Breastfeeding

Question 1

What are some benefits of breastfeeding to babies?

Answer 1

Lower rates of:
Allergies
Lung/Ear infections
Obesity
SIDs
Better long-term outcomes

Bonding

Question 2

What are some benefits of breastfeeding to mothers?

Answer 2

Reduces uterine bleeding
Burns calories
Reduces risk of breast, ovarian and uterine cancer

Reduced risk of:
Osteoporosis
Arthrities
Type II Diabetes
Heart disease

Bonding

Question 3

Pathway of milk?

Answer 3

Made in alveolar cells in glandular tissue
Travels through lactiferous duct
Out through nipple

Question 4

What hormones are involved in stimulating the production of milk during pregnancy?

Answer 4

Human placental lactogen - placenta
Progesterone - placenta
Prolactin - anterior pituitary gland

Question 5

What stimulates and inhibits milk ‘let down’?

Answer 5

Stimulated - prolactin

Inhibited - progesterone

Question 6

What is colostrum?

Answer 6

Initially produced fluid
High in immune cells and antibodies
Low in fat
Coats the babies GI tract and assists digestion

Question 7

How many days before milk production?

Answer 7

1-2 days

Question 8

What is the fattiest portion of the breast milk?

Answer 8

Increases as feeding session continues

Question 9

What makes for a good latch?

Answer 9

Wide open mough
Flanged lips
Nipple against roof of mouth
Tongue against bottom of areola

Question 10

What happens hormonally to allow milk letdown?

Answer 10

In hypothalamus, dopamine inhibited and prolactin produced.
Oxytocin released from posterior pituitary

Prolactin - produce milk
Oxytocin - milk glands contract

Question 11

What dip in babies weight would be normal after birth?

Answer 11

In first week when babies stomach is small and mother is producing colostrum a drop of up to 7% would be acceptable

Regained in 2nd week

Question 12

How often do babies feed?

Answer 12

Every 1-2 hours in fist few weeks.

Question 13

What enabled good milk production?

Answer 13

Healthy, balanced diet

Can be prevented by stress, medications, dehydration, use of formula feeds
breasts not being emptied

Question 14

How is a blocked milk duct treated?

Answer 14

Warmth

Continued feeding

Question 15

What are contraindications to breast feeding?

Answer 15

Certain medications
Illicit drugs
High alcohol intake
Maternal smoking
High doses of caffeine
Maternal infections (HIV - may be appropriate in impoverished settings)

Question 16

How does breastfeeding act as a form of contraception?

Answer 16

High prolactin inhibits gonadotropin-releasing hormone release from the hypothalamus, preventing ovulation.

Question 17

What hormone stimulates lactogenesis?

Answer 17

Prolactin

Question 18

What is the effect of human placental lactogen from the placenta?

Answer 18

Stimulates the hypothalamus to increase prolactin release from the anterior pituitary gland.

Question 19

What is breastfeeding-failure jaundice?

Answer 19

Neonatal jaundice due to inadequate intake.
Weight and fluid loss results in hypovolemia, leading to hyperbilirubinemia and sometimes hypernatremia.
Slower bilirubin elimination and increased enterohepatic circulation leads to jaundice.

Question 20

What vitamin supplementation is required in addition to breast milk?

Answer 20

Vitamin D supplementation is recommended for all children

Question 21

What class of anti-depressant should be avoided in breast-feeding?

Answer 21

SSRIs

Question 22

What professionals might be able to help a lady with breastfeeding?

Answer 22

Community midwife
Health visitors
Breastfeeding co-ordinators

Question 23

What are some antenatal preparations that might be made?

Answer 23

Antenatal classes
Positioning and attachment
Expressing

Question 24

How long ideally should a baby be breast fed for?

Answer 24

6 months minimum