Day One Flashcards
UNICEF
United Nations Children’s Fund
What three strategies have WHO and UNICEF set out to increase breastfeeding and initiation and duration
Promotion
Protection
Support
WHO
World Health Organization
Promotion
Focuses on advantages of BF
Protection
governmental, manufacturer, and social responsibility to assure BF ability. Includes addressing moms about BF rather than formula
International code of marketing of breast milk substitutes
Support
Interaction of helpers with family as well as program development
10 steps to successful BF UNICEF/WHO
- Written BF policy that’s routinely communicated to all health staff
- Train all health care staff in skills necessary to implement policy
- Inform all pregnant woman about benefits and management of BF
- Help mothers initiate BF with in one hour of birth
- Show moms how to BF and how to maintain lactation even If separated from infant
- No food/drink, other than breast milk, unless medically indicated
- Practice Rooming in: allow mom and baby to remain together 24 hours a day
- Encourage BF on demand
- No artificial teats or pacifiers
- Establish BF support groups and refer to them on discharge
How long is the CLC credential valid?
3 years. May be renewed via submission of 18 hours of continuing education in BF and lactation
Retrieve by attending more classes vas attending conferences
ALPP
Academy of Lactation Policy and Practice
Why mothers stop BF
Not enough milk
Latch-on difficulties
Breast pain/soreness
Work/school
Fastest drop off occurs when?
10 days after discharge
Why is BF so difficult that mothers need help
Unrealistic expectations
Lack of timely interventions
Misunderstanding about why mom stop BF
BF rates went up in the 1990’s because…
WIC program
Goals for 2000
75% initiation and 50% continuation to 6 mo.
Goals for 1990
75% initiation and 35% continuation to 6 mo.
What tissues in the breast contribute to milk making
- Milk making cells (glandular, lactocyte, or alveolar cells) with receptor sites
- Distal tissue
- Extensive vascular tissues: arteries, veins, capillar
- Lymphatic nodes
- 3rd, 4th, & 5th intercostal (thoracic) nerves
- Montgomery glands (tubercles)
Myoepithelial cells
Smooth muscle cell that forces milk through the duct and to the pores
Alveolar cells are Surrounded by myoepithelial cells. 3rd layer is capillary network
Outdated ideas of the internal structure of the Breast included…
Fat only behind mammary tissue
Ducts evenly spaced
9-27 nipple pores (opening at tip of nipple)
Making milk
Messages from the Breast travel through the nervous system to the brain. Hormones then travel to the breast through the blood stream
Modern ultrasound study of structure of breast
Fat mixed in throughout the Breast
Uneven spacing in ducts
5-9 nipple pores
No lactiferous sinus (milk would gather in duct-not true)
Montgomery glands (tubercles)
Unique blend of mammary and sebaceous glands. A waxy layer can start forming out of gland during pregnancy
Prolactin
- Makes milk
- Anterior pituitary
- Much more responsive in postpartum
- lengthening time between feeding=Lower baseline prolactin levels (weaning)
- levels go down in between nursing and rise shrine nursing
- infrequent nursing leads to lower levels and less rise
- non pregnant, non lactating women’s breasts and nipples respond to touch by triggering increases In prolactin secretion
Oxytocin
Posterior pituitary
De Carvalho’s Research
Frequent nursers: 10X per 24hours 138 min per day 14 min/nursing Wt. gain @ 15 days: 561 grams
Infrequent nursers: 7X per 24 hours 137 min per day 20 min/nursing Wt. gain @ 15 days: 347 grams
