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NURS783 Exam 3 > Breastfeeding > Flashcards

Breastfeeding Flashcards

1
Q

Which hormones affect alveolar development and breast maturation?

A

1) progesterone
2) prolactin
3) hPL

4) growth hormone
5) insulin-like growth factor

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2
Q

Describe breast weight increase

A

200g (nonpregnant) –> 500g (pregnant) –> 600-800g (lactatin)

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3
Q

What occurs to Montgomery tubercles during pregnancy and lactation?

A

sebaceous (oil) glands that appear as small bumps around areola –> enlarge

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4
Q

What is the function of Montgomery tubercles?

A

secrete lubricating, anti-infective substances (IgA) –> protect nipple and areola

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5
Q

What stimulates milk production?

A

prolactin stimulates alveolar cells

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6
Q

What precipitates milk ejection?

A

oxytocin stimulates myoepithelial cells around alveoli to contract

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7
Q

What is the effect of prolactin on menstruation?

A

serum prolactin suppresses LH and ovarian function

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8
Q

How often must one nurse to suppress ovulation?

A

MUST be nursing >8x/day for 10-20mins

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9
Q

What hormones support production of carbohydrates and lipids in breast milk?

A

1) cortisol
2) insulin
3) parathyroid hormone
4) growth hormone

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10
Q

lactogenesis I

A

alveolar development and breast maturation of breast d/t progesterone, prolactin, and hPL

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11
Q

At what point in pregnancy can the glands secrete milk?

A

mid-pregnancy (12-16 wks)

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12
Q

When is lactogenesis I complete?

A

at delivery

*PTB can interrupt breast development

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13
Q

lactogenesis II

A

milk volume increase

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14
Q

When does lactogenesis II occur?

A

over 7 days as progesterone falls after delivery of placenta

usually 3-7days PP

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15
Q

What can delay lactogenesis II?

A
  • primes
  • overweight
  • ineffective breastfeeding in first 24h
  • retained placenta
  • PTB
  • unscheduled C/S
  • maternal diabetes
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16
Q

Which hormones promote lactogenesis II?

A

1) prolactin
2) insulin
3) glucorticoids (cortisol)

17
Q

Describe the composition of colostrum (vs mature milk)

A
  • more protein (esp immunoglobulins)
  • more minerals
  • more fat-soluble vitamins (Na, Cl, K, carotenoids)
  • less lactose
  • less fat
  • less sugar
18
Q

What may impede successful lactation?

A

1) no breast enlargement in pregnancy
2) surgery: damage of lactiferous ducts and/or 4th intercostal nerve
3) pain, anxiety, insecurity inhibit ejection reflex
4) delayed lactogenesis II
5) pre/perinatal drugs (e.g. tobacco, SSRIs)
6) hormonal alterations
7) overweight, hx C/S, retained placenta –> delayed lactogenesis II
8) drugs, alcohol, smoking, stress, pain

19
Q

How does infant maturity affect breastfeeding?

A

less mature –> fewer sucks per burst and longer rest periods between sucks

20
Q

ankyloglossia

A

restricted motion of infant tongue –> interferes w/ feeding and can cause nipple trauma

AKA tongue tie!

21
Q

oral aversion

A

infant withdraws from oral stimuli (i.e. feeding)

22
Q

How much of human milk is water?

23
Q

When is colostrum present?

A

12-16wks GA onward

24
Q

What gives colostrum its color?

A

beta carotene

25
How do water-soluble vitamins enter breastmilk?
from mother's diet *supplement B12 if vegan
26
Describe the function of protein found in mature breastmilk
- 9g/L - enhances immune system - stimulates growth and development of gut
27
What is the principle carbohydrate of mature milk?
lactose (galactose + glucose)
28
What is the function of lactose?
+ galactose enhance colonization of gut w/ microflora --> competes w/ pathogens supports brain development
29
What is the vitamin D content of breastmilk?
deficient --> rickets, poor bone mineralization, vit D deficiency
30
List 4 beneficial substances in colostrum
1) high concentrations IgA 2) interferon (antiviral) 3) fibronectin (more aggressive phagocytes) 4) pancreatic trypsin inhibitor (protects and repairs intestines)
31
Which infant voiding patterns should be investigated?
<3-5 stools/day by day 5-7 OR stool not yellow by day 7
32
What are s/sx of mastitis?
- fever >101º - flu-like aches - inc HR - nausea, chills, pain, swelling - red, tender wedge-shaped area - red streaks toward axilla
33
What s/sx indicate baby needs to be seen today?
- fever, vomiting, lethargy, breathing problems, refusing to eat - forehead skin blanches yellow - nursing <8x/24h - BMs: <3x/day 3 or <4x/day 4 - dark stools day 4 - <4 wet diapers day 4 - can't hear swallowing - red stain in diaper day 3 or later - milk volume not increased by day 4
34
What herbs are galactogues?
- fenugreek - milk thistle - goat's rue - chaste tree seed - fennel seed

NURS783 Exam 3 (8 decks)

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