Breastfeeding Flashcards
1
Q
Mammalian Milk
=
- Components that promote h____ and s_____
- Composed of pro____, pep____, complex l____, oligo_____
A
Biomaterial that evolved to nourish growing mammals
- health, survivial
- proteins, peptides, lipids, oligosaccharides
2
Q
Human Development
- Milk -> ____ source of nutrition
- ______ absorbable food
- B____ food - brain grows faster than any other body part
A
- sole
- Highly
- Brain food!
3
Q
Human Milk
- Species Specific biological dynamic system
- High quality pro____
- Healthy f___
- Enhanced gastric ______
- Human milk oligo_____
- Bio____ and imm_____
- Species specific gr____ factors
A
- proteins
- fats
- emptying
- oligosaccharides
- Bioactive, immunoglobulins (IgA, IgG)
- growth
4
Q
Composition of Breastmilk
- Bio____ molecules
- Gr___ factors
- Preb____
- Dynamic fluid
- _____ within a feeding
- D_____
- Over lactation
- Between mothers and populations
A
- Bioactive
- Growth
- Prebiotics
- Dynamic
- Varies
- Diurnally
Beginning has more protein, end has more fat
5
Q
Composition of Breastmilk
(7)
HE FRAIL
A
Hormones (Growth)
Enzymes (lysozome, amylase, lipase)
Fatty acids (imp for brain development)
MicroRNA (protects for generations)
Essential Amino Acids
Immunoglobulins (IgG, IgA)
Lymphocytes (T and B)
6
Q
Human Milk
- 3-5 days = _______
- mostly immunologic (more protein against infection)
- 5-14 day postpartum = ________ Milk (mixture)
- 4-6 weeks postpartum = _______ Milk (more fatty)
- D____ fluid over time
-
Preterm Milk < ___ weeks gestation
- Higher in ______
A
- Colostrum
- Transitional
- Mature
- Dynamic
-
<36.6 wks
- Protein
7
Q
Benefits to Mother
- Decreased postpartum _____ loss
- More rapid involution of the ______
- Protects against breast and ovarian _____
- Decreased risk of Type 2 ______
- Increased ____ spacing lactation amenorrhea
- Decrease in postpartum _____
- Rate of a____/neglect significantly increased
- Protects against R______ A_____
- Lower Incidence of C_____ disease (HTN, DM, Br/Ov CA)
A
- blood
- uterus
- cancer
- DM
- Child spacing dt increased prolactin prevents pregnancy
- Depression
- abuse
- Rheumatoid Arthritis
- Carviovascular
8
Q
Benefits to Baby
- Protects against
- ____ infections, _ _ disorders, r_____ illnesses, U _ _
- D____, C____ disease
- Childhood C____, R_____ A_____, M _, dental c____, severe l____ disease, acute app_____, ob____
- S _ _ S
- Proper j___, t_____, and f____ development
A
- ear, GI, respiratory, UTI
- Diabetes, Celiac
- Cancer, Rheumatoid arthritis, caries, liver, appendicitis, obesity
- SIDS
- jaw, teeth, facial development (dt exercise of jaw mvement during feeding)
9
Q
AAP Breastfeeding Policy Statement 2012
- ____feeding and _____ milk are the referenced normative standards for infant in feeding and nutrition
- Documented short and long-term medical and n_____developmental advantages of breastfeeding
- Infant nutrition should be considered a ____ health issue and NOT only a lifestyle choice
A
- Breastfeeding, human milk
- neuro
- Public
10
Q
AAP Breastfeeding Policy Statement 2012
- Recommends EBF for first ____ months*
- _____ breastfeeding as complementary ___ are introduced
- Continuation of breast feeding for how long?
- Infant _____ should be monitored with WHO charts
A
- 6
- Continue, w foods
- 1 yr or longer as mutually desired by mother and baby
- growth
11
Q
AAP Policy Statement 2012 Chart
- AAP lists following outcomes for infants receiving human or donor milk for first 6 months, REDUCTION of?
A
12
Q
Infant Outcomes
- Risk of hospitalization for lower _____ tract infections in first year of life is reduced 72%
- If BF exclusively for 4 mos
- _____ Media - reduction 23%
- EBF > 3 mos decreases OM reduced by 50%
- Serious c____, ear, nose, ____ infectiosn reduced by 63%
- Any breastfeeding -> reduction by 64% in nonspecific ___ infections
- this effect lasts 2 mos after cessation of breastfeeding
A
- respiratory
- Otitis media
- colds, ear, nose, throat
- GI
13
Q
Benefits to Society
- Ec____
- Ec____
- Reduces healthcare ____
- Reduces infant ____
- Estimate 911 lives saved each year
- ______ benefit -> less absenteeism
A
- Economical
- Ecological
- costs
- mortality
- Employers
14
Q
Healthy People 2020 Objectives
- Increase the proportion of infants who are breastfed _____, at __ months, __ years, Exclusively through ___ or ___ months
- Increase the proportion of _____ that have worksite lactation support _____
- Reduce the proportion of breastfed newborns who receive ____ supplementation within first 2 days of life
- Increase proportion of live births in facilities that provide ______ care for lactating mothers and their babies
A
- Ever, 6m, 1y, Excusively 3m and 6m
- employers, programs
- reduce formula
- increase live births in facilities that provide recommended care
Overall moving in right direction
15
Q
Healthy People 2030 Breastfeeding Obective
2 Goals
Disparities in feeding rates are mainly because of?
