Objectives: Diabetes may delay milk letdown, and perceiving milk production as insufficient can lead to breastfeeding cessation. We evaluated whether prepregnancy or gestational diabetes is associated with cessation of breastfeeding by 1 week postpartum. Methods: We analyzed 2016-2018 data from 42 sites in the Pregnancy Risk Assessment Monitoring System, a population-based survey of women with a recent live birth. Participants were surveyed 2-6 months after childbirth. We used logistic regression models to evaluate the relationship between prepregnancy or gestational diabetes only and breastfeeding <1 week postpartum among women who had initiated breastfeeding. Results: Among 82 050 women who initiated breastfeeding, 4.5% reported breastfeeding <1 week postpartum. Overall, 11.7% of women reported any history of diabetes in the 3 months before becoming pregnant; 3.3% reported prepregnancy diabetes, and 8.4% reported gestational diabetes only. In both unadjusted and adjusted models, the prevalence of breastfeeding <1 week postpartum did not differ significantly among women with prepregnancy diabetes or gestational diabetes only compared with women without any history of diabetes. The prevalence of breastfeeding <1 week postpartum was 4.4% among women without any history of diabetes, 5.6% among women with prepregnancy diabetes (adjusted prevalence ratio [aPR] = 1.15; 95% CI, 0.91-1.46), and 4.5% among women with gestational diabetes only (aPR = 1.01; 95% CI, 0.84-1.20). Conclusions: We found no association between a history of diabetes prepregnancy or gestational diabetes only and breastfeeding <1 week postpartum in a large, population-based survey of postpartum women who initiated breastfeeding. Regardless of their diabetes status, women who want to breastfeed might benefit from interventions that support their ability to continue breastfeeding.

Aims: At the Ohio State University College of Medicine, medical students have the option to train in ultrasound and take part in global electives where they can utilize clinical ultrasound. This presents the opportunity for medical students to engage in bidirectional sharing of medical and ultrasound knowledge in geographic regions with limited resources. We developedBringing Ultrasound Internationally for Long-term development (BUILD), a longitudinal course, to provide standardized ultrasound education to students planning to enroll in global health electives.Material and methods: This was a pilot study of the BUILD curriculum. Third-year medical students planning to complete a global health elective were invited to participate. Enrolled students completed an online curriculum, hands-on scanning, and pathology sessions, which augmented the predeparture Global Health course work. Students received two resource assessments: one to be completed by the student, and one to be completed by the on-site preceptor. Main outcomes measured were number of enrolled students, primary indications for imaging, and number of scans per-day.Results: In total, 152 students participated in the study and traveled to 22 different global sites in Low-Income Countries (LIC’s). All enrolled students completed the curriculum. Between 3 and 25 scans were performed per day and the leading indication for ultrasound imaging was obstetric and abdominal pain evaluation.Conclusions: The BUILD curriculum is a feasible construct to prepare students for using ultrasound during global electives. Students successfully performed proctored scans in a variety of settings. This format can be adopted by other institutions to further support student and global ultrasound programs.