LACTATION

Question 1

Bleeding and cracked nipples on a breastfeeding mother (not cause by mastitis) should raise your concern for what cause?

Answer 1

Position of breast feeding

Question 2

Mastitis is most often caused by what bacteria?

Answer 2

Staph from the baby’s mouth

Question 3

Gentian violet is used to treat what kind of breast infections?

Answer 3

Candidal

Question 4

A woman with a 2 month old infeant comes in. She exlcusively breast feeds. She has a fever of 100.2 F and her breast examination demonstrates a red, tender, wedge-shaped area on the outer quadrant of her left breast. What is the most likely dx?

Answer 4

Mastitis

Question 5

What hormones suppress lactation and which support lactation?

Answer 5

Progesterone and Estrogen SUPPRESS, Prolactin with progesterone WITHDRAWAL support lactation

Question 6

True or False: mastitis causes intense nipple pain that worsens with breastfeeding

Answer 6

False, thats candidiasis

Question 7

How do we treat candidiasis of the breast?

Answer 7

Topical antifungal like clotrimazole or miconazole. Check baby’s mouth for candida and treat them with nystatin

Question 8

Breastfeeding mom comes in with sore nipples and burning pain the breast. She is afrebrile and the pain worsens when feeding. The breasts appear normal minus the tops of the nipples which are pink with shiny and peeling noted in the periphery. What is the most likely cause of this patient’s presentation?

Answer 8

Candida

Question 9

What kind of BC is preferred for breastfeeding mothers?

Answer 9

Progesterone based methods like an IUD.

Question 10

What are signs that a baby is getting sufficient milk with breastfeeding?

Answer 10

-3-4 stools in 24 hours
-6 wet diapers in 3-4 hours
-weight gain and sounds of swallowing

Question 11

Prolactic is responsible for milk production, ____________ is responsible for milk ejection

Answer 11

Oxytocin