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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?

A

87.5%

23
Q

When is colostrum present?

A

12-16wks GA onward

24
Q

What gives colostrum its color?

A

beta carotene

25
Q

How do water-soluble vitamins enter breastmilk?

A

from mother’s diet

*supplement B12 if vegan

26
Q

Describe the function of protein found in mature breastmilk

A
  • 9g/L
  • enhances immune system
  • stimulates growth and development of gut
27
Q

What is the principle carbohydrate of mature milk?

A

lactose (galactose + glucose)

28
Q

What is the function of lactose?

A

+ galactose

enhance colonization of gut w/ microflora –> competes w/ pathogens

supports brain development

29
Q

What is the vitamin D content of breastmilk?

A

deficient

–> rickets, poor bone mineralization, vit D deficiency

30
Q

List 4 beneficial substances in colostrum

A

1) high concentrations IgA
2) interferon (antiviral)
3) fibronectin (more aggressive phagocytes)
4) pancreatic trypsin inhibitor (protects and repairs intestines)

31
Q

Which infant voiding patterns should be investigated?

A

<3-5 stools/day by day 5-7

OR

stool not yellow by day 7

32
Q

What are s/sx of mastitis?

A
  • fever >101º
  • flu-like aches
  • inc HR
  • nausea, chills, pain, swelling
  • red, tender wedge-shaped area
  • red streaks toward axilla
33
Q

What s/sx indicate baby needs to be seen today?

A
  • 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
Q

What herbs are galactogues?

A
  • fenugreek
  • milk thistle
  • goat’s rue
  • chaste tree seed
  • fennel seed

NURS783 Exam 3 (8 decks)

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