Breastfeeding and Diabetes Risk Reduction

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Breastfeeding and Diabetes Risk Reduction

• Phoenix Indian Medical Center
• Diabetes Center of Excellence
• Charlton Wilson, MD
• Sue Murphy, MPH, RD, IBCLC

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Why Breastfeeding?
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Breastfeeding (BF) Reduces Risk of Diabetes

• Among Pima Indians being BF
• gt 2 months related to less risk for
  developing diabetes by 40 years of age (Pettitt,
  1998)

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Breastfeeding may reduce risk of
overweight/obesity among young children

• Almost 10,000 school age
• children in
• Germany
• (Von Kries, 1999)

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and the risk was less with time breastfed
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Overweight/obesity prevalence among children
ages 3 - 4 years by their feeding choice at 6
months of age
overweight/obese at 3-4 years of age
PIMC/ITCA Evaluation, 1999
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What then?
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Public Health Planning Model

• Baseline BF prevalence below Healthy People 2010
  Goal
• Interest and value in BF high
• Multiple levels of intervention needed
• Support for initiation and maintenance needed

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The Intervention

• Full time lactation consultant
• (new position)
• 24 hour hot-line support
• Staff education
• Patient/family education
• Outreach/follow-up/ and surveillance
• Breastfeeding Registry established in RPMS

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Outcome Percentage of Mother/Infants Exclusively
Breastfeeding at Birth (10/99-12/01)
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Percentage of Mother/Infants Exclusively
Breastfeeding at 8 weeks (10/99-12/01)
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Rate of Breastfeeding Cessation ? 8 weeks, (10/99
- 12/01)
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(No Transcript)
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Where to now?

• Continued surveillance
• Explore missing data elements such as
• Accomplishment of early latch not well
  documented in medical records, but noted
  statistically to be positively related to
  duration
• Perceived insufficient milk supply and pain
  (maternal) known to be the most universal
  reasons for lactation cessation
• Issues related to mother and baby separation
  (work/school)

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Evaluate reasons for cessation of breastfeeding
to design targeted interventionsEvaluate growth
patterns and health issues associated with
feeding choiceIntegrate breastfeeding support
service into organizational performance
improvement program
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• Expand collaborative efforts
• Share technical assistance with IHS/
  Tribal/Urban programs Explore program designs
  specific to individual community needs
• Assist with developing policy and procedure
  formats for
• establishing lactation support
  services Develop problem solving network for
  patient/program concernsFoster support for
  community events such as conferences, health
• fairs, local campaignsEncourage mutually
  beneficial affiliations with agencies such as
• WIC and Healthy Mothers, Healthy Babies
• Network knowledge of continuing education
  opportunities
• including supportive studying for formalized
  certification for
• lactation counselors Share staff in-service
  and class outlines and resources
• Collaborate to develop and share culturally
  appropriate education materials and promotions

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• The message is hope --
• there are ways to reduce the
  risk of
• diabetes --
• breastfeeding
• is one of them