mmol/L) two hours after a meal. Each time when checking the blood sugar level, keep a proper record of the results and present to the health care team for evaluation and modification of the treatment. If blood sugar levels are above targets, a perinatal diabetes management team may suggest ways to achieve targets. Many may need extra insulin during pregnancy to reach their blood sugar target. Insulin is not harmful for the baby. Breastfeeding In general, breast feeding is good for the child even with a mother with diabetes mellitus. In fact, the child's risk for developing type 2 diabetes mellitus later in life may be lower if the baby was breast-fed. Breast feeding also helps the child maintain a healthy body weight during infancy. However, the breastmilk of mothers with diabetes has been demonstrated to have a different composition than that of non-diabetic mothers, containing elevated levels of glucose and insulin and decreased polyunsaturated fatty acids. Although benefits of breast-feeding for the children of mothers with diabetes have been documented, ingestion of diabetic breast milk has also been linked to delayed language development on a dose-dependent basis. In some cases, pregnant women with diabetes may be encouraged to express and store their colostrum during pregnancy, in case their blood sugar is too low for feeding the baby breast milk after birth. There is no evidence on the safety or potential benefits when pregnant women with diabetes express and store breast milk prior to the baby's birth. Classification The White classification, named after Priscilla White who pioneered research on the effect of diabetes types on perinatal outcome, is widely used to assess maternal and fetal risk. It distinguishes between gestational diabetes (type A) and diabetes that existed before pregnancy (pregestational diabetes). These two groups are further subdivided according to their associated risks and management. There are 2 classes of gestational diabetes (diabetes which began during pregnancy): Class A1: gestational diabetes; diet controlled Class A2: gestational diabetes; medication controlled The second group of diabetes which existed before pregnancy can be split up into these classes: Class B: onset at age 20 or older or with duration of less than 10 years Class C: onset at age 10-19 or duration of 10–19 years Class D: onset before age 10 or duration greater than 20 years Class E: overt diabetes mellitus with calcified pelvic vessels Class F: diabetic nephropathy Class R: proliferative retinopathy