polypeptide hormone produced in the pancreas. Its function is to allow the entry of glucose into the cells for the normal functioning of metabolism. In type 1 diabetes the pancreas stops producing insulin; in type 2 diabetes there is not enough insulin to metabolize the ingested diet. Insulin as a drug must be administered parenterally (subcutaneously or intravenously) since it is not absorbed in the intestine.

Insulin administration is fully compatible with breastfeeding (Serrano 2015, Rowe 2013, WHO 2002). This is valid for any of its types and preparations: human, porcine, bovine, regular or soluble simple, delayed, protamine, rapid-acting (aspart, lispro, glulisine) or prolonged-acting (glargine, detemir, degludec) analogues, NPH, protamine, zinc, etc.

Its null oral bioavailability prevents its passage into the infant's plasma from ingested breast milk since, due to its protein nature, it is degraded in the gastrointestinal tract and is not absorbed (Rowe 2013). It has been administered orally to premature infants to improve their feeding tolerance. (Mank 2022)

Insulin is a normal component of colostrum and breast milk (Vass 2023, Young 2017, Whitmore 2012, Ley 2011, Shehadeh 2003 and 2001, Koldovský 1995, Jovanovic 1989, Kulski 1983) and decreases the risk of type 1 diabetes in breastfed infants, as it promotes gut maturation and induces insulin tolerance, suggesting its incorporation in commercial infant formulas (Mank 2022 and 2021, Shehadeh 2001;2 and 2001;90). Insulin concentration in donated breast milk decreases after pasteurization. (Law 2011)

Insulin requirements decrease after delivery and during the first months, more so in breastfeeding women, although to a highly variable extent. (Skajaa 2023, Kakoulidis 2022, Ringholm 2020, Nørgaard 2020, Roeder 2016, Riviello 2009, Davies 1989)


See below the information of this related product:

  • Maternal Diabetes mellitus (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)

Alternatives

We do not have alternatives for Insulin since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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José María Paricio, founder of e-lactancia.
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Other names

Insulin in other languages or writings:

Group

Insulin belongs to this group or family:

Tradenames

Main tradenames from several countries containing Insulin in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 0 %
Molecular weight 5.808 - 6.060 daltons
Protein Binding 5 %
VD 0. 15 - 0.37 l/Kg
Tmax 1.5 (variable) hours
T½ 2 (variable) hours

