BFI Audit Flashcards
The physiology of breastfeeding is regulated by hormones. Please describe these hormones and how they work to support breastfeeding initiation and establishment of a sufficient milk supply.
PROLACTIN-
‘makes milk’
stimulation and touch of the nipple releases prolactin which stimulate hormone receptor sites in milk-producing cells
OXYTOCIN-
‘delivers milk’
causes muscle cells to contract and squeeze milk out of breast to baby
known as the ‘let-down’ of milk
BOTH have a psychological effect on both mother and baby - produce feelings of calmness and reduces stress
What information would a pregnant woman need to help her to make an informed decision about whether to breastfeed her baby?
BABY-
reduced risk of urinary, gastro and ear infections
decreased chance of developing allergies
reduced risk of SIDS, diabetes and childhood leukaemia
MOTHER-
reduced chance of developing some cancers such as breast
BOTH in the long run have decreased chance of obesity and cardiovascular disease
+ financial aspect
Give three key constituents of human milk that are not found in infant formula
GROWTH FACTORS help development of babys gut
LYMPHOCYTES support a healthy immune system
STEM CELLS can become any cell in the body and act as a repairer of internal organs
ENZYMES help aid digestion and absorption
Thinking about the physiology, what practical measures can be taken to support a mother to get breastfeeding off to a good start?
hand expressing before birth to stimulate milk supply
skin to skin contact immediately after birth to promote instinctive stages that encourage first feed and boost hormone levels
ensure mother is comfortable and in the best position
ensure mother knows and understands CHIN principles in order to promote best position for baby
Why do you think breastfeeding rates in the UK are amongst the lowest in the world?
cuts in public health funding (midwives don’t have time to provide extensive support to each and every mother or may possibly due to lack of time, ‘over-help’ a baby)
lack of local support groups
negative attitudes towards breastfeeding in public may cause mothers to be afraid to do so (may lead to wanting to take formula when outside thus making it harder to breastfeed and may lead to eventual formula feeding)
lack of knowledge over health benefits of breastfeeding
taking advice from family members or friends who have formula fed
Why is skin-to-skin contact important at birth and in the postnatal period?
SKIN TO SKIN AT BIRTH:
helps baby go through instinctive stages that will encourage the first feed (birth cry, relaxation, awakening etc)
triggers hormonal release (will trigger milk supply)
calms and relaxes both mother and baby
regulate heart rate, breathing and temperature of baby)
stimulate digestion to occur
AT ANY TIME:
boosts hormones (oxytocin, love hormone helps to calm mother and baby, prolactin improving milk production)
again supports temperature control
A mother asks you how to hold her baby for breastfeeding. What is the key information you would share with her about how to position her baby at the breast?
explore what positions she would like to hold baby in (cradle, cross-cradle, rugby ball, lying down)
use CHIN acronym to explain key principles:
C = baby needs to be close enough to mother in order to scoop enough breast into mouth
H = head should be free from mothers hands, allows baby to tilt head back and allow chin to lead OR move head back if they don’t want to feed)
I = baby’s body should be in alignment, making swallowing easier as they don’t have to bend their neck
N = mother’s nipple should be just below baby’s nose(as they tilt head back, should slip into mouth)
How do babies attach at the breast?
baby will open mouth wide with tongue down and forward
baby will then take a big mouthful of breast tissue into mouth and milk will be released due to tongue compression and negative pressure in baby’s mouth
breast fills most of baby’s mouth and nipple rests between hard and soft palette
What signs would tell you that a baby is well attached to the breast?
wide open mouth
more areola of the nipple seen above the top lip than below
rapid sucks to begin with which turn into slow deep sucks and swallows (will become a rhythmic pattern)
baby seems contented and does not try to remove himself from breast
no pain for mother
Why is effective attachment important?
to prevent issues for mum (for example, sore nipples, engorgement, blocked ducts)
to ensure effective milk transfer and baby is being fed enough to support growth and development
Can you describe how you would support a mother with hand expressing?
explain to mother the benefits of hand expressing (tempting baby to feed in first few days, stimulates milk production, soften breasts if become too full)
teach mother to:
cup breast in a C shape around 2-3 cm from nipple
gently squeeze breast and bring fingers together
can be continued until flow stops and then swap to other breast
milk can be collected by cup or syringe
should be explained that breast milk collected can be stored for up to five days in the fridge or six months in freezer
How can you encourage this? (loving relationships)
encourage mothers to,,,
- pick up and soothe baby if crying
- have frequent skin to skin contact with baby
- keep baby near
- offer breast for comfort as well as feeding
- talking to baby
- looking into baby’s eyes
(can also be promoted pre-birth: thinking about baby, talking to or singing to baby)
Why is it important to encourage loving relationships between parents and babies?
to encourage positive brain development and to ensure secure attachment occurs - love and nurtured babies are more likely to become confident, secure adults.
Why is it important to avoid allowing any advertising of formula milks in the healthcare system?
advertising’s main purpose is to persuade people to buy their product
formula products can be marketing in a way that suggests they should replace breastfeeding (despite not having any of the health benefits of breastfeeding) and this can deter women to carry on with breastfeeding or even attempt it in the first place.
How can you encourage loving relationships when a baby is being bottle fed?
skin to skin contact
looking into baby’s eyes
having limited number of feeders (encourage mother to do this independently)
feeding baby responsively - waiting for feeding cues, not forcing the feed, inviting baby to take teat and not place in mouth