A
- Increase in proportion of babies EBF through 6 months
- Increase proportion of infants who are breastfed at 1 year
Variations in hospital routines
16
Q
Increasing Breastfeeding Duration
- Key issues Identified
- Education of (2)
- ____ system in the early weeks postpartum
A
Education of HCPs, Patients
Support system
17
Q
AAP Breastfeeding Policy Statement 2012
- Hospital routines should encourage and support
- WHO/UNICEF “___ ____ to Successful Breastfeeding”
-
National Strategies involved to facilitate breastfeeding practices in US hospitals and communities
- Surgeon _____ Call to Action
- C _ _
- The ____ Commission
- A _ _
- Breastfeeding is P_____
- _____ coverage for lactation help
- Free p_____
A
- 10 steps
- General
- CDC
- Joint
- ACA
- Preventative
- Insurance coverage
- Pumps
18
Q
Recommendations
for
- Full Term Infants?
- Pre Term Infants
A
- EBF first 6 months
- Continue with complementary foods 1+ y
- All on human milk (mom’s own or pasteurized donor milk)
- Fortifified for <1500 grams
19
Q
New York Strategies
(3)
A
- Lactation Rooms
- Paid Family Leave
- Medicaid Reimbursement for Donor Milk
20
Q
Exclusive Breastfeeding
=
- Supplementing
- ___ own milk
- _____ milk
A
Feeding at the breast
- Mom’s
- Donor’s
21
Q
Who has the Highest EBF rates?
Hospitals that follow the?
A
Ten Steps to Successful Breastfeeding
22
Q
Ten Steps to Successful Breastfeeding
- _____ based policy and practice steps
- Demonstrated to _____ feeding outcomes
- Additive effect
- Each additional step increases the chances that baby will be EBF at time of _____
- Mothers are __x more likely to achieve exclusive breastfeeding in a hospital practicing the Ten Step
A
- Evidence
- improve
- discharge
- 6x
23
Q
Baby Friendly Hospitals
- What organization? Baby-Friendly Hospital Initiative
A
WHO/UNICEF
- Highest breastfeeding rates*
- 1,074,446 births/yr,* 605 hospitals in US , 28.34% of annual US births , 37 hospitals in NYS, 134 maternity hospitals
24
Q
WHO/UNICEF Baby Friendly Hospital Initiative Steps
- Step 1 = Written Breastfeeding ______
- Step 2 = ____ all health care ____ in skills necessary to implement BF policy
- Step 3 = _____ all pregnant women on Be____ and Ma_____ of breastfeeding
- Step 4 = Nurse within how long after birth?
- Step 5 = ___ mothers ___ to breastfeed and maintain lactation if they are separated from their infants
A
- Policy
- Train all staff
- Inform all women on benefits and management
- within 60min of birth!
- Show how
25
Q
Steps 6-10
- Step 6 =
- Step 7 =
- Step 8 =
- Step 9 =
- Step 10
A
- BREASTMILK ONLY! - NO other food or drink unless medically indicated (no formula, water, glucose water), NO free samples, items bearing formula company names, coupons. Purchase formula at market value
- 24 hour Rooming In
- Encourage Breastfeeding on demand (of the baby)
- No artificial teats or pacifiers!
- Foster the establishment of BF support groups and refer mothers to them at discharge
26
Q
More Significant Opportunity for Improvement of EBF
- Continuous, untinterrupted ___-___ contact immediately after brith until first feeding occurs (and continued during hospital stay)
- R______ in both day and night
A
- skin to skin
- Rooming in
34
Q
A Newborn’s Stomach Sizes
How many oz?
- Day 1 =
- Day 3 =
- 1 week =
- 1 month =
A
- Cherry, 1-1.4 tsp
- Walnut, 0.75-1 oz
- Apricot, 1.5-2 oz
- Large egg, 2.5-5 oz
35
Q
Milk vs. Early Milk
What does it look like?
A
36
Q
Satisfied Baby
What do their hands look like?
A
Hand open or on head
Hand closed = still hungry
