Breastfeeding

Question 1

Discuss the physiology of initiation and maintenance of breastfeeding

Answer 1

Delivery of placenta = decrease in progesterone triggers milk production

Oxytocin released from posterior pituitary

• Caused by stretching of the nipple
• Compression of the areola
• Causes myoepithelial cells to contract and eject milk into the ducts (let-down reflex)

Prolactin - makes milk
oxytocin - ejects milk

How is breast feeding maintained
-once established, prolactin decrease
production of milk depends on amount of milk suckled from breasts
“feedback inhibitor of lactation” (FIL)
supply and demand
Weaning - milk increases the pressure in duct therefore tells lactocytes to stop producing milk

Question 2

Potential health risk of formula

Answer 2

Interferes with anti-infective properties of br.milk
↑ allergies to cow’s milk protein
↑ GI illnesses rt contamination, ↑ e-coli, ↓ protective immune factors
↑ otitis media(ear infection), resp.diseases, hospitalizations, Type 1 diabetes in infant and br. & ovarian ca of mother

Question 3

Engorged breast

Answer 3

Obj/subj.data: breast is enlarged, painful, shiny & edematous with diffuse red areas. Milk may not flow easily.
Milk supply will be compromised if unrelieved engorgement.
Contributing factors: delayed initiation, infrequent/restricted feeds, supplem’ts, ineffective latch, br. surg.

Question 4

Mastitis

Answer 4

Objective data: Breast is hot, swollen, tender. May c/o malaise, fever, chills, headache, and aching.
Treatment: warmth on breast prior to feed, freq. br feeding, ensure effective positioning, massage during feed, after feed- additional expression, cold packs, nutrition, analgesics. Antibiotic therapy prn

Question 5

Suppression of lactation

Answer 5

do not stimulate. express milk or expose to heat (hot shower)
wear a supportive bra = pressure on lactocytes will decrease the prodution of prolactin therefore decrease milk production
teach how to access, safely make & store formula
d/c during day so parents (buy formula)