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Nursing 401 > breast feeding > Flashcards

breast feeding Flashcards

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1
Q

List some factors associated with higher br.feeding initiation and exclusive BF rates

A
  • maternal age >30
  • post secondary education
  • married/commonlaw
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2
Q

What are the reccomendations for how long moms should breast feed their babies in canada?

A
  • exclusive BF for 6 months

- continue with supplementations for up to 2 years or beyond

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3
Q

Why might a woman stop breastfeeding before 6 months?

A
  • returning to work

- unsupportive environments for BF (work, public places)

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4
Q

List some benefits of breastfeeding.

A

Increased immunity

  • Decreased incidence of GI disease because it is easily digestible
  • bonding and attachment between mom and babe
  • proper vitamins, minerals, fluids–infant specific
  • acts as laxative to rid the body of bilirubin
  • assists to involute the uterus (promotes contraction)
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5
Q

breasts are specialized ____________ glands

A

sebaceous

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6
Q

list 3 functions of breasts

A

nourishment
protective antibodies
sexual pleasure

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7
Q

nipples are comprised of _______ tissue

A

erectile

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8
Q

What is the areola?

A

circular area around the nipple.

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9
Q

Where are montgomery tubules found? What is their purpose?

A

in the areola around the nipple, and they secrete a fatty substance that helps to lubricate and protect the nipple

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10
Q

breasts are composed of 3 types of tissue. List them

A

glandular
fibrous
adipose

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11
Q

milk in the breast is produced by what type of cell? Where are these cells found?

A
  • lactocytes

- lining of the ducts and alveoli

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12
Q

How does breast milk travel to the nipple?

A

-via the ducts and the ductules in the breast lobes

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13
Q

What hormone is responsible for developing breasts and preparing for lactation?

A

estrogen

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14
Q

What is the role of progesterone in the breast development?

A

increased progesterone promotes development of lobules and alveoli
-also suppresses lactation during pregnancy

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15
Q

How does the delivery of the placenta affect lactation?

A

it causes a decrease in progesteone, which triggers milk production

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16
Q

What is the role of prolactin in milk production?

A

prolactin is releast from the anterior pituitary gland in response to breast stimulation, which causes lactocytes to produce milk once the babe is born

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17
Q

What is “let down”? How is this caused?

A

the release of milk from the back of the breast, which contains the most nutrients to help sustain the baby
-oxytocin causes myoepithelial cells to contract and eject milk into the ducts

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18
Q

Hormones play a huge role in milk production. Explain this process

A
  • increased levels of hormones at full term
  • Delivery of placenta and breast stimulation–> anterior pituitary–>prolactin–>makes the milk
  • Stretching & Compression of the nipple–>posterior pit.–> oxytocin–> eject milk
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19
Q

Explain the Feedback Inhibitor of Lactation (FIL)

A

Milk contains a small whey protein called Feedback Inhibitor of Lactation (FIL) – the role of FIL appears to be to slow milk synthesis when the breast is full. Thus milk production slows when milk accumulates in the breast (and more FIL is present), and speeds up when the breast is emptier (and less FIL is present)

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20
Q

What are the 3 stages of human milk?

A
  1. Colostrum
  2. Transitional
  3. Mature
21
Q

What is colostrum?

A

the first stage of human milk

  • yellowish, clear/creamy with increased protein, fat soluble vitamins and minerals and IgA
  • 1-4 days pp
22
Q

What is transitional milk?

A

2nd stage of human milk

  • increased calories, lactose and WATER soluble vitamins than colostrum
  • until 2 weeks pp
23
Q

How would you describe “mature” milk?

A

13% solids, cho, proteins, fats, remainder is water,

-from 2 weeks pp and beyond

24
Q

What is the difference between foremilk and hindmilk?

A

-Both parts of mature human milk
FORE-initially during feed, increased water, vitamins and proteins, 1-2%fat
HIND-released after let-down, HIGH IN FAT

25
Q

provide nursing interventions for the following diagnosis:

Ineffective BF r/t lack of knowledge

A
  • assess desire, knowledge and learning style
  • teach skin to skin
  • teach feeding cues
  • teach baby-led positioning and latch on
  • early initiation and benefits
  • provide resources/pamphlets
26
Q

Provide nursing interventions for the following diagnosis:

inneffective BF r/t formula supplementation

A

assess knowledge

  • teach about nipple preference
  • decreased lactogenesis
  • increased breast engorgement
  • decreased duration of breastfeeding and benefits of breastfeeding
27
Q

Provide nursing interventions for the following diagnosis:

ineffective BF r/t sore nipples

A
  • assess nipples, latch and position q feed
  • assist PRN
  • teach feeding cues
  • discuss frequency of feeds
  • expressed breast milk on macerated nipples,
  • change breast pads after each feed
  • no soaps on nipples
  • analgesics
28
Q

Provide nursing interventions for the following diagnosis:

ineffective BF r/t engorged breasts

A
  • initiate early BF
  • BF on demand (8-12 in 24hrs)
  • ensure good latch and position
  • wake a sleepy babe q2-3h during the day
  • hand express to establish good supply
29
Q

list some ways that you can support a mom who is trying to suppress lactation

A
  • do not stimulate (express or expose to heat)
  • wear supportive bra
  • teach about how to mix and store formula
30
Q

How can mom prevent engorged breasts?

