Chapter 7: Nutrition During Lactation II Flashcards
Milk-to-Plasma Drug Concentration Ratio (M/P Ratio)
The ratio of the concentration of drug in milk to the concentration of the drug in maternal plasma. Since the ratio varies over time, a time-averaged ratio provides more meaningful information that data obtained at a single time point. It is helpful in understanding the mechanisms of drug transfer and should not be viewed as a predictor of risk to the infant, as it is the concentration of the drug in milk, and not the M/P ratio, that is critical to the calculation of infant dose and assessment of risk.
Exposure Index
The average infant milk intake per kilogram body weight per day X ( the milk-to-plasma ratio divided by the rate of drug clearance) X 100. It is indicative of the amount of the drug in breast milk that the infant ingests and is expressed as a percentage of the therapeutic (or equivalent) dose for the infant.
Hyperbilirubinemia
Elevated blood levels of bilirubin, a yellow pigment that is a by-product of the breakdown of fetal hemoglobin.
Kernicterus or Bilirubin Encephalopathy
The chronic and permanent clinical sequelae that are the end result of very high untreated bilirubin levels. Excessive bilirubin in the system is deposited in the brain, causing toxicity to the basal ganglia and various brainstem nuclei.
Meconium
Dark green mucilaginous material in the intestine of the full-term fetus.
Letdown Failure
Milk not being stimulated and released. Stress may inhibit oxytocin as well as alcohol and distractions. Prolonged letdown failure will cause lactation suppression. May try reducing caffeine and/or alcohol and using relaxation techniques.
Hyperactive Letdown
When letdown is overactive, milk streams from the breast as feeding begins. Milk may also leak from the breast that the infant is not being nursed from. The milk streams quickly, and the infant may be overwhelmed by the volume. The infant may choke, cough, or gulp to keep up with the flow. When the infant gulps, the infant may take in air, develop gas pain, and the become fussy.
Engorgement
Occurs when breasts are overfilled with milk when the supply and demand process is not yet established, and the milk is abundant. Also occurs with infrequent or ineffective removal of milk from the breast because of mother-infant separation, a sleepy baby, sore nipples, or improper breastfeeding technique.
Plugged Duct
A plugged duct is a localized blockage of milk resulting from milk stasis (milk remaining in the ducts). The mother may feel a painful knot in one breast and usually does not have a fever or other signs of illness. Treatment for plugged ducts is gentle massage, warm compresses, and complete emptying of the breast.
Mastitis
An inflammation of the breast most commonly found in breastfeeding women. it can be infective or noninfective. Some women get mastitis after having cracked or sore nipples, and some get it without any noticeable problem on the surface of the breast.
Low Milk Supply
Most common reason for cessation of breastfeeding. Usually caused by the mother not breastfeeding or pumping often enough or inefficient emptying of the breast caused by a poor latch or incorrect flange size while pumping. Stress may also be a factor.
Allergic Diseases
Conditions resulting from hypersensitivity to a physical or chemical agent.
Hypersensitivity (Food Allergy)
Abnormal or exaggerated immunologic response usually immunoglobulin E (igE) mediated, to a specific food protein.
Food Intolerance
An adverse reaction involving digestion or metabolism but not the immune system.
Hormonal Maternal Benefits of Breastfeeding
Oxytocin secretion causes uterine contractions in the early postpartum phase. Causes reduces postpartum blood loss and possibly long-term anovulation.
Physical Maternal Benefits of Breastfeeding
Reduced breast and ovarian cancer risk if the mother is under the age of 35
Decreased risk of RA
Weight loss
Psychosocial Maternal Benefits of Breastfeeding
Bonding
Self-confidence
Infant Nutritional Benefits of Breastfeeding
Dynamic nature of HM
Isosmotic- HM and plasma have like ionic concentration
Digestibility
High mineral bioavailability
As food for infants, HM is a stand alone-no other method of feeding babies is as perfect
Infant Immunity Benefits of Breastfeeding
Many substances in HM offer protection against both viral and bacterial infections
Leads to fewer acute illnesses among breastfed infants
Also appears to reduce risk of some chronic illnesses that occur during childhood