Breast feeding Flashcards
What is the puerperium?
time after childbirth lasting 6-8 weeks
What is meant by involution of the uterus
Uterus returns to pre-pregnant state
From what point can the fundus no longer be palpated
10 days (reduced to size below pubis symphysis)
How does the myometrium change during involution
Returns to normal thickness by ischaemia, autolysis and phagocytosis
How does the decidua change during involution?
Lining shed as locia, regeneration of endometrium
What happens during ischaemia of the myometrium
Contraction of empty uterus and apposition of uterine walls applying pressure to placental site
Reduction of blood supply to uterus
Resulting deoxygenation
What happens during autolysis of myometrium
Self-ingestion of myometrial cells by proteolytic enzymes resulting in reduction in size
Removal of reducant actin and myosin muscle fibre
What happens during phagocytosis of myometrium
Phagocytes engulf and remove waste products of autolysis which are eliminated by kidneys
What is lochia
Vaginal loss during the puerperium
How long is lochia red for?
3 days
How long is lochia pink for?
10 days
How long is lochia yellow for?
3-6 weeks
How does plasma volume change?
Reduction in plasma volume within 10 days
How does cardiac output, heart rate and stroke volume change?
Reduction to pre labour value after 24-72 hours
Decline to non-pregnant value 6-8 weeks
Why are women no longer short of breath after giving birth?
Reduction in compression of lungs due to reduction in uterine size leading to full inflation
Why do women no longer hyperventilate after giving birth?
Less oxygen demand as reduction in cardiac work and circulatory volume
How does sensitivity of central and peripheral nervous system change after giving birth
Increased sensitivity experienced during pregnancy but returns to normal 36 hours post partum
What hormone is responsible for hyperpigmentation of certain parts of the body?
Melanocyte
What hormone is responsible of ligamentous relaxation during pregnancy, leading to lordosis
Relaxin
How long before relaxin levels return to normal
5 months
How many lobes and lobules is breast made up of?
15-25 lobes
20-40 lobules
Define mamogenesis
Mammary duct gland growth and development
Define lactogenesis
Initiation of milk secretion in alveoli
Define galactokinesis
Removal of milk from gland
How does oestrogen affect breasts?
Growth of lactigerous ducts and tubules and increase in breast size
How does progesterone, prolactin and HPL affect breasts?
Proliferation and enlargement of alveoli
Promote fat deposition and stimulates development of lobes and lobules
What is happening to breasts at week 12
Nipple and areola become more pigmented
What is happening to breast at week 16
Colostrum formed
What happens in lactogenesis 1?
Initiation of milk secretion in breast tissue during
What happens in lactogenesis 2?
Production of colostrum and transitional milk followin fall im plasma progesterone
What happens in lactogenesis 3?
Maintenance of established lactation and removal of milk by baby
Where is prolactin secreted
Anterior pituitary gland
Where is oxytocin secreted
Posterior pituitary gland
Advantages for baby breast feeding
Protection from infectious diseases Less chance of vomiting Fewer chest and ear infections Balanced nutrients Reduced allergy incidence Free Temperature
Advantages of breast feeding for mother
Lowers risk of getting breast and ovarian cancer
Saves money
Strong physical and emotional bond
Lose weight
Disadvantages of breast feeding
Father unable to feed
Some women find it stressful
Sometimes difficult to wean baby of breast
Why do some women have sore nipples during lactation
Incorrect positioning ttachment- friction
What is engorgement
Build up of milk in ducts
Feels hard and lumpy
Caused by insufficient emptying breast
What is mastisis
Milk stasis and ifnection- if milk is not removed will back track
