Breastfeeding

Question 1

stages of lactation

Answer 1

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

Question 2

what is colostrum

Answer 2

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

Question 3

t/f colostrum has more protein than mature milk

Answer 3

true, mostly due to immunoglobulins (sIgA)

Question 4

what is transitional milk

Answer 4

milk produced starting 7-10 days

Question 5

what is mature milk

Answer 5

produced starting 14th day

87% water

Question 6

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

Answer 6

false, 50%, mostly phospholipids and triacylglycerols

Question 7

fatty acids not available in other milk

Answer 7

dha and ara

Question 8

hindmilk vs foremilk

Answer 8

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

Question 9

the low protein content in milk is matched with __

Answer 9

the still developing renal function of the neonate

Question 10

major components of milk protein

Answer 10

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

Question 11

major carbohydrate in human miilk

Answer 11

lactose

Question 12

t/f there are some minerals lacking in human milk

Answer 12

false, all minerals needed are present in milk

Question 13

cellular components found in milk

Answer 13

neutrophils, macrophages, and lymphocytes concentrated in colostrum

Question 14

enteromammary pathways

Answer 14

read

Question 15

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

Answer 15

false, only in human milk

Question 16

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

Answer 16

true

Question 17

components absent in commercial milk but present in human milk

Answer 17

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

Question 18

factors leading to breastfed infant having higher iq

Answer 18

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

Question 19

maternal benefits to breastfeeding

Answer 19

• 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

Question 20

ovulation in lactating vs nonlactating women

Answer 20

exclusively breastfeed do not ovulate until at least 6 mos

non-lactating ovulate by 6 w

Question 21

recommendations for brestfeeding

Answer 21

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

Question 22

reasons why women don’t breastfeed

Answer 22

lack of information
formula marketing
work and school
restriction on activity

Question 23

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

Answer 23

true, such as classic galactosemia

pku, msud can breastfeed with monitoring

Question 24

t/f breastfeeding is not acceptable for mothers with hepatitis

Answer 24

false, ok for all hepatitis

Question 25

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

Answer 25

false, low mw and low protein

Question 26

t/f occasional use of alcohol is a contraindication

Answer 26

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

Question 27

effects of maternal smoking on milk

Answer 27

diminishes milk supply, but not a contraindication to breastfeeding

Question 28

sensory innervation from ____ is essential to milk prodduction function

Answer 28

3rd to 6th intercostal nerves

Question 29

___: milk production ___: milk ejection

Answer 29

prolactin: milk production oxytocin: milk ejection

Question 30

major hormones in lactation

Answer 30

elevated estrogen and progesterone: prevent prolactin from stimulating milk fall in estrogen and progesterone after delivery = still elevated prolactin = milk production

Question 31

what is law of supply and demand

Answer 31

frequency of feeding regulates milk supply ``` + = frequent, effective milk removal - = late or infrequent feedings, feeding other things <6 mos, feed less than 8x/24h ```

Question 32

what is feedback inhibitor of lactation

Answer 32

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

Question 33

late sign of feeding

Answer 33

crying

Question 34

positions for breastfeeding

Answer 34

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

Question 35

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

Answer 35

latching

Question 36

steps to ensure good latching

Answer 36

1. elicit rooting reflex with nipple | 2. being baby into breast: lips widely flanged out with nose and chin touching breast

Question 37

signs of effective sucking

Answer 37

"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

Question 38

early hunger cues

Answer 38

waking up bringing hands to mouth rooting and mouthing movements

Question 39

signals for end of feeding

Answer 39

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

Question 40

normal breastfeeding pattern

Answer 40

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

Question 41

signs of adequate feeding

Answer 41

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

Question 42

what is ten steps to successful breastfeeding

Answer 42

basis of international baby friendly hospital initiative

Question 43

who code

Answer 43

read

Question 44

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

Answer 44

eo 51