Breastfeeding

Question 1

Myths about breastfeeding

Answer 1

• it’s painful and hard to learn
• breastfeeding babies cry a lot
• your baby won’t get enough milk
• you can’t work and breastfeed your baby
• breastfeeding ties you down

Question 2

Benefits of breastfeeding

Answer 2

• special bonding
• convenient
• better mouth development
• costs less
• ecological benefits
• decreases incidence of premenopausal cancer
• natural wt loss

Question 3

Benefits of breastfeeding (continued)

Answer 3

• perfect food for baby
• no constipation or overeating
• healthier baby
• antibodies protect baby

Question 4

How many calories should baby be getting?

Answer 4

110-120 cal/kg/day

Question 5

Pituitary role in breastfeeding?

Answer 5

Releases prolactin and oxytocin

Question 6

Prolactin

Answer 6

Stimulates milk production

Question 7

Oxytocin

Answer 7

Stimulates muscle contraction of uterus

Question 8

Ways to increase milk supply?

Answer 8

• make certain baby is alert
• 10 min each side minimum
• avoid pacifiers and bottles with formula
• avoid birth control pills (estrogen), medicines, etoh, smoking
• drink water or juice at feeding
• take afternoon break

Question 9

Colostrum

Answer 9

• 1st week
• thick yellow secretion
• high protein (keeps baby from going into hypoglycemia), fat soluble vitamins, minerals, IgA
• low calories, fat, lactose

Question 10

Transitional Milk

Answer 10

• 7-10 days

- fat, calories, lactose increase

Question 11

Mature milk

Answer 11

• bluish in color

- 20 cal/oz and nutrients sufficient for changing infants needs

Question 12

inverted nipples

Answer 12

• do pinch test
• wear breast shells third trimester
  - wear a few hours/day slowly increase
  - air holes in shells allow air flow

Question 13

Positioning for breastfeeding

Answer 13

• lying on side
• lying on back
• “football hold” or “clutch hold”
• “cradle” or “cuddle” “madonne” position

Question 14

Frequency of feedings

Answer 14

• q2hr not longer than 5 hrs

- leave on 1st breast at least 10-15 min

Question 15

Suggested daily food intake while breastfeeding

Answer 15

• balanced diet
• continue with prenatal vitamins
• increased calories (500-700 more)

(avoid foods that make baby gassy - cabbage, beans, etc)

Question 16

Help and encouragement for breastfeeding mothers

Answer 16

• mother support groups
• breastfeeding support groups
• HCP
• childbirth/breastfeeding educator
• WIC, breastfeeding, or lactation counselor

Question 17

Differences between bottle feeding and breastfeeding?

Answer 17

• size of nipple
• softness of nipple
• hole in nipple
• smell of nipple

Question 18

Rationale for formula feeding

Answer 18

• personal preference
• influence from family
• lack of familiarity
• contraindications
• damage
• may supplement breastfeeding if mothers milk supply is inadequate

Question 19

Formula feeding rules

Answer 19

• no propping
• no microwave
• no forcing to finish
• no saving

Question 20

Do NOT give cow’s milk to a baby under 1 yr old!

Answer 20

• too much protein
• the fat is too hard to digest
• high sodium
• forms a hard “curd” in baby’s stomach

Question 21

Readiness for feeding

Answer 21

• hands in mouth

- clinch up and screaming

Question 22

Feeding patterns

Answer 22

Bottle: q4hr
Breast: q2-3hr

Question 23

Feeding techniques

Answer 23

• finger under chin

- sit up

Question 24

Types of commercial formulas

Answer 24

• cows milk-based formulas
• soy-based formulas
• casein- or whey-hydrolysate formula
• amino acid formulas (PKU baby)
• PKU: cant break down protein

Question 25

Breastpumps

Answer 25

• manual expression and massage
• manual pump
• electric pump

Question 26

Calories in formula?

Answer 26

• premature formula: 24 cal/oz

- others: 20 cal/oz

Question 27

Storing breast milk

Answer 27

• store in plastic bags, bottles, glass (leave space on top for expansion)
• mark date and amount stored (2-4 oz)
• good at room temp for a few hrs
• store in refrigerator 24-72 hr
• store in freezer for 3 months (deep freezer: 12 months)
• defrosted milk 24 hr in fridge

Question 28

Weaning from breastfeeding

Answer 28

• will usually wean off by themselves by 18 months
• offer milk from cup before BF
• gradually eliminate BF
• hold baby instead
• nighttime feedings are usually last to go

Question 29

Experiencing emotional letdown (mother)

Answer 29

• depressed after giving up BF
• hormone shifts
• breast engorgement if wean abruptly
  
  • express some milk out to relieve engorgement and wear tight bra