Breastfeeding Flashcards
Colostrum
Initial yellow fluid that comes out of breast during first few days
- High in IgA 2. lactoferrin
- Higher protein,
- lower fat and lactose
- Bifidus factor:
-supports growth of non-pathogenic lactobacillus
- Facilitates:
Establishment of lactobacillus
- Passage of meconium (baby’s first poop)
Transitional milk
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
Moms diet FX on milk
- micro vs macronutrients
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
Mature milk
Main components
- water
- Lipids
- long chain polyunsaturdated FA, w-3 - Proteins
- whey > casein
- Lactoferrin - inhibits growth of Fe dependent bacteria in GI tract
Also has:
- Immunoglobulins
- Antimicrobial factors
- Carbohydrates
- Trace elements
- Vitamins
Active components of breastmilk that protects against illness in infant
- Cells (macrophages, lymphocytes)
- Antibodies - mainly IgA
- Probiotic, lactoferrin
- Protection against infections
- Gastroenteritis
- Resp infxns
- Acute otitis media - Protection against other diseses
- Atopy (atopic dermatitic, asthma)
- SIDS
- Diabetes
- Death
- Neurodevelopmental
Immediate Benefits for moms who breastfeed
- Suckling causes uterin contraction (oxytocin) - prevent post partum hemorrhage
- Lactational amenorrhea: decreases iron loss and higher inter-pregnancy interval
- More rapid return to post-partum weight (mixed)
Long-term benefits for moms who breastfeed
- Lower risk of Breast and ovarian CA (premenopausal)
- Lower risk of Osteoporosis
- Improved CV outcomes
- Bonding/stress reduction
WHO feeding recommendations
- Exclusive breastfeeding for 6 mo
- Continue until 2 yrs
- American Academy of pediatrics
- say continue to at least 1 yr
Which family member is crucial (other than mom) for breast feeding?
Father!
When should healthcare workers help mom initiate breastfeeding?
Within a half-hour after birth
Baby is born, what do?
Infant is placed skin-skin with mom for breastfeeding for first hour
Positive hospital practices for breastfeeding
- BF in 1st hr
- Skin to skin contact
- Rooming in
- Lactation consultants
- Peer role modeling
- Ad lib nursing/feeding
Negative hospital practices for breastfeeding
- Separation of infant/mom
- Mother discouraged BF/limited time suckling
- Covert formula feeding
- D/C packs with formula
- lack of support
- Pacifier use
Lactogenesis stage 2
- Occurs when?
- What stim it?
Occurs about 3-4 days after life “milk comes in”
- supply and demand
Where does the Energy for breast feeding come from in the first 3 days since milk “comes in” at 3-4 days after birth?
- Glycogen stores (lasts ~12 hrs)
- stimulated by intrauterine GCC - Low blood glucose –> decreases insulin and increases glucagon –> gluconeogenesis
- Stress
Frequency of BF
On demand!
~8-12x a day
Variable duration
Infants lose weight 5-7% after birth weight, when does this stop?
5 days
- Milks in!
- birth weight re-achieved by day 7-10
If weight loss > 7% think inadequate intake
How important is mom establishing effective attachment?
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
Insufficient milk syndrome
Occurs in ~ 5% of women
Common
Inadequate milk removal –> inadequate milk production
A common cause of weight loss in infants
How common is primary lactation failure?
Rare
Is infant formula FDA regulated?
Yes
- Cow milk based
- Protein load better approach hu milk (casein:whey)
- High quality aa mix
- Fortified w. essential vit + min
- Lipid blend modified, including w-3 FA
*has everything but immunoprotective factors in breast milk
Risk to formula feeding?
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)
Diff between infant growth btwn BF vs FF?
1st 3 months
- Same
after 3 mo:
Formula fed gain more weight
*this was recognized 20 yrs ago
Breastmilk bank
- Where is it typically used?
- What can it reduce in infants?
milk is donated
Screen (donor + milk) and pasteurized
TYpically used in NICUs
- 58% reduction in Necrotizing enterocolitis
