Breastfeeding

Question 1

Vitamin K 1 mg IM

Answer 1

Vastus lateralis
TB syringe, 5/8”, 25-gauge needle
Prevents generalized bleeding
Cord, petechiae

Question 2

Silver Nitrate 1% drops

Answer 2

Prophylaxis against opthalmia neonatorum
Gonorrhea
Legally-mandated

Question 3

Erythromycin 0.5% ointment

Answer 3

Delay 1 hour for bonding’
Gonorrhea + chlamydia
Legally-mandated

Question 4

Surgical procedure: prepuce (foreskin) separated from glans penis and excised
Most frequently-performed surgical procedure on NB
Practiced by Jews, Muslims
Widespread cultural acceptance: 55% US males (10% European)

Answer 4

Circumcision

Question 5

reduced heterosexual HIV transmission, HPV, genital herpes, UTI in infancy,
penile cancer

Answer 5

American Academy of Pediatrics - circumcision benefits

Question 6

Early potential problems: bleeding, infection, difficulty in voiding, separation of wound edges, pain
Later problems: irritation of meatus that can lead to ulceration/stenosis
Parents who decide NOT to circ.: teach to clean exposed glans, check for ability of foreskin to retract (fully by ages 3-6 years)

Answer 6

European opinions

Question 7

If decide to have baby circumcised: do when baby stable, has already voided once, not fed
within last hour
Nurse gathers equipment
Gomco clamp, Mogen clamp, Plastibell most common in US
Anesthesia: none, ELA-Max cream, penile block
General anesthesia can be used in those >1 month of age

Answer 7

circumcision

Question 8

↓ risk breast, uterine, ovarian Ca
estrogen 
↓ osteoporosis
Child spacing
Emotional health
Postpartum weight loss
Saves $400/year (formula $1200/yr.)

Answer 8

Breastfeeding - Benefits: Mother

Question 9

↑ IQ (cholesterol, fat favor nerves)
↑ visual acuity
↓ ear infections, need for tonsillectomies
↑ mouth development
↓ respiratory & GI infections
↓ allergies, eczema
Immune system benefits
↓ risk T1 diabetes

Answer 9

Benefits: Newborn

Question 10

increases & stimulates lactation

Answer 10

Prolactin

Question 11

Radiates out from nipple, forming 15-20 lobes; spaces between filled with adipose & lobes
connected by fibrous tissue
Each lobe divided into lobules, made up of alveoli (functional unit)
Special cell in alveoli: acini - Epithelial cell, produces milk

Answer 11

Glandular Tissue

Question 12

Baby put to breast
Stimulation sends impulses to spinal cord & brain (hypothalamus)
Oxytocin (from posterior pituitary) →anterior pituitary to release prolactin
→stimulates milk production

Answer 12

Mechanism of Lactation