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LC 02 > Breastfeeding > Flashcards

Breastfeeding Flashcards

1
Q

Colostrum

A

Initial yellow fluid that comes out of breast during first few days

  1. High in IgA 2. lactoferrin
  2. Higher protein,
  3. lower fat and lactose
  4. Bifidus factor:
    -supports growth of non-pathogenic lactobacillus
    - Facilitates:
    Establishment of lactobacillus
    - Passage of meconium (baby’s first poop)
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2
Q

Transitional milk

A 
2-14 days
Immunoglobulins and protein decrease
Lactose and fat increase
Increase in calories
Vitamin changes

*fat provides more substrates to support early, rapid fat accumulation in infant

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3
Q

Moms diet FX on milk

- micro vs macronutrients

A

Macronutrients should not change in babys milk, but mom may just make less milk if she doesnt have enough nutrients
- Same proportion of protein, fat, CHO

Mom low in certain diets
- micronutrients can be decreased in babys milk

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4
Q

Mature milk

A

Main components

  1. water
  2. Lipids
    - long chain polyunsaturdated FA, w-3
  3. Proteins
    - whey > casein
    - Lactoferrin - inhibits growth of Fe dependent bacteria in GI tract

Also has:

  • Immunoglobulins
  • Antimicrobial factors
  • Carbohydrates
  • Trace elements
  • Vitamins
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5
Q

Active components of breastmilk that protects against illness in infant

A
  1. Cells (macrophages, lymphocytes)
  2. Antibodies - mainly IgA
  3. Probiotic, lactoferrin
  4. Protection against infections
    - Gastroenteritis
    - Resp infxns
    - Acute otitis media
  5. Protection against other diseses
    - Atopy (atopic dermatitic, asthma)
    - SIDS
    - Diabetes
    - Death
    - Neurodevelopmental
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6
Q

Immediate Benefits for moms who breastfeed

A
  1. Suckling causes uterin contraction (oxytocin) - prevent post partum hemorrhage
  2. Lactational amenorrhea: decreases iron loss and higher inter-pregnancy interval
  3. More rapid return to post-partum weight (mixed)
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7
Q

Long-term benefits for moms who breastfeed

A
  1. Lower risk of Breast and ovarian CA (premenopausal)
  2. Lower risk of Osteoporosis
  3. Improved CV outcomes
  4. Bonding/stress reduction
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8
Q

WHO feeding recommendations

A
  1. Exclusive breastfeeding for 6 mo
  2. Continue until 2 yrs
  • American Academy of pediatrics
  • say continue to at least 1 yr
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9
Q

Which family member is crucial (other than mom) for breast feeding?

A

Father!

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10
Q

When should healthcare workers help mom initiate breastfeeding?

A

Within a half-hour after birth

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11
Q

Baby is born, what do?

A

Infant is placed skin-skin with mom for breastfeeding for first hour

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12
Q

Positive hospital practices for breastfeeding

A
  1. BF in 1st hr
  2. Skin to skin contact
  3. Rooming in
  4. Lactation consultants
  5. Peer role modeling
  6. Ad lib nursing/feeding
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13
Q

Negative hospital practices for breastfeeding

A
  1. Separation of infant/mom
  2. Mother discouraged BF/limited time suckling
  3. Covert formula feeding
  4. D/C packs with formula
  5. lack of support
  6. Pacifier use
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14
Q

Lactogenesis stage 2

  • Occurs when?
  • What stim it?
A

Occurs about 3-4 days after life “milk comes in”

- supply and demand

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15
Q

Where does the Energy for breast feeding come from in the first 3 days since milk “comes in” at 3-4 days after birth?

A
  1. Glycogen stores (lasts ~12 hrs)
    - stimulated by intrauterine GCC
  2. Low blood glucose –> decreases insulin and increases glucagon –> gluconeogenesis
  3. Stress
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16
Q

Frequency of BF

A

On demand!
~8-12x a day
Variable duration

17
Q

Infants lose weight 5-7% after birth weight, when does this stop?

A

5 days

  • Milks in!
  • birth weight re-achieved by day 7-10

If weight loss > 7% think inadequate intake

18
Q

How important is mom establishing effective attachment?

A

Very

Or else:
1. Pain + dmg to nipples –> engorgement
2. Breastmilk not removed effectively/baby unsatisfied and wants to feed often
3. Mother-frustrated at apparent poor milk supply
Infant frustrated and refuses to suckle
5. less breastfeeding–> less milk
6. infants fails to gain weight

19
Q

Insufficient milk syndrome

A

Occurs in ~ 5% of women

Common
Inadequate milk removal –> inadequate milk production

A common cause of weight loss in infants

20
Q

How common is primary lactation failure?

A

Rare

21
Q

Is infant formula FDA regulated?

A

Yes

  1. Cow milk based
  2. Protein load better approach hu milk (casein:whey)
  3. High quality aa mix
  4. Fortified w. essential vit + min
  5. Lipid blend modified, including w-3 FA

*has everything but immunoprotective factors in breast milk

22
Q

Risk to formula feeding?

A

Allergens

  • cow milk protein #1 food allergen in infants
  • Soy protein #2 food allergen in infants

Bovine serum albumin found in infant formula can trigger autoimmune response (increased risk of diabetes)

23
Q

Diff between infant growth btwn BF vs FF?

A

1st 3 months
- Same

after 3 mo:
Formula fed gain more weight

*this was recognized 20 yrs ago

24
Q

Breastmilk bank

  • Where is it typically used?
  • What can it reduce in infants?
A

milk is donated
Screen (donor + milk) and pasteurized
TYpically used in NICUs
- 58% reduction in Necrotizing enterocolitis

25
Q

Risks of sharing breast milk

A

not screened

  • infectious risks
  • mom on medications
26
Q

WHO vs CDC growth chargs

A

BF (WHO) vs Formula fed (CDC)

Biggest differences in growth after 6 months

Who can:

  • have earlier recognition of “overweight”
  • Fewer diagnoses of “growth faltering”
27
Q

Which Immunoglobulins are in milk?

A

All of dem
IgA, IgM, I gG, IgD, IgE

*lvls highest in colostrum

28
Q

Bifidus factor:

A
  • supports growth of non-pathogenic lactobacillus
  • Facilitates:
    Establishment of lactobacillus
  • Passage of meconium (baby’s first poop)
29
Q

Minerals that are found in hu milk that is not dependent on maternal diet

A

selenium and iodine

30
Q

Single most important factor in prevention of death in children

A

Exclusive breastfeeding thru 6 mo

31
Q

How should women with HIV breastfeed according to WHO?

A

ART to mom and baby + exclusive breast feeding x 12 mo

  • exclusive BF more protective than mixed
  • less cracks
32
Q

type of women who breastfeed

A
  1. > 24
  2. More educated
  3. Employed part time
  4. Not employed
  5. Not participating in Women, Infants, & Children (WIC) program
  6. Live in New England, Mountain, or Pacific regions
33
Q

Feeding pattern

A

from day 2 of life:

every 1.5-3 hours
8-12x / day

34
Q

Jaundice risks for infants

  • when does it occur
  • What can cause it
A

first 1-2 weeks of life

caused by:

  1. Dehydration
  2. Undernourished
  3. Poor breastfeeding management

LC 02 (15 decks)

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