Breastfeeding Flashcards
Mammalian Milk
=
- Components that promote h____ and s_____
- Composed of pro____, pep____, complex l____, oligo_____
Biomaterial that evolved to nourish growing mammals
- health, survivial
- proteins, peptides, lipids, oligosaccharides
Human Development
- Milk -> ____ source of nutrition
- ______ absorbable food
- B____ food - brain grows faster than any other body part
- sole
- Highly
- Brain food!
Human Milk
- Species Specific biological dynamic system
- High quality pro____
- Healthy f___
- Enhanced gastric ______
- Human milk oligo_____
- Bio____ and imm_____
- Species specific gr____ factors
- proteins
- fats
- emptying
- oligosaccharides
- Bioactive, immunoglobulins (IgA, IgG)
- growth
Composition of Breastmilk
- Bio____ molecules
- Gr___ factors
- Preb____
- Dynamic fluid
- _____ within a feeding
- D_____
- Over lactation
- Between mothers and populations
- Bioactive
- Growth
- Prebiotics
- Dynamic
- Varies
- Diurnally
Beginning has more protein, end has more fat
Composition of Breastmilk
(7)
HE FRAIL
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)
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 ______
- Colostrum
- Transitional
- Mature
- Dynamic
-
<36.6 wks
- Protein
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)
- blood
- uterus
- cancer
- DM
- Child spacing dt increased prolactin prevents pregnancy
- Depression
- abuse
- Rheumatoid Arthritis
- Carviovascular
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
- 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)
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
- Breastfeeding, human milk
- neuro
- Public
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
- 6
- Continue, w foods
- 1 yr or longer as mutually desired by mother and baby
- growth
AAP Policy Statement 2012 Chart
- AAP lists following outcomes for infants receiving human or donor milk for first 6 months, REDUCTION of?
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
- respiratory
- Otitis media
- colds, ear, nose, throat
- GI
Benefits to Society
- Ec____
- Ec____
- Reduces healthcare ____
- Reduces infant ____
- Estimate 911 lives saved each year
- ______ benefit -> less absenteeism
- Economical
- Ecological
- costs
- mortality
- Employers
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
- 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
Healthy People 2030 Breastfeeding Obective
2 Goals
Disparities in feeding rates are mainly because of?
- Increase in proportion of babies EBF through 6 months
- Increase proportion of infants who are breastfed at 1 year
Variations in hospital routines
Increasing Breastfeeding Duration
- Key issues Identified
- Education of (2)
- ____ system in the early weeks postpartum
Education of HCPs, Patients
Support system
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_____
- 10 steps
- General
- CDC
- Joint
- ACA
- Preventative
- Insurance coverage
- Pumps
Recommendations
for
- Full Term Infants?
- Pre Term Infants
- 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
New York Strategies
(3)
- Lactation Rooms
- Paid Family Leave
- Medicaid Reimbursement for Donor Milk
Exclusive Breastfeeding
=
- Supplementing
- ___ own milk
- _____ milk
Feeding at the breast
- Mom’s
- Donor’s
Who has the Highest EBF rates?
Hospitals that follow the?
Ten Steps to Successful Breastfeeding
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
- Evidence
- improve
- discharge
- 6x
Baby Friendly Hospitals
- What organization? Baby-Friendly Hospital Initiative
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
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
- Policy
- Train all staff
- Inform all women on benefits and management
- within 60min of birth!
- Show how
Steps 6-10
- Step 6 =
- Step 7 =
- Step 8 =
- Step 9 =
- Step 10
- 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
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
- skin to skin
- Rooming in