References

  1. Skajaa GØ, Kampmann U, Ovesen PG, Fuglsang J. Breastfeeding and insulin requirements in women with Type 1 diabetes mellitus in the first year postpartum. Acta Diabetol. 2023 Jul;60(7):899-906. Abstract
  2. Vass RA, Bell EF, Roghair RD, Kiss G, Funke S, Bokor S, Molnár D, Miseta A, Bódis J, Kovács K, Ertl T. Insulin, Testosterone, and Albumin in Term and Preterm Breast Milk, Donor Milk, and Infant Formula. Nutrients. 2023 Mar 19;15(6). Abstract Full text (link to original source)
  3. Mank E, Sáenz de Pipaón M, Lapillonne A, Carnielli VP, Senterre T, Shamir R, van Toledo L, van Goudoever JB; FIT-04 Study Group. Efficacy and Safety of Enteral Recombinant Human Insulin in Preterm Infants: A Randomized Clinical Trial. JAMA Pediatr. 2022 May 1;176(5):452-460. Abstract Full text (link to original source)
  4. Kakoulidis I, Ilias I, Linardi A, Michou A, Milionis C, Lekkou A, Venaki E, Koukkou E. Insulin requirements during lactation in women with diabetes mellitus type 1 in comparison with pre-pregnancy levels: A 10-year retrospective study. Health Care Women Int. 2022 Jan-Mar;43(1-3):309-312. Abstract
  5. Mank E, van Toledo L, Heijboer AC, van den Akker CHP, van Goudoever JB. Insulin Concentration in Human Milk in the First Ten Days Postpartum: Course and Associated Factors. J Pediatr Gastroenterol Nutr. 2021 Nov 1;73(5):e115-e119. Abstract
  6. Nørgaard SK, Nørgaard K, Roskjær AB, Mathiesen ER, Ringholm L. Insulin Pump Settings During Breastfeeding in Women with Type 1 Diabetes. Diabetes Technol Ther. 2020 Apr;22(4):314-320. Abstract
  7. Ringholm L, Stougaard EB, Nørgaard SK, Damm P, Mathiesen ER. Diabetes Management During Breastfeeding in Women with Type 1 Diabetes. Curr Diab Rep. 2020 Jun 19;20(8):34. Abstract
  8. Young BE, Patinkin Z, Palmer C, de la Houssaye B, Barbour LA, Hernandez T, Friedman JE, Krebs NF. Human milk insulin is related to maternal plasma insulin and BMI: but other components of human milk do not differ by BMI. Eur J Clin Nutr. 2017 Sep;71(9):1094-1100. Abstract Full text (link to original source)
  9. Roeder HA, Moore TR, Ramos GA. Changes in Postpartum Insulin Requirements for Patients with Well-Controlled Type 1 Diabetes. Am J Perinatol. 2016 Jun;33(7):683-7. Abstract
  10. Serrano Aguayo P, García de Quirós Muñoz JM, Bretón Lesmes I, Cózar León MV. Tratamiento de enfermedades endocrinológicas durante la lactancia. [Endocrinologic diseases management during breastfeeding.] Med Clin (Barc). 2015 Jan 20;144(2):73-9. Abstract
  11. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  12. Whitmore TJ, Trengove NJ, Graham DF, Hartmann PE. Analysis of insulin in human breast milk in mothers with type 1 and type 2 diabetes mellitus. Int J Endocrinol. 2012;2012:296368. Abstract Full text (link to original source)
  13. Ley SH, Hanley AJ, Stone D, O'Connor DL. Effects of pasteurization on adiponectin and insulin concentrations in donor human milk. Pediatr Res. 2011 Sep;70(3):278-81. Abstract
  14. Riviello C, Mello G, Jovanovic LG. Breastfeeding and the basal insulin requirement in type 1 diabetic women. Endocr Pract. 2009 Abstract
  15. Shehadeh N, Khaesh-Goldberg E, Shamir R, Perlman R, Sujov P, Tamir A, Makhoul IR. Insulin in human milk: postpartum changes and effect of gestational age. Arch Dis Child Fetal Neonatal Ed. 2003 May;88(3):F214-6. Abstract Full text (link to original source)
  16. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)
  17. Shehadeh N, Shamir R, Berant M, Etzioni A. Insulin in human milk and the prevention of type 1 diabetes. Pediatr Diabetes. 2001 Abstract
  18. Shehadeh N, Gelertner L, Blazer S, Perlman R, Solovachik L, Etzioni A. Importance of insulin content in infant diet: suggestion for a new infant formula. Acta Paediatr. 2001 Jan;90(1):93-5. Abstract
  19. Koldovský O. Hormones in milk. Vitam Horm. 1995;50:77-149. Review. No abstract available. Abstract
  20. Jovanovic-Peterson L, Fuhrmann K, Hedden K, Walker L, Peterson CM. Maternal milk and plasma glucose and insulin levels: studies in normal and diabetic subjects. J Am Coll Nutr. 1989 Apr;8(2):125-31. Abstract
  21. Davies HA, Clark JD, Dalton KJ, Edwards OM. Insulin requirements of diabetic women who breast feed. BMJ. 1989 Abstract
  22. Kulski JK, Hartmann PE. Milk insulin, GH and TSH: relationship to changes in milk lactose, glucose and protein during lactogenesis in women. Endocrinol Exp. 1983 Oct;17(3-4):317-26. Abstract

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