Maternal Health

How Gestational Diabetes Affects Your Baby

Medically reviewed by Dr. Lisa Okafor, MD, FACOG · Board-Certified OB-GYN

Content reviewed against published ACOG, NIH, March of Dimes guidelines

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Your health matters just as much as your baby's. If you are dealing with how gestational diabetes affects your baby, here is what you need to know.

The short answer

Well-managed gestational diabetes (GDM) typically results in healthy babies. When blood sugar is not well controlled, the baby may grow larger than expected (macrosomia), which can complicate delivery. After birth, babies of GDM mothers may have temporary low blood sugar. Good blood sugar management during pregnancy significantly reduces all these risks.

Key takeaways

  • Well-managed gestational diabetes (GDM) typically results in healthy babies. When blood sugar is not well controlled, the baby may grow larger than expected (macrosomia), which can complicate delivery. After birth, babies of GDM mothers may have temporary low blood sugar. Good blood sugar management during pregnancy significantly reduces all these risks.
  • Usually normal when: Baby growing within normal range despite GDM diagnosis
  • Call your doctor if: Baby is not moving as expected (decreased fetal movement)
  • Varies by age — see the age-by-age breakdown below
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What Parents Should Know

According to ACOG, NIH, March of Dimes guidelines, well-managed gestational diabetes (GDM) typically results in healthy babies. When blood sugar is not well controlled, the baby may grow larger than expected (macrosomia), which can complicate delivery. After birth, babies of GDM mothers may have temporary low blood sugar. Good blood sugar management during pregnancy significantly reduces all these risks. At Second trimester, after GDM diagnosis (usually 24-28 weeks), controlling blood sugar is the best way to reduce risks to your baby. Excess glucose crosses the placenta, causing the baby to produce extra insulin and store more fat. This is why blood sugar management is so important. With good control, your baby's growth will be monitored and risks are substantially reduced. It is generally considered normal when baby growing within normal range despite GDM diagnosis. However, you should contact your pediatrician promptly if baby is not moving as expected (decreased fetal movement).

Sources: [1], [2], [3]

Normal vs. Concerning

Usually Normal
Worth Discussing
Baby growing within normal range despite GDM diagnosis
Baby is not moving as expected (decreased fetal movement)
Blood sugar well controlled and baby developing normally on ultrasound
Very high blood sugar readings that cannot be controlled
Mild temporary low blood sugar in the newborn that resolves with feeding
Newborn showing signs of low blood sugar: jitteriness, poor feeding, lethargy

By Age

What to expect by age

Second trimester

After GDM diagnosis (usually 24-28 weeks), controlling blood sugar is the best way to reduce risks to your baby. Excess glucose crosses the placenta, causing the baby to produce extra insulin and store more fat. This is why blood sugar management is so important. With good control, your baby's growth will be monitored and risks are substantially reduced.

Third trimester

Your provider will monitor the baby's growth with ultrasounds, particularly checking estimated weight. If the baby is growing larger than expected, adjustments to your diabetes management or delivery planning may be discussed. Non-stress tests may be recommended to check fetal well-being. Most babies of well-managed GDM parents are healthy.

Labor & delivery

After birth, the baby's blood sugar will be monitored, as it may drop temporarily when the placental glucose supply stops but the baby's insulin production is still elevated. This usually resolves quickly with feeding. Breastfeeding early and often helps stabilize blood sugar. Rarely, babies may need IV glucose supplementation.

What to Tell Your Pediatrician

  • Describe when you first noticed how gestational diabetes affects your baby and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if ultrasound shows the baby is measuring larger than expected.
  • Mention if you are struggling to manage blood sugar and worried about baby's health.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

What Should You Do?

When to take action

Probably normal when...
  • Baby growing within normal range despite GDM diagnosis
  • Blood sugar well controlled and baby developing normally on ultrasound
  • Mild temporary low blood sugar in the newborn that resolves with feeding
Mention at your next visit when...
  • Ultrasound shows the baby is measuring larger than expected
  • You are struggling to manage blood sugar and worried about baby's health
  • You want to understand how delivery will be managed with GDM
Act now when...
  • Baby is not moving as expected (decreased fetal movement)
  • Very high blood sugar readings that cannot be controlled
  • Newborn showing signs of low blood sugar: jitteriness, poor feeding, lethargy

What You Can Do at Home

  • Keep track of when you notice how gestational diabetes affects your baby — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that baby growing within normal range despite GDM diagnosis — this is generally within the range of normal.
  • At Second trimester, focus on observation rather than intervention unless your pediatrician advises otherwise.
  • Prioritize your own rest and nutrition. Accept help when offered, and do not hesitate to reach out to your healthcare provider.
  • While monitoring at home, seek immediate care if baby is not moving as expected (decreased fetal movement).

