Lactation Flashcards
What are the WHO guideline for breastfeeding?
Exclusive for around 6 months and up to 2 years and beyond
What is the full duration of breastfeeding per child?
Between 4 and 7 years
What are the antiviral functions of human milk?
- Monolaurin
- Vit A
- Extracellular vesicles
- Lactoferrin
- Bacteriophages
- Cytokines
- Tenascin C
- Lysozyme
- Lewis X
- Lactadherin
- Mucins
- Oligosacchardies
- Gylcosaminoglycans
- Oxysterols
- Gangliosides
- sIgA
What does variance in the infant gut microbiome depend on?
Almost solely on breast milk for the first 14 months
How does breastfeeding aid maternal health?
- Breastfeeding reduces risk of breast cancer
•20% reduction in triple-negative breast cancers - High risk genetic mutations (e.g., BRCA1)
•1 yr breastfeeding to risk reduction 35-40%
•2 yr breastfeeding to risk reduction 55-60% - Reduced risk ovarian and endometrial cancer
- Reduced risk of postnatal depression
What is the process for lactation?
- Sucking stimulus
- Spinal cord
- Supraoptic and paraventricular nuclei
- Posterior lobe of pituitary
- Oxyctocin
- Milk Let down
What are normal breastfeeding patterns?
- Typically feed at least 8 – 12 times per 24 hours
- Four month growth spurt
- Cluster feeds
- Differing content
What is normal newborn sleep?
- 50% “active sleep” ≈ REM
1. Active sleep (~30m) to quiet sleep (~50m) to active sleep
What can arousal in active sleep be caused by?
- Hunger
- Cold
- Discomfort
- Startle reflex
- Unfamiliar conditions: It is normal that newborns “won’t be put down”
At birth is there a circadian rhythm?
NO clear
What factors can decrease supply of breast milk?
- Supplementing with formula milk
- Using a dummy in the early weeks
- Separating mother and baby
- Trying to follow a routine
- Sleep training
What is responsive feeding associated with?
- High prolactin levels
- Longer duration of breastfeeding
- Fewer breastfeeding difficulties
- Increased milk supply
- Lower risk of overweight
- Later satiety responsiveness
What is responsive feeding?
- Concept of demand and supply
- Rapid increase in prolactin & oxytocin after placenta removed
- Removal of milk from breast triggers prolactin
- Feeding whenever baby signals to be fed
- Typically very frequently
- Night feeding
Is feeding at night common?
- Normal to feed at night – and in many cultures feed more often as get older
- Infants who co-sleep feed more frequently
- Formula fed infants sleep more in early days but not as they get older
How effective is exclusive donor milk?
Service evaluation of first 2 years:
•>75 families supported with donor milk
•Normal growth and development
•Positive impact on maternal mental health
•Positive impact on maternal breastfeeding