lactation and infant feeding Flashcards
What does breastfeeding do?
Increases physical and emotional well-being
Breastfeeding benefits to baby
Immune-system development
Establishment of gut health
Decreased hospitalization and communicable diseases
Decreased resp and gi allergies, obesity, DM, HTN, and crohn’s disease
breastfeeding benefits to mom
Amenorrhea
Temporary contraception
Decreased risk of ovarian CA, osteoporosis, decreased blood loss postpartum, weight loss, decreased risk of postpartum breast cancer
How to deal with latch problems
Important for mom’s comfort
Lips should be flanged
Ear, shoulder and hip aligned. head tilted back
Aim nipple toward baby’s upper lip and nose
barriers to breastfeeding
lack of knowledge lactation problems poor family and social support health services embarrassment employment and child care social norms
How to deal with Cracked and sore nipples usually caused by improper latch.
Check baby for tongue tie or thrush.
Start on less tender side
Massage breast during breast feeding
Cotton bras, nsaids, lanolin, no excessive washing
How to deal with Low milk production… what causes it?
Lactogenesis
Low prolactin, inadequate mammary gland tissue all result in low milk production
Is mom supplementing with formula? Pacifier use?
Herbs and medications that increase your milk supply
Galactagogues
ex. oatmeal
how to deal with Obstructed lactiferous duct (clogged duct)
Wear loose-fitting bras, increase fluids, increase feedings with infant. Heat and massage before and during nursing to facilitate flow of milk through ducts. Cold compress after feeding
Pain, engorgement of breat
If systemic sx treat (mastitis)
Obstructed lactiferous duct (clogged duct)
As endocrine and digestive systems mature, bili levels decrease
Often caused by infrequent feeding and low milk intake
Often 3-5 days of life
Physiologic Neonatal Jaundice
Risk factors, appearance and tx of physiologic neonatal jaundice
Risk factors: Blood group incompatibility, <37 wks, excessive weight gain, east Asian and Native American, gestation diabetes
Appears on face and moves down body.
Treat with frequent breastfeeding or formula supplementation as needed
1-2 days after breastfeeding is established and baby has appropriate weight gain
Bili level usu decrease by 8-12 weeks
Usually no need to intervene
Neonatal jaundice
How many times per day will newborns typically feed?
8-12
Must be addressed!
Appears within 24 hrs of birth
Rapidly rising bili, increase in bili by 5mg per day
Total bili >17mg/dL in full term baby
Pathologic Jaundice
what to do if a baby has Pathologic Jaundice?
Address immediately.
Evaluate for bili obstruction and hepatitis
Goal: Prevent chronic bili encephalopathy (bili levels high enough to cross BBB and damage basal ganglia and brainstem) or Kernicterus
Tx with phototherapy
When does the WHo recommend introducing solid foods for babies?
Introduction of solids at 6 months and continued breastfeeding for up to 2 years
% birthweight may be lost in first week of life
8-10%
Supplementation initiated if more than 10% birthweight lost in first week
what should Infant Formulas be fortified with during 1st year of life
fortified with iron needed for first year of life
Caloric density
Carb source
Protein composition
No cows milk, goats milk, soy drinks, and low iron infant formula should not be used in first year of life
how much formula needed per lb of body weight?
2.5 oz of formula for every lb of body weight (per day)
How much does 1 month old baby eat (oz) per feeding… how many feedings in 24 hrs.
2-4 oz
6-8 x
How much does 2 month old baby eat (oz) per feeding… how many feedings in 24 hrs.
5-6 oz
5-6 x
How much does 3-5 month old baby eat (oz) per feeding… how many feedings in 24 hrs.
6-7 oz
5-6 x
Complaints with formula feeding
Spitting up vs GERD vs pyloric stenosis
gas/constipation
Diarrhea
Crying for fussing after feeding
introduce one new food then wait ______ days before next new food
3-5 days
infant with abd pain, bloody diarrhea. Not able to metabolize breast milk. Very rare
Galactosemia
how often to assess for IPV during pregnancy?
every trimester
