Breastfeeding Flashcards
What are the 3 stages of lactation?
Lactogenesis 1
Lactogenesis 2
Lactogenesis 3
describe lactogenesis 1
breast development and colostrum production from approx 16 weeks gestation
Describe lactogenesis 2
Onset of copious milk secretion occurring between 32 and 96 hours after birth
Describe lactogenesis 3
maintenance of milk production
What is the areola?
the pigmented area at the centre of the breast. Lobules (alveoli) it is the mammary gland that produces and secrets milk
What is the duct?
It carries milk secreted by the lobules through the breast tissue to open up at the nipple
What is the Glandular tissue?
develops during puberty, but it is only during pregnancy that the development of the glandular tissue us complete and has the ability to produce milk.
What happens after birth?
oestrogen and progesterone levels drop. Prolactin and oxytocin levels rise in response to touch, smell and sight of baby. Baby begins spontaneous breast seeking behaviour. Mothering behaviours initiated.
What are the 2 major hormones that regulate lactation?
prolactin and oxytocin
Where are the hormones produced?
In the pituitary gland that is located at the base of the hypothalamus
What is the prolactin response?
- baby suckles
- sensory impulses pass from the nipple to the brain
- Prolactin secreted by the anterior pituitary gland goes via bloodstream to the breasts
- Acini (milk- secreting) cells produce milk
What are the effect of the prolactin response?
more secreted at night
suppresses ovulation
levels peaks after the feed, to produce milk for the next feed
What is the prolactin receptor theory?
Surges of prolactin prime the receptor sites
the expulsion of the placenta opens receptor sites
Unprimed receptor sites shut down, reducing potential for milk production
Frequent prolactin release maximises long term milk supply
What does oxytocin do?
Works on our feelings and emotions Lowers blood pressure and improves sleep reduces stress levels by taking on cortisol reduces pain sensitivity Boosts the immune system
What is the oxytocin reflex?
- baby suckles
- sensory impulses pass from the nipple to the brain
- oxytocin secreted by the posterior pituitary gland goes via blood stream to the breasts
- Myo-epithelial (muscle) cells contract and expel milk
What are the effects of the oxytocin reflex?
helped by sight, sound and smell of baby
becomes conditioned over time
Hindered by anxiety, stress, pain and doubt
works before or during the feed to make the milk flow
What makes the milk to be ejected through the lactiferous ducts?
the action of contraction of the myo-epithelial cells surrounding the alveoli occurs under the influence of oxytocin this contraction causes the milk to be ejected from the lactiferous duct
known as the let down reflex
Describe the let down reflex.
can be felt as a tingling sensation in the breast. in the first few days after birth may feel a uterine contractions and experience increased blood loss through the vagina. the let down reflex is initially triggered by the baby suckling but also seeing , hearing touching and smelling her baby. When the child is older it may be triggered by thinking abut feeding or hearing another baby cry.
What is Feedback Inhibitor of Lactation (FIL)?
FIL is a protein secreted by the lactocytes which regulate milk production at a local level. as the alveoli distend and there is a build up of FIL and milk synthesis by the lactocytes is inhibited. When the breastmilk is effectively removed, and distension removed FIL levels will fall and milk synthesis will increase
Describe skin to skin.
Skin to skin contact calms the baby and helps regulate their heartbeat, temperature and breathing. It also stimulates them to seek the breast. The mother goes through physical and emotional changes at this time which prepare her for breastfeeding and mothering.
What is the recommendation for skin to skin?
Undisturbed skin to skin contact between mother and bab after birth. baby gently placed on the mother for skin to skin with nappy and worm towel placed over them. Skin to skin should be the default method of care for all babies at birth.
Why is breast milk good?
it is always the right temperature, requires no preparation, and it is available even in environments with poor sanitation and unsafe drinking water. Breastfeeding guarantees babies access to reliable and sufficient quantity of affordable, nutritious food
When is optimal breastfeeding started?
starting within one hour of giving birth, exclusive breastfeeding for the first 6 months of life and continued breastfeeding until the age of 2
What is colostrum?
This is produced by the breast from around 16 weeks of pregnancy and is the first food for a breastfed baby
What are the special features of colostrum?
packed with protective factors concentrated nutrition strong anti- inflammatory stimulates gut growth small volumes- intentionally laxative effect- to clear meconium
What are the risks for baby by not breastfeeding?
Gastoenteritis Respiratory infections Allergies Obesity Type 1 Type 2 diabetes SIDS
What are the risks for mum by not breastfeeding?
breast cancer
ovarian cancer
hip fractures
heart disease
reduces risk of post natal depression
weight comes of faster
How do babies pick up their familial microbiome?
when they pass through the vagina at birth and through their mother’s milk in the postnatal period and beyond
Why is prolonged skin to skin especially important in c section cases?
because the bay never passed through the vagina so didn’t pick up the microbiome from there so pro longed skin to skin and breastfeeding are extra important
What is epigenetics?
changes in genes can be passed down to future generations via maternal line. Breastfeeding may result in epigenetic changes which impact on:
baby’s brain development
baby’s immune system
baby’s metabolic system
What do parents using formula need to know?
No need to follow on all brands are similar and mostly made of cows milk information on preparing and sterilising cows milk from 1 year responsive bottle feeding
What reflexes are present in a healthy baby at birth?
Rooting reflex
Sucking reflex
swallowing reflex
Name 5 breast feeding positions.
cradle hold cross cradle hold Lying on your side football hold laid back
What is the suck swallow pattern of a breastfeed?
Beginning of feed is short rapid sucks
Active feed is long, slow, rhythmic sucking and swallowing, with pauses
End of feed- flutter sucking with occasional
What are some responsive bottle feeding tips?
Feeding baby when they show signs of being hungry- feeding cues
Hold baby close in a semi upright position- looking into their eyes and talking to them whilst they feed
Gently insert teat into baby’s mouth
Follow cues for when baby needs a break or has had enough
What are some early feeding cues?
stirring mouth opening turning head hand in mouth stretching sucking sound
How do you know there is effective attachment?
Chin touching the breast
Mouth wide open
Cheeks full and rounded
More areola visible above top lip
baby rhythmically takes long sucks and swallows
Feeding is pain free although first few sucks may feel strong
What does CHIN stand for?
Baby is close to mum
Head is free
baby should be inline
nose to nipple
