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11 Neonatology > Breastfeeding > Flashcards

Breastfeeding Flashcards

1
Q

stages of lactation

A

lactogenesis 1: 12th week of pregnancy until after delivery, development of breast tissue and colostrum

lactogenesis 2: 2nd to 4th postpartum day, milk “cmoing in” in greater quantity

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2
Q

what is colostrum

A

present during pregnancy and first 2-4 days after birth

provides ideal nutrient and immunological substance so baby has successful transition from sterile to non-sterile environment

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3
Q

t/f colostrum has more protein than mature milk

A

true, mostly due to immunoglobulins (sIgA)

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4
Q

what is transitional milk

A

milk produced starting 7-10 days

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5
Q

what is mature milk

A

produced starting 14th day

87% water

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6
Q

t/f 80% of the calories in breastmilk is lipids

A

false, 50%, mostly phospholipids and triacylglycerols

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7
Q

fatty acids not available in other milk

A

dha and ara

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8
Q

hindmilk vs foremilk

A

hindmilk: near the end of the feed, rich in fat
foremilk: beginning of feed, less fat

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9
Q

the low protein content in milk is matched with __

A

the still developing renal function of the neonate

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10
Q

major components of milk protein

A

whey: dominant, water, electrolytes, proteins
casein: milk curd when milk is <5 ph, insoluble calcium caseinate calcium phosphate complex

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11
Q

major carbohydrate in human miilk

A

lactose

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12
Q

t/f there are some minerals lacking in human milk

A

false, all minerals needed are present in milk

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13
Q

cellular components found in milk

A

neutrophils, macrophages, and lymphocytes concentrated in colostrum

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14
Q

enteromammary pathways

A

read

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15
Q

t/f lipase is present in both human and commercial milk

A

false, only in human milk

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16
Q

t/f vitamins d and k are lacking in human milk

A

true

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17
Q

components absent in commercial milk but present in human milk

A

anti-infective properties, growth factors, digestive enzymes, hormones

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18
Q

factors leading to breastfed infant having higher iq

A
  • nutrients found only in human milk
  • close relationship w mother
  • lowered risk for illnesses
19
Q

maternal benefits to breastfeeding

A
  • decreased post-partum blood loss
  • rapid uterine involution
  • better bonding
  • reduced stress
  • better weight loss
  • lesser risk for t2dm and ovarian, breast cancer
  • child spacing
20
Q

ovulation in lactating vs nonlactating women

A

exclusively breastfeed do not ovulate until at least 6 mos

non-lactating ovulate by 6 w

21
Q

recommendations for brestfeeding

A
  • exclusive breastfeeding for 6 mos
  • introduction of complementary foods through second year of life and beyond
  • no limit to age of breastfeeding
22
Q

reasons why women don’t breastfeed

A

lack of information
formula marketing
work and school
restriction on activity

23
Q

t/f there are no nutritional reasons to deny infants breastmilk unless they have special health problems

A

true, such as classic galactosemia

pku, msud can breastfeed with monitoring

24
Q

t/f breastfeeding is not acceptable for mothers with hepatitis

A

false, ok for all hepatitis

25
Q

t/f drugs of high molecular weight or high protein binding can pass into breastmilk

A

false, low mw and low protein

26
Q

t/f occasional use of alcohol is a contraindication

A

false, not contraindication but must avoid breastfeeding for 2 hours after 1-2 alcohol drinks

27
Q

effects of maternal smoking on milk

A

diminishes milk supply, but not a contraindication to breastfeeding

28
Q

sensory innervation from ____ is essential to milk prodduction function

A

3rd to 6th intercostal nerves

29
Q

___: milk production
___: milk ejection

A

prolactin: milk production
oxytocin: milk ejection

30
Q

major hormones in lactation

A

elevated estrogen and progesterone: prevent prolactin from stimulating milk

fall in estrogen and progesterone after delivery = still elevated prolactin = milk production

31
Q

what is law of supply and demand

A

frequency of feeding regulates milk supply

\+ = frequent, effective milk removal
- = late or infrequent feedings, feeding other things <6 mos, feed less than 8x/24h
32
Q

what is feedback inhibitor of lactation

A

body avoids the fullness and engorgement of breasts when milk is not removed by secreting FIL

FIL = decreases milk secretion

33
Q

late sign of feeding

A

crying

34
Q

positions for breastfeeding

A

cradle (cross chest)
modified cradle (small babies)
side sitting (football – after cs)
side lying

35
Q

one of the most important factors that prevent early problems that may lead to premature weaning

A

latching

36
Q

steps to ensure good latching

A
  1. elicit rooting reflex with nipple

2. being baby into breast: lips widely flanged out with nose and chin touching breast

37
Q

signs of effective sucking

A

“call up suckling” (few rapid sucks at beginning with no active swallows)
nutritive suckling: deeper and slower sucks with audible swallowing
3-4 good sized bowel movements in 24 h
25-30 g weight gain per day

38
Q

early hunger cues

A

waking up
bringing hands to mouth
rooting and mouthing movements

39
Q

signals for end of feeding

A

spontaneously releasing the breasts
falling asleep with nipple in its mouth
discontinuing suck/swallow

40
Q

normal breastfeeding pattern

A

within first 60 mins of birth
every 1-3 hrs daily
8-12 feeds per day

41
Q

signs of adequate feeding

A

POOP PEE SWALLOW FULL GAIN

frequent soft bowel movements (yellow by day 4)
wet diaper (>/= 6 every 24 hrs by day 3)
sound of swallowing during feed
contented between feeds
daily weight gain 20-30 g, weekly 100-200 g

42
Q

what is ten steps to successful breastfeeding

A

basis of international baby friendly hospital initiative

43
Q

who code

A

read

44
Q

aims to protect and promote breastfeeding and regulate marketing of breast milk substituted, supplements, and other related products

A

eo 51

11 Neonatology (9 decks)

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