1. Promoting Breastfeeding to Decrease Type Two Diabetes Development After Gestational Diabetes Sophia Olsen and Dominique Lima, BSN Nursing Student Class of 2015 Department of Nursing, University of New England Introduction The purpose of this poster is to inform mothers of the benefits to breastfeeding after a Gestational Diabetes Mellitus (GDM) pregnancy to decrease the risk of developing postpartum Type 2 Diabetes Mellitus (T2DM). Up to 60% of women with GDM subsequently develop T2DM (Kim et al., 2002). T2DM can lead to other serious comorbidities, which can decrease quality of life and life expectancy. Goal Increase Breastfeeding Rates o Evidence o On average, mothers who breastfed their children developed T2DM ten years later than mothers who did not breastfeed (Zieglar et al., 2012). o The United States Preventative Services Task Force (USPSTF) gives breastfeeding a “B” recommendation (USPSTF, 2008). Intervention o Implementation of Motivational Interviewing (MI) into practice by nurses during antenatal care visits (Miller & Rollnick, 2012). Benefits for the Mother Breastfeeding helps mothers to lose weight (Lie et al., 2013), resulting in a lower lipid and glucose metabolism, which further prevents the development of T2DM (Zieglar et al., 2012). Benefits for the Offspring Breastfeeding helps to lower the risk of developing obesity, hypertension, cardiovascular disease, and diabetes development later in life (Gunderson, 2007). Figure 1 displays the risk of postpartum T2DM development in women with GDM who breastfed for >3 months compared with those who breastfed for ≤3 months or those who did not breastfeed (Zieglar et al., 2012). References Gunderson, E. P. (2007). Breastfeeding after gestational diabetes pregnancy: Subsequent obesity and type 2 diabetes in women and their offspring. Diabetes Care, 30, S161-8. doi: 10.2337/dc07-s210 Kim, C., McEwen, L., Kerr, K., Peitte, J., Chames, M., Ferrara, A., & Herman, W. (2007). Preventative counseling among women with histories of gestational diabetes mellitus. Diabetes Care, 30 (10): 2491-2495. doi: 10.2337/dc07-0435 Lie, M. S., Hayes, L. L., Lewis-Barned, N. J., May, C. C., White, M. M., & Bell, R. R. (2013). Preventing type 2 diabetes after gestational diabetes: Women’s experiences and implications for diabetes prevention interventions. Diabetic Medicine, 30 (8), 986-993. doi: 10.1111/dme.12206 Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change (3 rd ed.). New York, NY: Guilford Press. U.S. Preventive Services Task Force. (2008). Primary care interventions to promote breastfeeding: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med, 149, 560-4. Ziegler, A., Wallner, M., Kaiser, I., Rossbauer, M., Harsunen, M., Lachmann, L., &... Hummel, S. (2012). Long-term protective effect of lactation on the development of type 2 diabetes in women with recent gestational diabetes mellitus. Diabetes, 61 (12), 3167-3171. doi:10.2337/db12-0393 Table 1 demonstrates communication skills that are utilized when MI is implemented into practice (Adapted from Miller & Rollnick, 2012). From “New mothers 'bribed to breastfeed' by NHS with £200 shopping vouchers,” by Laura Donnelly, 2013, Retrieved from: http://www.telegraph.co.uk/health/healthnews/10442290/New-mothers-bribed-to-breastfeed-by-NHS-with-200- shopping-vouchers.html