Chapter 24

Question 1

Advantages of Breast Feeding

Answer 1

~Allergies are less likely to develop.
~Immunologic properties help prevent infections.
~Composition meets infants specific nutritional needs. (fats, protein, and carbohydrates)
~Breast milk is easily digested.
~Unlikely to be contaminated.
~No bottles, formula to prepare or purchase.
~Mother will usually eat a more balanced diet.
~Infants have less constipation.
~Promotes bonding with infant.
~Convenient…always have milk ready

Question 2

Disadvantages of Breast Feeding

Answer 2

~Only the mother can feed the infant, unless the milk is pumped and stored.
~Difficult for working mothers to pump milk at work.
~Family and friends may not be supportive of breast feeding.

Question 3

How do you know if the baby is getting enough milk?

Answer 3

~infant will eat every 1 ½ -3 hours during the day. Possibly 8-12 times in a 24 hour period.
~you will hear the infant swallowing. May see milk in the baby’s mouth or milk dripping occasionally from the breast.
~infant seems satisfied after feedings.
~breasts will get softer by the end of the feeding.
~you will see nutritive sucking and swallowing with periodic rest periods
~the milk production is based on “supply and demand.” The more the baby nurses, the more milk the mother will make.
(first they lose weight, then they gain it)

Question 4

Types of Breast Milk

Answer 4

foremilk, hindmilk, colostrum, transitional mik, mature milk

Question 5

foremilk

Answer 5

the first breast milk received in a feeding

Question 6

hindmilk

Answer 6

breast milk received near the end of a feeding, contains a higher fat content than foremilk.

Question 7

colostrum -

Answer 7

a thick, yellow breast fluid secreted during pregnancy and the first week of birth. High in protein, vitamins and minerals and antibodies which help protect the G.I. tract from infection. Also has a laxative effect which helps the passage of meconium.

Question 8

transitional milk -

Answer 8

his is the milk that appears during the changes from colostrum to mature milk. The milk is increasing in fat and calories at this point.

Question 9

mature mlik -

Answer 9

usually appears at 2 weeks. This milk may have a bluish tint to it. This milk contains approximately 20 cal/ounce.
**20 cal/oz so is formula

Question 10

From 1 Feeding to the Next

Answer 10

The mother will begin feeding on one side and finish on the other.
~Feedings may take 10-20 minutes on each side.
~The infant may be burped between breasts and after 2nd breast.
~For the next feeding: the mother will begin on the side that she finished on. You want to encourage complete emptying of the first side so that the infant receives the hindmilk.

Question 11

Daily Calorie and Fluid Needs of the Newborn

Answer 11

Calories: 110kcal/kg (45 to 50 kcal/lb) An average 7 ½ lb. infant requires 19-21 oz of milk/day.

Fluid: 60 to 80ml/kg (18-27ml/lb) (for first 2 days)
Fluid: 100 to 150ml/kg (45-68ml/lb) (by day 3- 7 days of life)

Newborns lose water easily from skin and kidneys. Breast milk and formula meet the infant’s fluid needs. Additional water is unnecessary.

Question 12

prolaction

Answer 12

at birth, the decrease of progesterone and estrogen results in increased levels of Prolactin and causes milk production. Secreted from the anterior pituitary.

Question 13

oxytocin

Answer 13

increases in response to nipple stimulation and causes the milk-ejection reflex, known as “let-down reflex.”
Secreted from the posterior pituitary.

Question 14

let down reflex

Answer 14

When the mother sees, hears, or thinks about her infant and/or feeding, there will be an increase in Oxytocin and will begin “let down.”
Also, Oxytocin causes the uterine contractions that mothers may or may not feel at the beginning of breast feeding

Question 15

cradle hold -

Answer 15

infant tummy-tummy with mom with mom’s fingers at 6 and 12

Question 16

modified cradle hold -

Answer 16

Mom’s fingers in 9 and 3 position.

Question 17

football hold

Answer 17

infant held like a football with mom’s fingers at 6 and 12.

Question 18

side lying -

Answer 18

avoids pressure on mother’s abdominal incision or episiotomy.

Question 19

Preparing the Breasts to Feed

Answer 19

Mom needs to massage breast to increase the flow of hormones and to get the mom thinking about breast feeding.
When infant is in position, mom may squeeze a small amount of colostrum from nipple to rub across infant’s lips to increase rooting and latch-on.
Mom may continue to massage breast while infant begins feeding until let-down occurs.

Question 20

At the end of breastfeeding

Answer 20

, teach the mother to break the suction of the infant by having her insert her clean finger in the corner of the infant’s mouth. This will help prevent irritation of the nipples.

Most hospitals offer breastfeeding mothers a cream to apply to her nipples for soreness. The most effective way to prevent soreness is by air drying the nipples after breastfeeding.

Question 21

Signs of Infant Problems with Breastfeeding

Answer 21

Falling asleep after feeding less than 5 minutes
Refusal to breastfeed
Tongue thrusting
Smacking or clicking sounds
Dimpling of cheeks
Failure to open mouth wide at latch-on
Non-nutritive sucking at the beginning of the feeding.
Baby having stuffy nose and then trouble breast feeding
Lower lip turned in
Short, choppy motions of jaw
No audible swallowing
Use of formula
Fewer than 3 stools daily by 3rd day
Infant not satisfied after feedings

Question 22

Signs of Maternal Breastfeeding Problems

Answer 22

Hard, tender breasts
Painful, red, cracked, blistered, or bleeding nipples
Flat or inverted nipples
Localized edema or pain in either breast
Fever, generalized aching, or malaise

Question 23

engorgement

Answer 23

swelling of the breasts. There is an accumulation of milk that causes pain and tenderness to the breasts. Mother will need to massage the breast and express some of the milk from the breast in order for the baby to latch on.

Question 24

mastitis

Answer 24

inflammation of the breast that may look and feel like Engorgement. Can be caused by an accumulation of milk or infection.

Question 25

Human Donor Milk

Answer 25

Breast milk that is donated, cleaned, pateurized and used as medicine for infants in the NICU.
This milk is used as the first milk for premature infants. Consent signed for this.
Donor Milk can be used when a mother does not want to breastfeed or pump her milk.
Decreases Necrotizing Enterocolitis (NEC) and coats the G. I. track to decrease infections.