Hand Expression Flashcards
using the model identify the structures and their functions
Adobos and fatty structure that make the shape of the breast
Nipple- erectile tissue
Areola- darker circle, raise dots onto of this are Montgomery tubercles ( release sebum to keep nipple lubricated)
Alveoli- contain milk producing hormones (lacto cites)
Myoepithelial cells surround the alveoli contract to expel the milk
Milk travels to the lactiferous ducts which propels te milk to the ducts for the baby
Name the hormone that stimulates milk production and identify its source and target cell
Explain the physiological process which stimulates the initiation of milk production
3 examples of how effective milk production can be achieved
Prolactin-released from the anterior pituitary gland these levels rise immediately after the delivery of the placenta
Acts of the lactiferous ducts to stimulate milk production
This is in correlation with the drop of oestrogen and progesterone
Three example- Early feeding right as baby is born, good positioning and attachment, effecting emptying of the breast
Identify the hormone responsible for the let down reflex- where is it released from
Name the cells the hormone acts in and the effect it has on them
explain the factors that will help or hinder the release
Oxytocin (feel good hormone)- released from the posterior pituitary
This hormone caused a release of milk through the milk ducts
Factors that help- Being close to baby, hearing, smelling and touching baby and having things around you that make you feel calm happy an comfortable
Factors that hinder- Stress, anxiety, lack of sleep, being away from baby (NICU)
Name the whey protein involved in the autocrine production and maintenance of breastmilk- explain how it works
Feedback inhibitor of lactation- increases as milk builds up in breast
This protein excerpts a negative feedback mechanism- stops further supply of breastmilk
Important to empty the breast fully to increase supply
How soon should a woman be taught hand expression - identify 4 reasons why she will need to be able to do hand expression
Should tried to be taught antenatally bu also should be shown to woman 6-24 hours after having baby
Woman may not be with the baby after delivery- eg baby in the nicu
Woman might be leaving the house and want a prepared feed before leaving
Further down the line when mums going back to work
Boobs may feel. engorged, mastitis, full and need emptying
Helps to keep milk supply up
How can Abeje be helped to prepare for hand expression
Relaxed, comfortable,private
Feel educated- having guidance and understanding when and how often this should be done
Midwife should show a hands off approach so you feel able at home
Have all equipment with and next t you (syringe, cup) to collect mil so no need to move when getting the supply and being comfortable
How many times a day would you advice she hand expresses if unable to feed from breast and why
8-10 times a day
Ideally one at night as prolactin is high and ill help with milk supply and stop FILL stopping the milk
Allows effective emptying
Explain to Abeje how to stimulate the oxytocin reflex
Try be relaxing and have baby near by or have something that relates to the baby near
Describe breast massage techniques
Breast massaging- fluttering ( feather tough around breast) Rolling (circular movement towards the nipple) Fingertip ( fingers moving towards nipple)
Choose what feels more comfortable- always massage towards nipple not away
Stimulate entire breast
Nipple stimulating
Using a visual aid explain how Abeje should hand express milk
To start hand expression-
First wash hands- 7 steps of hand washing and 5 moments of hand hygiene
Second- massage the way you feel most comfortable
Third- using your thumb and finger in a c shape, cup you hand round the breast about 2-3cm or when you feel a change of texture from the areola
Fourth- gently squeeze ( Compress and release) in one spot until milk begins to flow
At first when having a baby it may only be. small amount of colostrum however as milk comes in it will build up
Fifth- Moving round the breast empty the milk ducts the whole way round
Six- Start the process on the other side
If sore or tenderness stop- Woman should not be dragging bad best to reassert positioning to start again
What advice would you give for storage of milk-
at room temperature- 6-8 hours
in a fridge- 3 days ( back of fridge)
freezer - 3-6months ( depends on temperature)
What advice should be given to Abeje regarding defrosting stored breastmilk
- take it out freezer and put into fridge to de frost
- just leave it in room temperature to defrost in a bow of hot water
Never microwave breastmilk to defrost as it may patch defrost and leave an uneven temperature throughout
