Breastfeeding Flashcards
stages of lactation
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
what is colostrum
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
t/f colostrum has more protein than mature milk
true, mostly due to immunoglobulins (sIgA)
what is transitional milk
milk produced starting 7-10 days
what is mature milk
produced starting 14th day
87% water
t/f 80% of the calories in breastmilk is lipids
false, 50%, mostly phospholipids and triacylglycerols
fatty acids not available in other milk
dha and ara
hindmilk vs foremilk
hindmilk: near the end of the feed, rich in fat
foremilk: beginning of feed, less fat
the low protein content in milk is matched with __
the still developing renal function of the neonate
major components of milk protein
whey: dominant, water, electrolytes, proteins
casein: milk curd when milk is <5 ph, insoluble calcium caseinate calcium phosphate complex
major carbohydrate in human miilk
lactose
t/f there are some minerals lacking in human milk
false, all minerals needed are present in milk
cellular components found in milk
neutrophils, macrophages, and lymphocytes concentrated in colostrum
enteromammary pathways
read
t/f lipase is present in both human and commercial milk
false, only in human milk
t/f vitamins d and k are lacking in human milk
true
components absent in commercial milk but present in human milk
anti-infective properties, growth factors, digestive enzymes, hormones
factors leading to breastfed infant having higher iq
- nutrients found only in human milk
- close relationship w mother
- lowered risk for illnesses
maternal benefits to breastfeeding
- 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
ovulation in lactating vs nonlactating women
exclusively breastfeed do not ovulate until at least 6 mos
non-lactating ovulate by 6 w
recommendations for brestfeeding
- exclusive breastfeeding for 6 mos
- introduction of complementary foods through second year of life and beyond
- no limit to age of breastfeeding
reasons why women don’t breastfeed
lack of information
formula marketing
work and school
restriction on activity
t/f there are no nutritional reasons to deny infants breastmilk unless they have special health problems
true, such as classic galactosemia
pku, msud can breastfeed with monitoring
t/f breastfeeding is not acceptable for mothers with hepatitis
false, ok for all hepatitis
t/f drugs of high molecular weight or high protein binding can pass into breastmilk
false, low mw and low protein
t/f occasional use of alcohol is a contraindication
false, not contraindication but must avoid breastfeeding for 2 hours after 1-2 alcohol drinks
effects of maternal smoking on milk
diminishes milk supply, but not a contraindication to breastfeeding
sensory innervation from ____ is essential to milk prodduction function
3rd to 6th intercostal nerves
___: milk production
___: milk ejection
prolactin: milk production
oxytocin: milk ejection
major hormones in lactation
elevated estrogen and progesterone: prevent prolactin from stimulating milk
fall in estrogen and progesterone after delivery = still elevated prolactin = milk production
what is law of supply and demand
frequency of feeding regulates milk supply
\+ = frequent, effective milk removal - = late or infrequent feedings, feeding other things <6 mos, feed less than 8x/24h
what is feedback inhibitor of lactation
body avoids the fullness and engorgement of breasts when milk is not removed by secreting FIL
FIL = decreases milk secretion
late sign of feeding
crying
positions for breastfeeding
cradle (cross chest)
modified cradle (small babies)
side sitting (football – after cs)
side lying
one of the most important factors that prevent early problems that may lead to premature weaning
latching
steps to ensure good latching
- elicit rooting reflex with nipple
2. being baby into breast: lips widely flanged out with nose and chin touching breast
signs of effective sucking
“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
early hunger cues
waking up
bringing hands to mouth
rooting and mouthing movements
signals for end of feeding
spontaneously releasing the breasts
falling asleep with nipple in its mouth
discontinuing suck/swallow
normal breastfeeding pattern
within first 60 mins of birth
every 1-3 hrs daily
8-12 feeds per day
signs of adequate feeding
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
what is ten steps to successful breastfeeding
basis of international baby friendly hospital initiative
who code
read
aims to protect and promote breastfeeding and regulate marketing of breast milk substituted, supplements, and other related products
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