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OB > 3. Breastfeeding > Flashcards

3. Breastfeeding Flashcards

1
Q

Detrimental peripartum experiences that influence breastfeeding (5)

A
  • Late initiation of breastfeeding after birth
  • Extended separation from infant
  • Supplementation with formula
  • Limited or no help with breastfeeding
  • Gift packages with formula
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2
Q

Negative impact on suckling

A

Anesthesia / Analgesia

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3
Q

Enhanced breastfeeding 2/2…

A

continuous support through labor

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4
Q

HIV / AIDS policy with breastfeeding in the US

A

o Since HIV virus exists in breast milk, it is the current protocol to recommend exclusive bottle feeding for all HIV+ patients

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5
Q

General guidelines for breastfeeding

A
  • Exclusive up to 6 months

* Continue until 1st birthday

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6
Q

What makes colostrum so great?

• Components (4)

A
  • High in protein, minerals and fat soluble

* Rich in immunoglobulin’s (IgA) which help protect newborn’s GI tract

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7
Q

Whenv does mature milk happen?

A

Day 10

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8
Q

How many calories per ounce in mature breast milk?

A

20 cal / oz

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9
Q

Mature milk:
• % Fat
• % Carbs

A
  • Fat (58%)

* Carbs (30-40%) in form of lactose

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10
Q

Composition of breastmilk (7 components)

A
  • Protein (whey)
  • Fat (58%)
  • Carbs (30-40%) in form of lactose
  • Water
  • Minerals
  • Vitamins
  • Enzymes
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11
Q

Breastfeeding: 7 benefits to newborn - GI system

A

o Good GI bacteria
o Reduces incidence of stomach upset, diarrhea and colic
o Reduces risk of newborn constipation
o Provides easily tolerated and digestible formula that is sterile, at proper temperature and readily available with no artificial colorings, flavorings or preservatives
o Is less likely to result in overfeeding, leading to obesity
o Promotes better tooth and jaw development

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12
Q

8 maternal advantages to breastfeeding

A

o Weight loss
o Decreases uterine bleeding
o Promotes uterine involution as a result of release of oxytocin
o Lowers risk against breast cancer and osteroperosis
o Affords some contraceptive protection
o Economical
o Associated with avoidance of type 1 diabetes and heart disease
o Bonding benefits

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13
Q

8 contraindicated substances for breastfeeding

A 
o	Alcohol (in large amounts)
o	Amphetamines
o	Cocaine
o	Cyclosporine (immunosuppressant)
o	Heroin
o	Lithium
o	Methadone
o	Antihistamines dry you up
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14
Q

When does breast development begin?

A

5th week of embryonic life

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15
Q

Where does breast development begin?

A

From the milk lines, a line of glandular tissue

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16
Q

Major divisions of breast tissue (2)

A

1) Parenchyma

2) Stroma

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17
Q

Parenchyma components

A

Includes orderly, tree-like lactiferous ducts that open onto the surface of the nipple and the lobular-alveolar structure

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18
Q

Stroma components (4)

A
  • CT
  • Fat
  • Blood vessels
  • Lymphatics
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19
Q

Alveolar cell Funciton

A

• Produces milk and excretes it into lumen of the alveolar sack

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20
Q

What carries milk from the alveolus to nipple pore?

A

Ductules and ducts

21
Q

5 characteristics of the nipple

A
  • Located slightly below midpoint of the breast
  • Has 15-25 small openings that are endings: Endings of ducts that connect back to the lobular-alveoli system
  • Elastic
  • Contains smooth muscle fibers
  • Enervated with both sensory and autonomic nerve endings
22
Q

3 characteristics of the areola

A
  • Surrounds the nipple
  • Enlarges and darkens during pregnancy and lactation
  • Montgomery’s tubercles (small pimples) secrete a substance that lubricates and provides antimicrobial protection
23
Q

Breast changes: 1st trimester

A

Rapid ductular-lobular-alveolar growth due to changing levels of circulating hormones

24
Q

Breast changes in 3rd month of pregnancy

A

Secretory material, colostrum begin to appear due to prolactin

25
Q

Breast changes by 16th week of pregnancy

A

Breast is fully prepared for lactation - physiologic completion of cycle

26
Q

Breast changes in last timester

A

Alveoli filled with colostrum

27
Q

Functioning mammary gland responds to what type of signals in order to produce and deliver milk? (2)

A
  • Nervous

* Endocrine

28
Q

Hormones responsible for breast development (2)

A
  • Luteal

* Placental

29
Q

Hormones responsible for continued and developed breast growth (5)

A
  • Lactogen
  • Prolactin
  • Chorionic Gonadotropin
  • Estrogen
  • Prolactin
30
Q

Essential hormone for lobular-alveolar completion in pregnancy. Initiates milk secretion via secretion on alveolar walls
(& Where is it secreted from?)

