breastfeeding

Question 1

what is the advice regarding length of breastfeeding and why

Answer 1

exclusively breastfeeding for the first 6 months, and sustained for up to two years or longer with appropriate complementary feeding, is important for the nutrition, immunologic protection, growth and development of infants and toddlers

Question 2

what are the benefits of breastfeeding to the child

Answer 2

less infections (middle ear, GI, upper resp, NEC)

decreased risk of certain illnesses and chronic conditions (allergies, diabetes, certain childhood cancers)

optimal cognitive devel

Question 3

what are the benefits of breastfeeding to the mother

Answer 3

weight loss
decreased risk of osteoporosis
less post partum bleeding
less uterine and breast cancer

Question 4

what are the benefits of breastfeeding to society

Answer 4

less cost
less garbage
less pollution
less loss of work time

Question 5

how quickly does baby usually feed after birth

Answer 5

1 hour

Question 6

should you bundle baby?

Answer 6

no–hats off at 6 hr

Question 7

what is appropriate skin to skin positioning

Answer 7

airways clear
spread eagled
sniff postion
clear view of babys face
Hcp assessing babies

Question 8

what is good evidence of milk transfer during breastfeeding

Answer 8

output from baby

weight

Question 9

what are the three rules of breastfeeding

Answer 9

1. feed the baby
2. stimulate the breasts
3. help baby learn to feed

Question 10

how do you take care of rule number 1: feed the baby?

Answer 10

skin to skin

look for feeding opportunities

improve the latch

stimulate the baby

massage/compress breast

increase frequency

Question 11

average volume of breastmilk per feed for a…

0-24 hour infant

Answer 11

7 mL

total per day 4-26 mL

Question 12

average volume of breastmilk per feed for a…

24-48 hour infant

Answer 12

14mL

total per day 44-335 mL

Question 13

average volume of breastmilk per feed for a…

48-72 hour infant

Answer 13

38 mL

total per day 98-775 mL

Question 14

average volume of breastmilk per feed for a…

72-96 hour infant

Answer 14

58 mL

total per day 378-876 mL

Question 15

average volume of breastmilk per feed for a…

96-120 hour infant

Answer 15

70 mL

total per day 452-876 mL

Question 16

what are some reasons to supplement feeds

Answer 16

asymptomatic hypoglycemia unresponsive to frequent feeds (symptomatic, start IV)

clinical and lab evidence of dehydration –> more than 10% weight loss, high sodium, poor feeding, lethargy

weight loss of 8-10% accompanied by delayed lactogenesis II (day 5 or later)

delayed bowel movements or continued meconium stools on day 5

insufficient intake despite adequate milk supply

when macronutrient supplementation is indicated

hyperbilirubinemia–when assoc with poor feeding or insufficient breastmilk jaundice

Question 17

what are some maternal indications to supplement feeds

Answer 17

delayed lactogenesis II and inadequate intake

breast pathology or surgery

intolerable pain

Question 18

why do most infants lose weight in first 12-96 hours

Answer 18

all infants diurese in first 12-96 hours

Question 19

name a galactogogue

Answer 19

domperidone

Question 20

what is one cause of sore nipples when breastfeeding

Answer 20

ankyloglossia (tight frenulum)

clipping tight frenulum showed to decrease breastfeeding pain and increase milk transfer rate and production