Breastfeeding Flashcards
What initiative exists to encourage mothers to breastfeed?
Baby-Friendly Hospital Initiative (BFHI) - WHO and UNICEF launched this
What is the BFHI document that helps women to breastfeed?
10 steps to successful breast-feeding in ‘Protecting, Promoting and Support Breast-Feeding: a Joint WHO/UNICEF Statement’
What is colostrum?
produced from about 20 weeks gestation, is the early form of milk supply. starts to mature to breast milk after around 2 weeks until around 4 weeks
What is the appearance of colostrum?
thick yellow fluid
What key nutrients are present in colostrum?
- high concentration of secretory IgA
- rich in proteins that are important for gut maturation and immunity
What volumes of colostrum are produced for the baby?
small quantities
What happens to the volume of milk that is produced following birth?
the amount of milk rapidly increases to about 500ml at 5 days post-partum
How many calories does breast milk contain and how does this compare to formula milk?
- 57-65kcal/dL (2/4-2.7 mJ/L)
- more energy efficient than formula milk
What should happen immediately following the birth and the baby?
skin-to-skin contact - asap, provided as ‘Kangaroo care’: holding baby to chest
What is the benefit of early skin-to-skin contact after birth?
increases breast feeding if occurs within first 2h birth, and increased duration of breast-feeding, when compared with delay of 4 hours of more
What should determine frequency of breast-feeding and why?
demand feeding: benefits of less weight loss in immediate post-partum period and increased duration of breast feeding subsequently; helps prevent engorgement, and breast-feeding is established more easily
What positive effect can frequent feeding in the early neonatal period have?
associated with less hyperbilirubinaemia
What is the median number of times in a day that exclusively breast-fed term infants feed?
8 times a day (6 during day and twice at night)
How frequent are feeds typically in the first 24-48 hours?
tend to be infrequent, could be as few as 3 feeds in first 24h (should not cause concern if baby otherwise well)
What happens to frequency of breast feeding as time passes after birth?
gradually increases, reaches peak around 5th day of life
How long does WHO recommend exclusive breast feeding for?
4-6 months
What are 10 benefits of breast feeding for the infant?
Reduced risk of:
- Gastrointestinal illness
- UTIs
- Respiratory infection
- Atopic illness
- Leukaemias, acute lymphoblastic leukaemia, Hodgkin’s disease, neuroblastoma
- Giardiasis
And:
- Intelligence (maybe improved)
- Improved bonding
- Contains omega 3 fatty acids - visual development in small infants
- Effects of colostrum on immunity
What are 5 benefits of breast feeding for the mother?
- Uterine involution + reduces risk of PPH
- Lactational amenorhoea (amenorrhoea helpful for anaemia in developing countries)
- Protects against premenopausal breast cancer
- Protects against premenopausal ovarians cancer
- Protects against osteoporosis
How can breast feeding produce lactational amenorrhhoea and how effective is this as contraception?
full or nearly full breast feeding for up to 6 months - nearly 99% effective
drops to 97% at 12 months
What are 5 problems associated with breast feeding?
- Inadequate milk supply
- Breast engorgment
- Mastitis
- Breast Abscess
- Sore or cracked nipples
What proportion of women are physiologically incapable of producing an adequate milk supply?
<1%
What are 6 options for treatment of insufficient milk in the mother?
- Adequate fluids
- Nutrition
- Secure and private environment
- Dopamine antagonists
- Thyrotropin-releasing hormone
- Oxytocin