A

Prolactin - secreted by anterior pituitary

31
Q

Negative control of prolactin

& Where is it secreted from?

A

Prolactin inhibiting factor from hypothalamus

32
Q

o Delivery of placenta → HORMONAL RESPONSE → HORMONAL RESPONSE

A

o Delivery of placenta → Estrogen and progesterone levels drop → Triggers release of high prolactin (from anterior pituitary gland)

33
Q

What maintains prolactin?

A

o Suckling → Initiates milk secretion → Prolactin maintained

34
Q

How long does it take prolactin levels to drop to those of a non-pregnant, non-lactating woman?

A

• Without nipple stimulation, prolactin levels drop to those of non-pregnant, non-lactating women within 2 weeks

35
Q

Role of oxytocin in breastfeeding (3)

A
  • Released during suckling 2/2 nipple stimulation and sensory pathways
  • Causes myoepithelium to contract, ejecting milk from the alveoli and lobules
  • Promotes mother-infant bonding as well as other maternal behaviors
36
Q

Phases of milk production (3)

A

o Lactogenesis I: Initial synthesis of milk components (colostrum) that begins during pregnancy.

o Lactogenesis II: Begins after delivery of placeta with rapid fall levels of progesterone, resulting in copious secretion of milk 2-3 days postpartum

o Lactogenesis III: Galactopoiesis: Ongoing production of mature milk.

37
Q

Fancy term for weaning

A

Breast involution

38
Q

Mechanism of breast involution (2)

A
  • 1) Secretory cells undergo apoptosis

* 2) Mammary gland’s basement B membrane undergoes proteolytic degeneration, with reabsorption of mammary epithelium

39
Q

BFHI (2 characteristics)

A

“Baby Friendly hospital initiative”

  • Created by UNICEF and WHO
  • Recognizes maternity facilities internationally that create environment that promotes, protects and supports breastfeeding
40
Q

Ten steps to successful breastfeeding (just read, don’t memorize)

A
  • 1) Establishment of facility-wide breastfeeding policy to guide practice
  • 2) All staff must be oriented to facility’s breastfeeding policy and be knowledgeable of its content
  • 3) Parental education must integrate knowledge about breastfeeding
  • 4) Early mother-infant contact and early initiation of breast feeding
  • 5) Positive and frequent breastfeeding teaching interactions between staff members and mothers (Breastfeeding is a learned behavior—not instinctive)
  • 6) Discourage unnecessary supplementation of breastfed infants
  • 7) Develop practice of rooming-in when possible
  • 8) Offer breast milk according to infant cues, not clock timing
  • 9) Avoid use of pacifiers, bottle nipples – unless medically indicated
  • 10) Maternity faculty is responsible to assist mothers in finding postpartum support systems
41
Q

Optimal # of daily feednigs

A

8-12

42
Q

4 characteristics of an infant who is optimally breast fed

A
  • Have a minimum of 3-4 bowel movements every 24 hours
  • Wet diaper 6x daily
  • Gain 15-30 grams daily
  • Be at or above birth weight by 10 days of age
43
Q

4 characteristics of nipple discomfort

A
  • Most common reason for early weaning
  • Usually caused by poor positioning / attachment of newborn
  • Treat nipple fissures with air + breast milk
  • Evaluation for Candidiasis and Rx with topical nystatin
44
Q

What is engorgement?

A

Excessive fullness in early postpartum period

45
Q

What is the treatment for engorgement (5)

A
  • Unlimited access to feeding on baby’s cue
  • Comfortable positioning
  • Warm shower
  • Massage
  • Red cabbage leaves
46
Q

Babies cry for four reasons:

A

Burp
Feed
Change
Pick up

47
Q

Breastfeeding: 3 immunological benefits to baby

A

o Lymphocytes and neutrophils in colostrum promotes optimal mother-infant bonding.
o Passive immunity
o Strong immune system

48
Q

Functional unit of milk making

A

Alveolar cell

OB (15 decks)

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