Lactation Flashcards
What causes bleeding cracked nipples during breastfeeding?
Poor positioning, resulting in poor latch
What is Gentian violet used for?
Candidal infection of breast
How does candida of breast present? How to treat?
Severe discomfort and pain
Treat with clotrimazole or miconazole cream
Topical antibiotics/muciprocin may be indicated for concurrent nipple fissures
Topic steroids to decrease inflammation
What is treatment for baby if mother has candida of breast?
Oral nystatin, followed by oral fluconazole
What hospital policies best promote breastfeeding?
Baby on breast within 30 min of delivery; rooming-in for baby (i.e. unlimited access)
Pacifiers and bottle feeding may cause nipple confusion and delay breastfeeding establishment
Which hormones must come down to allow for breast milk production?
Estrogen and progesterone
Progesterone inhibits production of alpha-lactalbumin by rough ER
Alpha-lactalbumin stimulates lactose synthase
What are signs of sufficient milk to baby?
3-4 stools in 24h
6 wet diapers in 24h
Weight gain
Sounds of swallowing
What hormones are involved in breast milk activities?
Prolactin - milk production
Oxytocin - milk ejection (production stimulated by suckling)
Cortisol and insulin - act in concert with other hormones to stimulate growth and development of milk-secreting apparatus
What is first-line for pregnant and lactating patients who have breast mass?
Ultrasound; mammogram is not as sensitive or specific during lactation
What tests are indicated after ruling out pathologic cause and pregnancy?
Prolactin and TSH (Hypothyroidism can cause galactorrhea)
Subareolar breast mass with multicolored, blue, or green-brown discharge
Mammary duct ectasia
Localized plugged duct vs galactocele
Plugged duct is painful, tender lump - due to stasis
Galactocele is soft, cystic, nontender, subareolar mass - due to duct obstruction
