Feeding Flashcards
In terms of lactation what does oestrogen promote the growth of?
The ductile system
In terms of lactation what does progesterone promote the growth of?
Development of lobule-alveolar system
What is producing and releasing milk initiated by?
Placental expulsion and the sudden decrease in oestrogen/progesterone at birth (hormonal response with continuous positive feedback)
How does oestrogen/progesterone circulating in the blood inhibit milk secretion?
By blocking the release of prolactin from pituitary
Making the mammary gland unresponsive to this pituitary hormone
The ejaculatory process is initiated by which hormone?
Oxytocin
What does colostrum look like?
Low volume (few mm at each feed)
no fat
rich in immunoglobulin
TRUE/FALSE
Colostrum has a laxative effect which helps the baby pass meconium and prevent jaundice
TRUE
TRUE/FALSE
Mature milk has the same overall daily intake of immune proteins as in colostrum
TRUE
What does mature breastmilk look like?
Slightly blush, translucent with a thin cream layer on standing as it contains a little caesin
Why do newborn babies need very little milk during the first 48-72h post birth?
Their immature kidneys are adjusting from secreting large amounts of fluid as blood volume reduces by 25%
Milk volume in the breast increase after 20-48h. After which day do breasts feel full and tight?
day 3
TRUE/FALSE
Placental products retained in utero will not effect the process of milk coming in
False- they will delay the process
TRUE/FALSE
The highest fat content of the feed is right at the very beginning
FALSE
As the breast drains, fat is expressed into the ducts and the calorie content increases
What does the sucking stimulus release?
Oxytocin
What reflex is the release of milk often referred to as?
The let-down reflex
In the are of the breast not being drained ———– and signal to breast tissue to stop milk production
Lactation inhibitory factors
How long is exclusive breast-feeding recommended for?
First 6 months
At what age are solid foods introduced?
6 months
TRUE/FALSE
IF a breast-fed infant loses up to 10% of their birth weight in the first few days this shows that there is an inadequate feeding technique
FALSE
this is completely normal
ALL babies should be given vitamin D supplements regardless of feeding method and their mothers intake TRUE/FALSE
8.5-10 micrograms for breastfed babies
NONE for infant-fed babies
Healthy start vitamin drops can be given from which age?
6 months
How can risk of HIV transmission be reduced?
ART for mother and infant
Birth by c-section
avoidance of breastfeeding
Benefits of breastfeeding?
Mum
-lowers risk of breast and ovarian cancers
-lose wt faster (500kcals a day)
bonding
Baby
- IgA immunity
- Long-term outcomes (obesity, diabetes)
How long can breast milk be stored?
<5 days in fridge
<2wks in freezer compartment of fridge
<6months in freezer
What are 4 potential problems for the mother if attachment is poor?
Painful nipples
engorgement
low milk supply
mastitis
TRUE/FALSE
If attachment is effective then the chin should be indenting the breast and the baby needs a wide gaping mouth
TRUE
If areola is visible when feeding there should be more above the top lip than the bottom lip TRUE/FALSE
TRUE
What is engorgement?
Painful swelling of the breasts
What is mastitis?
Red inflamed breasts
If pain relief is needed for sore breasts then Paracetamol/aspirin/ibuprofen can be used TRUE/FALSE
FALSE
Aspirin implicated in Reyes syndrome
If symptoms of painful breasts continue after 12h despite expressing milk and appropriate pain relief then treat with suitable antibiotics prescribed. What would this be?
Fluclox ( of clindamycin if pen allergic)
If a breast abscess develops they are a goner, don’t bother treating them TRUE/FALSE
TRUE
alternatively you could aspirate and surgically drain
TRUE/FALSE
Overall breast size determines the amount fo milk produced
FALSE
What are positive signs that the baby is getting sufficient milk?
Wt
6+ wet and 3+ dirty nappies in 24h
Use topical medication to treat painful nipples in the absence of nipple infection TRUE/FALSE
FALSE ya crazy kid
Infant formaula is suitable for infants up to 12m. However there is a big advantage of changing to follow on formula from 6 months TRUE/FALSE
FALSE
it is suitable up to12m but here is no advantage of changing to follow-on milk
How does wt gain look different in formula fed children?
Lose less wt in first few days following birth
Gain wt more quickly around 4-6 months
(increased risk of cardiovascular disease in the future)
The cows protein in formula milk can increase the risk of juvenile onset diabetes TRUE/FALSE
TRUE
What are the benefits of the whey protein that is found in breastmilk?
Easier to digest
Bacteriocidal effect
What does lactoferrin do?
Allows iron to be absorbed
What is used to investigate cow’s milk protein allergy in infants under 6 months of age?
A trial of hydrolysed infant formula
What is the whey:caesin ratio of whey dominant formulas?
60:40
Microwave ovens without a specialised steamer and dishwashers are ideal to use to sterilise bottles etc TRUE/FALSE
BIIIG LIE
Not ideal
Cannot guarantee that they reach high enough temperatures
What are the two forms that formula can come in?
Dried powder
Ready to feed liquid
TRUE/FALSE
Infants are more likely to become constipated on formula milks than breast milk
TRUE (ESP IF MADE UP INCORRECTLY)
What are 3 clues that the baby may use to indicate that they are hungry?
Mouthing
Rooting
Fussing
What angle should the bottle be at to feed the child?
Keep the bottle tilted and sit the baby upright so that milk doe snot pool at the back of his mouth
Why do younger infants not need to feed as often as older infants?
They have smaller stomachs
What is the average milk intake from 4 days- 6 months?
150ml/kg body wt in a 24h period
In hot weather why might formula fed infants become thirsty?
The solute load of formula is greater than that of breast milk
In hot weather plain, cooled boiled water can be given to babies if they are thirsty TRUE/FALSE
FALSE
can be given to infant fed babies
not to breast milk ( the composition changes as needs be)
Storing infant formula
Constantly below 5 degrees
use within 24h (if leftover from feed discarded after 2h)
use a cool box with ice bricks if need to carry prepared feeds
Why should a microwave not be used to warm refrigerated feeds?
Ongoing heating- will continue to heat after removal from the microwave
“Hot spots”
