Infant Feeding Flashcards
Ingredients only in breastmilk
Growth factors
Stem cells (repair)
Lactoferrin (iron absorption)
Oilgosaccharides (prevent bacteria sticking to gut wall)
White cells - lymphocytes and leukocytes
Bifidus factor (acidic, discourage bacterial growth)
Antibody IgA
Milk lipids
Enzymes
What is first milk called
Colostrum
Purpose of colostrum
Prime baby’s immune system and has laxative effect to aid pass of meconium
How many stages of lactogenesis
3
Stage 1 lactogenesis
What and when?
Pregnancy
Epithelial cells to lactocytes from prolactin
Breast growth - tender
Hormones - oestrogen, progesterone, human placental lactogen
When colostrum produced
From 16 weeks
Other pregnancy changes (3)
Areola and nipple darken
Montgomery tubercles secrete antiseptic sebum (lubricate and scent)
Blood supply increase (shinier and veins)
When lactogenesis 2
At birth
Onset milk production 32-92 hr
What happens for lactogenesis 2 to happen?
Drop in oestrogen and progesterone due to birth of placenta triggers milk production
Prolactin and oxytocin rise in response skin to skin, smell, sight touch
What stimulates prolactin
Sucking
What causes let down/milk ejection
Oxytocin
When does prolactin peak? (2)
45 min after start of feed (so enough milk for next)
At night
Oxytocin reflex
See, hear, smell, touch
Other oxytocin effect
Uterine contractions to return uterus to ‘before’
What can inhibit oxytocin production
Cortisol and adrenaline
Lactogenesis 3
Long term milk production
Feedback inhibitor of lactation (FIL)
What is FIL produced by?
How does it work?
Produced by breast alveoli
If milk not removed, FIL builds up and signals lactocytes to stop producing milk
Regulates supply and demands and helps when comes to time of weaning
Significance of prolactin receptors
If all busy, alveoli open more receptors, so more ability to produce more milk as ‘switched on’
Off to a good start ‘factors’ (5)
First golden hour
Skin to skin
Early frequent and effective feeds
Responsive feeding
Avoid unnecessary supplements
Benefits of skin to skin
Stimulates birth of placenta
Reduces post partum bleeding - contraction of uterus
Increase milk ejection reflex - oxytocin release
Lower stress levels
Initiates bonding
Keeps baby warm
Regulates heart rate and breathing
Encourages feeding behaviours
Biome
Familiar with scent - find nipple for feeding
Responsive feeding (4)
In response to feeding cues
In need of comfort (mother baby)
Convenience
When breasts full
Position for breastfeeding
C held CLose to mother
H able to tilt Head back
I head and body in straight line
N nose to nipple
Good attachment (4)
Wide open mouth
Chin leads
Bottom lip touches breast well away from base nipple
Nipple towards rear of roof of baby mouth
Signs of effective attachment
Pain free
Mouth wide open
Chin indents breast and nose away
Cheeks full and round
If areola visible more above top lip
Baby content and stays on breast
Effective milk transfer
Short rapid sucks to
Active feeding - long, slow, rhythmic suck and swallow with pauses
Flutter sucking with occasional swallows
What indicates poor milk transfer
Suck ratio more than 2:1
Signs effective feeding
Wet nappies/ dirty nappies/active alert no jaundice/no bottles/dummy/8-10 feeds 5-30 min/nipple shape same or slightly elongated/all signs effective attachment
Why hand expression?
Colostrum for sleepy baby
Soften full breast with baby struggling to attach
Clear blocked duct
In case of separation from baby
Responsive bottle feeding
Cues
Close and eye contact
Limit number of people
Pace feed- baby control milk flow
Do not force to finish
How to pace bottle feed
Semi-upright
Place teat gently
Bottle horizontal or slightly tipped to cover end with milk
Follow cues
Safe formula prep
Clean hot soapy water
Sterilise
Boil tap water
Cool
Add powder at 70
Do not overfill
Check temp
Cool under tap
Bin leftovers
Make feed as needed
9 instinctive phases in first hour
Cry
Relaxation
Level of activity
Larger movement
Rest times
Crawling
Lick/taste/touch (can last 20 min)
Self attach initiate feed
Sleep
Getting breastfeeding off to best start (6)
Talk through any concerns
Skin to skin
Feeding cues
Position
Feeding regularly- FIL
Attachment- CHIN
Why is separation detrimental to breastfeeding
Miss of cues
FIL
No stimulation for milk production/ prolactin
No skin to skin - oxytocin release/ milk ejection reflex
How to help expressing colostrum/milk
In front of baby
Photo of baby
Scent of baby
Oxytocin releasing conditions
How to express
Encourage milk flow massage and nipple to stimulate hormones to release milk
C shape of thumb and finger 2-3 cm from nipple
Gentle press and release until milk flows
Move round breast as required
When no more move to other breast
Breastfeeding benefits for mothers
Decrease postpartum depression
Reduction ovarian and breast cancers
Benefits for babies
Decrease obesity
Reduction SIDS
Everything they need,
What’s in it
