Chapter 6: Nutrition During Lactation Flashcards
Mammary Gland
The source of milk for offspring, also commonly called the breast. The presence of mammary glands is a characteristic of mammals.
Alveoli
A rounded or oblong-shaped cavity present in the breast.
Secretory Cells
Cells in the acinus (milk gland) that are responsible for secreting milk components into the duct.
Myoepithelial Cells
Specialized cells that line the alveoli and that can contract to cause milk to be secreted into the duct.
Oxytocin
A hormone produced during letdown that causes milk to be ejected into the ducts. Increases during infant suckling, baby crying, and thinking about infant.
Lobes
Rounded structures of the mammary gland.
Lactogenesis
Another term for human milk production.
Colostrum
The milk produced in the first 2-3 days after the baby is born. Colostrum is higher in protein and lower in lactose than milk produced after a milk supply is established.
Macrophages
A white blood cell that acts mainly through phagocytosis.
Neutrophils
Class of white blood cells that are involved in the protection against infection.
T-Lymphocyte
A white blood cell that is active in fighting infection. These cells coordinate the immune system by secreting hormones that act on other cells.
B-Lymphocyte
White blood cells that are responsible for producing immunoglobulins.
Epithelial Cells
Cells that line the surface of the body.
Secretory Immunoglobin A
A protein found in secretions that protect the body’s mucosal surfaces from infections. The mode of action may be by reducing the binding of a microorganism with cells lining the digestive tract. It is present in human colostrum but not transferred across the placenta.
Morbidity
The rate of illnesses in a population.
Mortality
Rate of death.
Doula
An individual who surrounds, interacts with, and aids the mother at any time within the period that includes pregnancy, birth, and lactation; may be a relative, friends, or neighbor and is usually but not necessarily female. One who gives psychological encouragement and physical assistance to a new mother.
Lactation Consultant
Health care professional whose scope of practice is focused on providing education and management to prevent and solve breastfeeding problems and to encourage a social environment that effectively supports the breastfeeding mother– infant dyad.
Letdown Reflex
Stimulates milk release from the breast. The stimuli from the infant suckling are passed through nerves to the hypothalamus, which responds by promoting oxytocin release from the posterior pituitary gland. The oxytocin causes contraction of the myoepithelial cells surrounding the secretory cells. As a result, milk is released through the ducts, making it available to the infant. Other stimuli, such as hearing a baby cry, sexual arousal, and thinking about nursing, can also cause letdown, and milk will leak from the breasts.
Sore Nipples
Can be common in first 1-2 weeks of nursing. Women should seek help to rule out improper latch or positioning, infection, and infant suck problem.
Treatment for Sore Nipples
Allow breasts to air dry after nursing
Special ointments (Lansinoh)
Warm compresses
Hyperactive Letdown
Excessive milk secretion at the beginning of a feeding. Express some HM first, then allow baby to eat.
Hyperlactation
Production exceeds infant demand. Cabbage leaves or cold compresses can provide comfort for the mom and reduce supply. Try feeding on one side only.
Engorgement
Breasts contain too much milk, which could result in pain/discomfort for the mom and difficulty latching on for the infant.
Engorgement Prevention
Feed the baby frequently Avoid unnecessary mom-infant separation Warm shower/compresses before feedings Acceptable pain meds/cold packs/cabbage leaves between feedings Express HM first as needed
Plugged Duct
Area of blocked milk flow in the breast. Main symptom is a lump on the breast. To treat massage the area when the baby nurses, change breastfeeding positions, or lecithin. If left untreated it may lead to mastitis.
Mastitis
Breast inflammation with or without infection. Often presents as the flu with a red breast lump.
Mastitis Management
Continue feeding the baby frequently Rest for the mother See a doctor if symptoms do not resolve in a day Antibiotics for infection Can try engorgement relief techniques Don't wear tight bras/shirts
ETOH and Breastfeeding
ETOH crosses quickly into HM so that HM levels match the maternal BAC. It can suppress lactation and reduce an infant’s sleep and psychomotor development. General guideline is to limit drinking to two or less drinks daily or occasionally.
Nicotine and Breastfeeding
It is best not to smoke and breastfeed, but it’s better to breastfeed and smoke than to not breastfeed at all.
Caffeine and Breastfeeding
<25 oz coffee is often tolerated by the baby. Monitor infant for sensitivity.
Hyperbilirubinemia Treatment
Monitor baby for stool output
Breastfeed early and often, no HMS
Phototherapy
Exchange transfusion
Trial withdrawal of breastmilk only in severe or persistent jaundice cases
Careful monitoring of infant while in-house professional evaluation after d/c
Breastfeeding with Multiples
Nutritional needs of multiples can be met with breastmilk alone. Barriers to lactation:
These infants are often born premature, SGA, or LBW making initiating breastfeeding a challenge
Time and fatigue
Lack of family support
HIV or HTLV
HIV status is a contraindication to breastfeeding. HTLV is the sexually transmitted virus that causes T-cell lymphoma/leukemia in adults.
Active TB
No breastfeeding until treatment is provided.
Baby with PKU
Ok to breastfeed, but phenylalanine levels must be monitored; supplemental phenylalanine-free formula may be needed.
Galactosemia
An absolute breastfeeding contraindication.
