Facilitating Initiation of Lactation Flashcards

1
Q

What does the WHO recommend for skin to skin after birth?

A

Uninterrupted skin-to-skin from the moment of birth until after the first feeding. Initiation of breastfeeding is often the result of direct skin to skin contact.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How long will it take for a healthy term infant to self-latch if placed skin to skin at delivery

A

They will self latch within the first hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Some examples of interventions that should be delayed, minimized or eliminated in the first hour of life

A
  • suctioning
  • routine procedures (weight, measurements, eye prophylaxis, vitamin K
  • bathing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Nine behavioural phases an infant will progress through when allowed uninterrupted skin-to-skin in the first hour

A

Crying, relaxing, awakening, being active, crawling, resting, familiarizing, suckling, sleeping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is an infant safety concern to be aware of during continuous skin-to-skin?

A

Sudden Unexpected Postnatal Collapse (SUPC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List some elements of fostering an environment that supports the establishment of breastfeeding

A
  1. The dyad should remain together as much as possible
  2. routine infant assessments should take place in the infant’s room
  3. healthcare providers should be aware of the impact of interrupting nursing
  4. provide for the parents emotional and physical comfort
  5. cluster care to minimize intrusion in the family space
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Four indicators of an effective latch

A
  • Upper and lower lips are flanged outward
  • tongue is cupped under the breast and is visible above the lower gum ridge
  • wide gliding jaw movements
  • no nipple pain or trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Signs of an ineffective latch:

A
  • tight, pursed lips
  • lower lip pulled in
  • dimpling of the cheeks
  • nipple pain
  • flattened or misshapen nipples
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Is clicking or smacking always a sign of a poor latch?

A

Not necessarily. A baby with a good latch can learn to release suction with an overactive let down, for example. Take whole picture into context.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

One suck per second typical of ______ sucking

A

nutritive sucking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Rate of sucking in nonnutritive sucking

A

about 2 sucks per second with minimal or no swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Crying is a _____ indicator of hunger

A

Late

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Minimum number of feeds in 24 hours

A

8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Elimination patterns that might indicate potential feeding problems

A
  • Not passing transitional stool by day 4
  • having fewer than 6 voids per day by day 4
  • appearance of urate crystals after day 3
  • fewer than 4 daily stools by day 4
  • continuation of meconium stool by day 5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Steps to evaluate a feeding (every 8-12 hours in the first days PP

A
  • assess for effective latch and position (correct as needed)
  • improve the latch if any nipple pain, even if infant appears to be swallowing and satisfied
  • assess for milk transfer (sustained rhythmic suck-swallow-breathe + swallowing
  • evaluate end of feeding (nipple rounded, parent relaxed, infant relaxed and satiated)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Some reasons for failure to latch and feed

A
  • drowsy as a result of labour medications
  • mechanical or physical results of labour and delivery
  • separation of dyad
  • prematurity
  • infant illness or congenital anomolies
  • parental physical or psychological issues
  • challenging anatomy
17
Q

If the infant is unable to feed effectively after first 24 hours, what needs to be done?

A

Protect the milk supply, feed the baby

18
Q

Teach hand expression within ______ hour(s) of birth

A

one

19
Q

Healthy infant’s average intake of colostrum

A

first 24 hours: 2-10ml
24-48 hours: 5-15 ml
48-72 hours: 15-30ml
72-96 hours: 30-60ml