3.2 Nutrition - breastfeeding part one

Question 1

To support breastfeeding these strategies are helpful:

• have a written breastfeeding ____ within delivery care settings
• support initation of breastfeeding within ___________ of birth
• give no artificial teats or pacifiers to breastfeeding infants until _____

Answer 1

• policy
• 1 hour
• breastfeeding is established, typically at 4 weeks of age

Question 1

What is the sequence of breastmilk production

Answer 1

• colostrum
• transitional milk
• mature milk

changes as baby grows and changes

Question 3

How does initiation of breastfeeding at birth help promote a healthy microbiome

Answer 3

allows for the growth of protective bacteria to support healthy microbiome

Continuation of breastfeeding promotes fur-
ther growth of these bacteria, immunoglobulin A (IgA) secretion and decreased inflammation in the intestinal epithelial cells and underlying tissues.

Question 4

What are 3 benefits for mothers breastfeeding

Answer 4

• strong bonding
• decreased risk of breast/ovarian cancer
• decreased CV risks

Question 5

What are contraindications to breastfeeding

5

Answer 5

• infant with galactosemia
• maternal cancer
• maternal HIV (unless actively getting antiretroviral treatment)
• herpes lesions on maternal breasts
• maternal drug use

Galactosemia is a rare, hereditary disorder of carbohydrate metabolism that affects the body’s ability to convert galactose to glucose.

Signs of galactosemia in babies usually appear within the first week of life and include poor feeding, vomiting, jaundice, and an enlarged liver. Other symptoms include lethargy, diarrhea, weight loss, and weakness

Question 6

Colostrum- when does production of colostrum start

Answer 6

16 weeks gestation

The pregnant woman may notice a small amount of yellow discharge on her nipple or clothing.

Question 7

What is colostrum rich in

Answer 7

immunoglobulins esp sIgA and antibodies

low in calories and fat

Question 8

What does sIgA do for the infant

Answer 8

coats gut to protect against invasion of bacteria

also decreases gut inflammation

Question 9

What function does colostrum help with for the infant

Answer 9

passage of meconium

colostrum is higher in sodium, potassium, chloride, protein, fat-soluble vitamins, and cholesterol than mature milk and facilitates the passage of meconium.

Question 10

Is there any supplementation needed when a baby only has colostrum for the first few days of life

Answer 10

no- meets all nutritional needs of healthy term newborn

Question 11

When does transitional milk appear

Answer 11

between 32-96 hours after bith

Question 12

What triggers the development of transitional milk

2

Answer 12

drop in placental hormones and increased prolactin levels

As a general rule, transitional milk has more lactose, calories, and fat and less total protein than colostrum.

Question 13

When does mature milk come in

Answer 13

two weeks after birth

Ongoing milk production is supported by autocrine, endocrine, and metabolic controls.

Question 14

Why can breastmilk meet the hydration needs of infants

Answer 14

it is 90% water

Question 15

After water, what is the next greatest precentage of breastmilk

Answer 15

lipids (fats)

Question 16

What iron supplement is recommended for infants and at what age for exclusively breastfed infants

Answer 16

1mg/kg/day starting at 4 months old

Question 17

At what week of pregnancy is the breast capable of breast milk

Answer 17

20 weeks

Question 18

What action of the infant is essential to establish and maintain lactation

Answer 18

suckling

Question 19

Supply and Demand- part one

• suckling stimulates the _________ to decrease _____________
• prolactin levels are directly proportional to ________ level of _______________ by infant
• prolactin levels are more important in the_____________ of lactation than the ________ of it

Answer 19

• suckling stimulates the hypothalamus to decrease **inhibition of- and increase stimulation of- prolactin **
• prolactin levels are directly proportional to level of suckling by infant
• prolactin levels are more important in the initation of lactation than the maintenance of it

Question 20

Supply and Demand - part 2

• The hypothalamus also stimulates the synthesis and release of _________ which causes contractions to force-__________
• this action increases milk pressure called the-_____

Answer 20

• The hypothalamus also stimulates the synthesis and release of oxytocin which causes contractions to force milk down the ducts
• this action increases milk pressure called the let-down reflex or the milk ejection reflex

Oxytocin also aids in maternal uterine involution, a mechanism protective of the new mother’s life by reducing blood loss after birth.

Question 21

Does the size of a breast predict the volume of breast milk or breastfeeding success

Answer 21

no