Infant Feeding Flashcards

1
Q

Ingredients only in breastmilk

A

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

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2
Q

What is first milk called

A

Colostrum

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3
Q

Purpose of colostrum

A

Prime baby’s immune system and has laxative effect to aid pass of meconium

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4
Q

How many stages of lactogenesis

A

3

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5
Q

Stage 1 lactogenesis
What and when?

A

Pregnancy
Epithelial cells to lactocytes from prolactin
Breast growth - tender
Hormones - oestrogen, progesterone, human placental lactogen

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6
Q

When colostrum produced

A

From 16 weeks

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7
Q

Other pregnancy changes (3)

A

Areola and nipple darken
Montgomery tubercles secrete antiseptic sebum (lubricate and scent)
Blood supply increase (shinier and veins)

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8
Q

When lactogenesis 2

A

At birth
Onset milk production 32-92 hr

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9
Q

What happens for lactogenesis 2 to happen?

A

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

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10
Q

What stimulates prolactin

A

Sucking

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11
Q

What causes let down/milk ejection

A

Oxytocin

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12
Q

When does prolactin peak? (2)

A

45 min after start of feed (so enough milk for next)
At night

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13
Q

Oxytocin reflex

A

See, hear, smell, touch

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14
Q

Other oxytocin effect

A

Uterine contractions to return uterus to ‘before’

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15
Q

What can inhibit oxytocin production

A

Cortisol and adrenaline

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16
Q

Lactogenesis 3

A

Long term milk production
Feedback inhibitor of lactation (FIL)

17
Q

What is FIL produced by?
How does it work?

A

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

18
Q

Significance of prolactin receptors

A

If all busy, alveoli open more receptors, so more ability to produce more milk as ‘switched on’

19
Q

Off to a good start ‘factors’ (5)

A

First golden hour
Skin to skin
Early frequent and effective feeds
Responsive feeding
Avoid unnecessary supplements

20
Q

Benefits of skin to skin

A

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

21
Q

Responsive feeding (4)

A

In response to feeding cues
In need of comfort (mother baby)
Convenience
When breasts full

22
Q

Position for breastfeeding

A

C held CLose to mother
H able to tilt Head back
I head and body in straight line
N nose to nipple

23
Q

Good attachment (4)

A

Wide open mouth
Chin leads
Bottom lip touches breast well away from base nipple
Nipple towards rear of roof of baby mouth

24
Q

Signs of effective attachment

A

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

25
Q

Effective milk transfer

A

Short rapid sucks to
Active feeding - long, slow, rhythmic suck and swallow with pauses
Flutter sucking with occasional swallows

26
Q

What indicates poor milk transfer

A

Suck ratio more than 2:1

27
Q

Signs effective feeding

A

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

28
Q

Why hand expression?

A

Colostrum for sleepy baby
Soften full breast with baby struggling to attach
Clear blocked duct
In case of separation from baby

29
Q

Responsive bottle feeding

A

Cues
Close and eye contact
Limit number of people
Pace feed- baby control milk flow
Do not force to finish

30
Q

How to pace bottle feed

A

Semi-upright
Place teat gently
Bottle horizontal or slightly tipped to cover end with milk
Follow cues

31
Q

Safe formula prep

A

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

32
Q

9 instinctive phases in first hour

A

Cry
Relaxation
Level of activity
Larger movement
Rest times
Crawling
Lick/taste/touch (can last 20 min)
Self attach initiate feed
Sleep

33
Q

Getting breastfeeding off to best start (6)

A

Talk through any concerns
Skin to skin
Feeding cues
Position
Feeding regularly- FIL
Attachment- CHIN

34
Q

Why is separation detrimental to breastfeeding

A

Miss of cues
FIL
No stimulation for milk production/ prolactin
No skin to skin - oxytocin release/ milk ejection reflex

35
Q

How to help expressing colostrum/milk

A

In front of baby
Photo of baby
Scent of baby
Oxytocin releasing conditions

36
Q

How to express

A

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

37
Q

Breastfeeding benefits for mothers

A

Decrease postpartum depression
Reduction ovarian and breast cancers

38
Q

Benefits for babies

A

Decrease obesity
Reduction SIDS
Everything they need,
What’s in it