Frequently asked questions

Is how gestational diabetes affects your baby normal?
Well-managed gestational diabetes (GDM) typically results in healthy babies. When blood sugar is not well controlled, the baby may grow larger than expected (macrosomia), which can complicate delivery. After birth, babies of GDM mothers may have temporary low blood sugar. Good blood sugar management during pregnancy significantly reduces all these risks.
When should I call the doctor about how gestational diabetes affects your baby?
Baby is not moving as expected (decreased fetal movement) Very high blood sugar readings that cannot be controlled Newborn showing signs of low blood sugar: jitteriness, poor feeding, lethargy
When is how gestational diabetes affects your baby normal?
Baby growing within normal range despite GDM diagnosis Blood sugar well controlled and baby developing normally on ultrasound Mild temporary low blood sugar in the newborn that resolves with feeding
What causes how gestational diabetes affects your baby?
Well-managed gestational diabetes (GDM) typically results in healthy babies. When blood sugar is not well controlled, the baby may grow larger than expected (macrosomia), which can complicate delivery. After birth, babies of GDM mothers may have temporary low blood sugar. Good blood sugar management during pregnancy significantly reduces all these risks. Common explanations include: Baby growing within normal range despite GDM diagnosis. Blood sugar well controlled and baby developing normally on ultrasound.
What should I mention to my pediatrician about how gestational diabetes affects your baby?
You should mention how gestational diabetes affects your baby at your next visit if: Ultrasound shows the baby is measuring larger than expected. You are struggling to manage blood sugar and worried about baby's health. You want to understand how delivery will be managed with GDM.
Is how gestational diabetes affects your baby normal at Second trimester?
After GDM diagnosis (usually 24-28 weeks), controlling blood sugar is the best way to reduce risks to your baby. Excess glucose crosses the placenta, causing the baby to produce extra insulin and store more fat. This is why blood sugar management is so important. With good control, your baby's growth will be monitored and risks are substantially reduced.
Is how gestational diabetes affects your baby normal at Third trimester?
Your provider will monitor the baby's growth with ultrasounds, particularly checking estimated weight. If the baby is growing larger than expected, adjustments to your diabetes management or delivery planning may be discussed. Non-stress tests may be recommended to check fetal well-being. Most babies of well-managed GDM parents are healthy.
Should I go to the ER for how gestational diabetes affects your baby?
Seek emergency care if baby is not moving as expected (decreased fetal movement), or if very high blood sugar readings that cannot be controlled. When in doubt, call your pediatrician's after-hours line for guidance.
Does how gestational diabetes affects your baby go away on its own?
In many cases, how gestational diabetes affects your baby resolves on its own, especially when baby growing within normal range despite GDM diagnosis. By Labor & delivery, after birth, the baby's blood sugar will be monitored, as it may drop temporarily when the placental glucose supply stops but the baby's insulin production is still elevated. This usually resolves quickly with feeding. Breastfeeding early and often helps stabilize blood sugar. Rarely, babies may need IV glucose supplementation.

References

  1. [1]American College of Obstetricians and Gynecologists. Gestational Diabetes. ACOG Practice Bulletin No. 190, 2018. ACOG
  2. [2]National Library of Medicine. Gestational Diabetes. StatPearls, 2023. NIH
  3. [3]March of Dimes. Gestational Diabetes. March of Dimes, 2023. March of Dimes

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss How Gestational Diabetes Affects Your Baby.

Things to mention

  • Describe when you first noticed how gestational diabetes affects your baby and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if ultrasound shows the baby is measuring larger than expected.
  • Mention if you are struggling to manage blood sugar and worried about baby's health.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

Observations to share

  • Ultrasound shows the baby is measuring larger than expected
  • You are struggling to manage blood sugar and worried about baby's health
  • You want to understand how delivery will be managed with GDM

Urgent signs to report immediately

  • Baby is not moving as expected (decreased fetal movement)
  • Very high blood sugar readings that cannot be controlled
  • Newborn showing signs of low blood sugar: jitteriness, poor feeding, lethargy

My notes

From ismybabyalright.com — free, evidence-based baby health guides

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members

Bottom line

Most cases of how gestational diabetes affects your baby are normal. Talk to your pediatrician if baby is not moving as expected (decreased fetal movement).

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

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Gestational Diabetes Risk

Gestational diabetes develops when your body cannot produce enough insulin during pregnancy to handle the increased blood sugar levels. It affects about 6-9% of pregnancies and is very manageable with diet, exercise, and sometimes medication. Most women with gestational diabetes deliver healthy babies with proper monitoring and care.

Managing Gestational Diabetes with Diet

Gestational diabetes (GDM) can often be managed through diet modifications, with about 70-85% of people achieving blood sugar control through nutrition and exercise alone. The key is balancing carbohydrates with protein and healthy fats, eating at regular intervals, and monitoring blood sugar levels to understand how foods affect you.

Concerns About a Large Baby (Macrosomia)

Macrosomia means a baby estimated to weigh more than 8 pounds 13 ounces (4,000 grams) at birth. It occurs in about 9% of pregnancies. Risk factors include gestational diabetes, post-term pregnancy, obesity, and genetics. While most large babies are born safely, macrosomia increases the risk of delivery complications, so your provider will discuss the safest delivery approach.

Dealing with Abnormal Prenatal Screening Results

An abnormal prenatal screening result can be terrifying, but it is important to understand that screening tests are designed to cast a wide net and have significant false-positive rates. Most people with abnormal screening results go on to have healthy babies after further testing confirms the baby is fine. An abnormal screening is a reason for more information, not a diagnosis.

Pregnancy Over 35 (Advanced Maternal Age)

While pregnancy after 35 carries some increased risks (including chromosomal abnormalities, gestational diabetes, and hypertension), the vast majority of people over 35 have healthy pregnancies and healthy babies. The term "geriatric pregnancy" is outdated and does not reflect reality. With appropriate prenatal care and monitoring, outcomes are excellent.

Amniocentesis Questions and Fears

Amniocentesis is a diagnostic test performed between 15-20 weeks that analyzes amniotic fluid to detect chromosomal conditions and genetic disorders with over 99% accuracy. The risk of pregnancy loss from the procedure is approximately 1 in 500-1,000 when performed by an experienced provider. Understanding the actual risks can help you make an informed decision.