Breastfeeding

Question 1

What is colostrum?

Answer 1

Thick yellow fluid produced from the breast from about 20 weeks gestation. It has a high concentration of secretory IgA, and is rich in proteins that play an important part in gut maturation and immunity in the infant

Question 2

How soon after delivery should skin-to-skin contact start after delivery?

Answer 2

ASAP - early contact increases breast-feeding within first 2h after birth and increases duration of breast-feeding when compared with delay

Question 3

How often is breast feeding required?

Answer 3

Varies widely - demand feeding is the best approach as it prevents immediate weight loss post-partum in the neonate and prevents maternal engorgement

Question 4

What are the GI benefits of breast feeding in the infant?

Answer 4

Exclusively breast fed - Experience less GI morbiditiy for GI infection than those with mixed feeds

Question 5

What are the benefits of breast milk against infection?

Answer 5

Provide passive immunity - protects against UTI’s, Resp infection

Question 6

What haematological benefits are there to breast feeding?

Answer 6

Reduces risk of developing childhood ALL, hodgkin’s disease and neuroblastoma

Question 7

What are the benefits of breast feeding to the mother?

Answer 7

• Helps uterine involution and reduces risk of PPH
• Provides lactational amenorrhoea/contraception
• Protects against premenopausal breast cancer, ovarian cancer and osteoporosis

Question 8

What problems can occur when breastfeeding?

Answer 8

• Breast engorgement
• Mastitis - obstruction of milk drainage
• Breast abscess
• Sore/cracked nipples

Question 9

What can cause mastitis when breastfeeding?

Answer 9

• Restriction of feeding
• Badly positioned baby
• Blocked ducts
• Small bra

Question 10

What drugs are generally contraindicated in breastfeeding?

Answer 10

• Amiodarone
• Chloramphenicol
• Ergotamine/Cabergoline/Ergot alkaloids
• Methotrexate
• Lithium
• Tetracyclines
• Alcohol
• Cocaine
• Caffeine
• Idoine
• ACEi

Question 11

Can HIV be transmitted through breast-feeding?

Answer 11

Yes - dependent on viral load, duration of breastfeeding and presence of breast lesions/neonatal oral lesions

Question 12

Should individuals with herpes simplex virus breast feed?

Answer 12

Yes - if there are no breast lesions

Question 13

If a mother has chickenpox whilst breastfeeding, should she continue breastfeeding?

Answer 13

Yes - provides antibodies against chickenpox virus for the infant