A
  • anti-inflammatories
  • cold compresses between feeds
  • avoid unneccesary supplementation
31
Q

how can you assist breast feeding women who are trying to wean?

A
  • maintain skin to skin
  • initiate early bf
  • massage
  • hand expression/bottle
32
Q

to ensure a good latch, nipple should be pointed towards babes _____ and chin should be _______

A

nose

buried in breast

33
Q

how should the nipple appear immediately after a successful feed?

A

round and full, not flat

-No cracks, blisters or bleeding on nipples

34
Q

what is the difference between lactogenesis and engorgement?

A

L- normal breast fullness that usually occurs on day 3-4 when milk increases. Breasts are heavy, hot, firm and milk flows well
E-breasts become over full, can result in blocked ducts. breasts are swollen, tender, warm, red, throbbing. Skin is tight and shiny, with flat nipples and a fever.

35
Q

what causes engorgement?

A
  • missed feeds
  • babe not sucking or latching
  • separation of mom and babe
  • infrequent or restricted feeds
  • supplementation
36
Q

what does the acronym LATCH stand for?

A 
Latch
Audible swallowing
Type of nipple
Comfort
Hold
37
Q

Your mom complains that, while baby was previously feeding very well, babe has suddenly started refusing (nursing strike). What could be some possible explanations of this?

A
  • menses
  • change in diet
  • teething
  • distractions during feeding
  • babe is sleepy when offering breast
38
Q

Your pp mom presents with a red, sore, firm lump in her breast. What do you suspect is happening here?

A

plugged lactiferous duct, meaning that milk builds up and doesnt flow out d/t missed feed, restrictive bra)

39
Q

How can you help treat blocked lactiferous ducts?

A
  • BF q2-3hrs
  • warm shower/compress
  • massage breasts
  • drain breast completely before switching sides
  • change position to assis with drainage
  • avoid restrictive bras
40
Q

If your patient has mastitis, how would you expect her to present?

A
  • temp>38
  • breast is red, firm, swollen, painful
  • malaise, fever, chills, headache
41
Q

what is the appropriate tx for a patient with mastitis?

A
  • abx
  • anti-inflammatories
  • rest
  • keep the breast well emptied by frequent feeding
  • if too painful to feed, express/pump q2-3h
42
Q

what is the appropriate treatment for your patient with a breast abscess?

A
  • needle aspiration/surgical drainage
  • abx
  • rest
  • feed on unaffected side until affected side drained and abx commenced
43
Q

your patient is 4 days pp and has not yet produced any milk. What could be some possible causes of impaired lactogenesis?

A
  • c-section
  • primip
  • long traumatic labour
  • hemorrhage
  • diabetes
  • obesity
  • retained placental fragments
  • stress
  • vit. B6 deficiency
  • polycystic ovary disease
  • smoking, ETOH, contraceptives
44
Q

If mom is experiencing delayed lactogenesis, what are some things you would want to assess in the baby?

A
  • I&O
  • bowel sounds
  • abd. distension
  • hydration
  • weight
  • jaundice
  • feeding cues
45
Q

Your patient is producing milk, but it is clearly not enough to sustain the baby exclusively. How can you help to treat “not enough milk”

A
  • increase frequency of feeds, healthy diet, avoid caffeine, decrease stress
  • massage breasts and stimulate nipples
  • concentrate on baby and milk flow, offering babe enough time to nurse
  • use relaxation and breathing techniques
  • synthetic oxytocin,, domperidone or fenugreek
46
Q

If mom must use formula, what must you include in your documentation?

A
  • parents have made an informed choice for same
  • type and amount of formula given
  • method of administration
  • babes tolerance
  • instructions given to mom
  • communication with HCT
47
Q

List some MEDICAL indications for supplementation

A
  • infant at risk for hypoglycemia (<2.6)
  • mom severely ill
  • some maternal medications
  • infants with metabolism problems
  • infants with dehydration or failure to thrive
48
Q

If you see these signs and symptoms in the infant, you should consider formula supplementation. Also list some other interventions

A
  • weight loss of 8-10%
  • insufficient intake (not latching)
  • delayed passing of meconium (5d)
  • hyperbilirubinia, pre-term, low birth weight
  • express into teaspoon
  • feed expressed breast milk
  • skin to skin
49
Q

List some maternal indications for supplementation

A
  • delayed lactogenesis
  • intolerable pain during feedings
  • unavailable mother
  • breastfeeding is emotionally traumatic

Nursing 401 (9 decks)

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