Lecture 4: Breastfeeding Flashcards

1
Q

describe breast development

A

takes 3-5 years, commencing at puberty

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2
Q

describe function and physiology of lactating breast

A

mammary tissue makes and transports milk.
- Alveoli, small sacs of milk-secreting cells
- Ducts, transport the milk to the outside via the
nipple
- Blood supply (nutrients), lymphatic system
(removes waste), nerves (sensitive, hormones)

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3
Q

physiology of breast milk production

A

Prolactin, stimulates the production of breast milk. The greater suckling the more prolactin released. Feeding is important for milk production in the first 6 weeks.

Oxytocin, stimulates muscle contraction and transports milk to help the baby get milk easily. This can be triggered by the mother hearing her baby cry or by touching, smelling or seeing her baby.

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4
Q

Position and attachment of breastfeeding

A

Poor attachment is often the cause of many problems experienced by mothers and is learnt behaviour.

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5
Q

Approximate milk intake for exclusively breastfed infant?

A

900-1000ml/24 hours

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6
Q

what is colostrum? (transition and mature)

A

a thick, yellow fluid produced in the first days after delivery. it is low in energy and fat, high in protein, minerals and fat-soluble vitamins. also has an immuno-protective role.

transition: clear and watery to more creamy

mature: about 2 weeks, lower protein than cow’s and other mammal milks. half of the energy in milk is derived from fat, reflects the weight status of the mother (conc.) and mothers diet (composition), more fat in the hind vs fore milk

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7
Q

how does a mother’s nutritional intake change during breastfeeding?

A

it is considerably greater than pregnancy. requirements include, energy, protein, carbohydrates and fats.

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8
Q

what vitamins/micronutrients are important for mothers nutritional intake for breastfeeding?

A

Vit A – unlikely to be a problem in Australia as widely available as retinol (animal foods) and
beta-carotene (plant foods), though can be low in developing nations (supplements)
* B vitamins – likely adequate in a varied diet, especially including fortified grains
* Vit D – content is low in breastmilk but appears adequate with incidental sunlight exposure;
women with dark pigmentation, who cover themselves or live at high latitudes may requires
supplementation
* Iodine – very sensitive to maternal iodine status and mild-moderate iodine deficiency in
pregnant women has been found in Australia; NHMRC recommends 150micorgrams/day
supplement

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9
Q

what are some common problems and strategies for breastfeeding?

A
  • sore or cracked nipples: check positioning and attachment
  • breast fullness and engorgement: express some milk prior to feeding
  • mastitis: painful breasts with flu-like symptoms
  • self-perceived milk insufficiency: uncommon though can occur due to severe illness, inadequate mammary tissue and stress.
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10
Q

what are some short term health benefits for infant/

A
  • Optimal source of nutrition for growth and development
  • Increased bonding with mother
  • Reduces infant mortality and provides protection against gastroenteritis, diarrhoea, respiratory tract
    infections, otitis media and sudden infant death syndrome
  • There is a dose-response relationship and protection extends beyond breastfeeding
  • Infections are a major cause of mortality and mobility especially in developing nations
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11
Q

what are some short-term health benefits for the mother?

A
  • Stimulates uterus contraction
  • Increased bonding with infant
  • May help return to pre-pregnancy weight
  • Cost and time saving
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12
Q

what are some long-term health benefits for infants?

A
  • Improved cognitive performance
  • Influences the development of the microbiome
  • Probable reduction in risk of overweight and obesity and cardiovascular disease risk factors, such as
    hypertension and high cholesterol
  • Reduced risk of type I and type II diabetes mellitus, coeliac disease, inflammatory bowel disease, allergy
    and asthma
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13
Q

what are some long-term health benefits of mother?

A
  • Contraceptive effect, and therefore may
    delay another pregnancy
  • Reduced risk of breast and ovarian cancer and type II diabetes mellitus (post gestational diabetes
    mellitus)
  • Reduced risk of postnatal depression
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14
Q

importance of breastfeeding for global health

A

can cause death, many cases of preventable death worldwide

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15
Q

long term health benefits of breastfeeding in society?

A
  • Estimated that premature weaning in Australia costs $60-$120 million/year for gastroenteritis, respiratory
    infection, necrotising entercolitis and eczema
  • Estimated in the UK, that even modest increases in breastfeeding rates will improve health and
    economic outcomes
  • Estimated in the USA, if 90% infants were exclusively breastfed until 6 months, this would prevent 911
    deaths/year and lead to a $13 billion/year savings
  • Globally, reduced intelligence and economic losses are approximated to be $302 billion/year (0.49% of
    the world gross national income)
  • Environmentally friendly product
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16
Q

what are the seven key indicators for breastfeeding in global health?

A
  1. Funding for breastfeeding programmes
  2. Access to breastfeeding support
  3. Systems to track performance of national policies
  4. Implementation of the marketing code for breastmilk substitutes
  5. Paid maternity leave
  6. Community support for breastfeeding
  7. Appropriate breastfeeding practices in maternity facilities
17
Q

what are some maternal conditions that prevent safe breastfeeding?

A
  • Consuming some chemotherapeutic and radioactive drugs
  • Severe illness
  • Active tuberculosis
  • Breast cancer treatment
  • Syphilis lesions on the breast
  • Herpes simplex virus type 1
  • Untreated brucellosis
  • HIV-positive mothers
  • Nicotine, alcohol and other drugs
18
Q

breastfeeding in priority populations (aboriginal and torres strait islander children)

A
  • breastfeeding rates for indigenous peoples is lower than non-indigenous population.
  • breastfeeding reduces risk of otitis media, which is prevalent in indigenous children
19
Q

how does workplace and employment affect breastfeeding mothers?

A

breastfeeding rates are lower among employed mothers and can be supported by maternity leave.

parental leave - eligible employees can get parental leave pay from either or both, Australian their employer

returning to work - workplaces with flexible hours, access to breaks, and supportive culture

20
Q

who are the priority populations?

A
  • Aboriginal and Torres Strait Islander Mothers
  • Culturally and Linguistically Diverse (includes migrants, refugees and asylum seekers)
  • Low socio economic background or low education level
  • Mothers of preterm infants
  • Young mothers (under 25 years of age)
  • Daily smoker
  • Mothers who are obese
  • Caesarean births, obstetric or childbirth complications
21
Q
A