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FN 2241 > Lecture 4 - Part II > Flashcards

Lecture 4 - Part II Flashcards

1
Q

What does the total milk volume vary with?

A

With infant age

Not with moms fluid intake

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2
Q

How much water should you drink while breast feeding?

A

3.8L/day

And while baby nurses

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3
Q

In hot temperatures what will baby do?

A

Adjust schedule in hot temps

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4
Q

How much milk is produced/day?

A

3/4L/day

-requires 400-650cals extra/day which is pulled from additional food and fat stores

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5
Q

What decreases milk production?

A

Severe energy restriction

-doesn’t impact composition

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6
Q

What is the additional EER cals for the first 6 months post partum and the second 6 moths?

A

First: 330kcals/day

Second: 400kcals

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7
Q

Does the amount of carbs fluctuate in milk?

A

Mother diets has no effect on carb content of milk

-70g lactose/L

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8
Q

What is the recommendations for carbs when breastfeeding?

A

210g/day RDA

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9
Q

Does the amount of protein fluctuate in milk?

A

Mother diets has no effect on protein content of milk

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10
Q

What are the protein recommendations during lactation?

A

71g/day

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11
Q

Does the amount of fat fluctuate in milk?

A

Moms diet hs an effect on breast milk fatty acid composition

  • increase PUFA and DHA content of milk from increase in diet of mom
  • NOT on total fat and cholesterol content
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12
Q

Does HMS contain cholesterol?

A

no

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13
Q

Does the amount of vitamins and minerals fluctuate in milk?

A

Generally nutrition inadequacies decrease in quantity not quality of milk

  • even if supplies are limited milk is adequate in carb protein fat and most minerals
  • quality maintained at the expense of maternal stores
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14
Q

Which vitamins if deficient in mom will be deficient in baby?

A

B6 and B12

-milk will be deficient in these

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15
Q

Which vitamins change in milk based on moms diet?

A

Vitamin ADK

-not all infant givent vitamin K shot

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16
Q

Do minerals in moms diet have an effect on milk?

A

Does not influence their concentration in milk

-mineral content on human milk is less than cows

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17
Q

IS supplementation recommended during lactation?

A

only recommended for specific nutrient/needs

-veg diets

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18
Q

Can you do physical activity while breast feeding?

A

Yes

-but compensation for cals is important

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19
Q

What are the benefits of physical activity during lactation?

A

Support healthy weight
Improve mental health post partum
Social Aspect/break from routine
Fresh air

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20
Q

Why might break feeding help with weight loss?

A

May help by facilitating mobilization of fat stores

-does not promote rapid easy weight loss

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21
Q

How much should you lose in the first 4-6months?

A

1-2lbs/month

DRI: 0.8kg/month for first 6 months

22
Q

When do you normally see sore nipples?

A

4-5days post birth, then should get better

-if not most people switch to bottles

23
Q

How do you alleviate pain during breast feeding?

A

Ensure proper positioning
Wash with warm water only
Let air dry
Proper pumping equipment

24
Q

What is engorgement and what is the cause?

A

Breasts overfill with milk

Cause: infrequent or ineffective removal of milk

25
Q

What is the solution to engorgement?

A

Warmth, pressure, express milk before feed until breast is not hard, BF often, pump less, anti inflammatory for let down, cold compress between feeds

26
Q

What are plugged milk ducts and what are the signs and solutions?

A

Milk remains in duct and causes bloackage

Painful knot in breast

Warmth, pressure, complete emptying, supplements for let down
-can lead to mastitis

27
Q

What is mastitis and what causes it?

A

Inflammation of the breast

Missing one or more feeds, tight bra, unresolved rengorgement or plugged duct

28
Q

What are the signs and solutions of mastitis?

A

Signs: simulate to plugged duct with addition of fever/flu-like symptoms

Solution: continue BF, empty at each feed, ibuprofen, rest, hydration, nutrition, antibiotics may be needed

29
Q

What are letdown issues?

A

Inadequate: stress, alcohol, distractions may inhibit oxytocin, which then decreases let down reflex

Hyperactive: milk sprays on its owne

30
Q

What is hyper lactation and what are the signs and symptoms?

A

Overproduction of milk
Signs: spitting up, green frothy stool, chronic plugged ducts, leaking between feed, poor infant wt gain

Soplutions: only one side per feed, express some milk before starting feed cold compress before feed

31
Q

What happens if mom has a cold when breast feeding?

A

Dont take meds, can dry up milk supply

Hydrate well

32
Q

Can communicable disease appear in breastmilk?

A

Communicable disease

HIV/AIDS can be transmitted but low risk

33
Q

What is post partum amenorrhea?

A

Lactational an ovulation (prolactin)

  • favours birth spacing
  • can take up to 1yr to replenish moms nutrient reserves

Its not always protective
Length depends on exclusive breastfeeding or not
Uterus returns to normal size in 6wks.

34
Q

What is weaning?

A

Parent or baby led weaning

End of lactation

35
Q

How can you end lactation?

A

Without suckling stimulation
Inhection of estrogen
Bromocriptine (Med)
Large dose of B6

36
Q

What are the issues with premies breastfeeding?

A

Heart/breathing instability
Poor temp control
Fewer glycogen and fat stores=increase risk for hypoglycaemia
Immature immune system
Immature suck/swallow coordination
Tire easily, hard to get a full feed every time

37
Q

Whats it like breastfeeding babies born before 34wks?

A

Tube fed for at least a while
Can be given fortified pumped breast milk
Soother to help learn suck/swallow

38
Q

What is it like breastfeeding babies born 34-37wks?

A 
3/4 of all singleton preterm births 
Shout not be treated as Tull term
Insufficient milk intake
Jaundice
Hypoglycemia
Poor wt gain
39
Q

What are the preterm infant breastfeeding goals?

A
  1. Build and maintain milk supply
    - feed and pump after
  2. Feed infant adequately
    - Wake infant 2-4 hours
    - weight infant pre and post feeding
    - appropriate d/c planning
40
Q

What are the benefit of breastmilk for premies?

A

Easier to digest and absorb than formula
Better Brian and eye development
Reduced risk of infectious disease

41
Q

What are the drawbacks of of breastmilk for premies?

A

May gains wt/length slower

May have poorer bone mineralizationi

42
Q

What is the key to breastfeeding multiples?

A

Frequent feeds and or pumps (supply and demand)
Time management
Feed both at once if possible

43
Q

What are the possible road blocks with breastfeeding multiples?

A

Prematurity
Lack of sleep or adequate nutrition/hydration
Stress
Lack fo education

44
Q

Can babies have short-term allergies/intolerances while breastfeeding?

A

Some foods in moms diet may cause colic or irritability
Record keeping to help determine which foods causing discomfort
Reaction is 4-24hr post ingestion
Will see relief after 5-7 days without food in diet

45
Q

What influences longterm allergies and intolerances while breastfeeding?

A 
Genetics
Duration of breastfeeding
Introduction of foods 
Smoking during pregnancy
Air pollution
Exposure to infectious disease
Maternal diet
Maternal immunity
46
Q

What is jaundice?

A

Too much bilirubin in the blood
Affect 80% premies, 40% FT
Can lead to permanent neurological damage if not addressed and corrected

2 types: breastfeeding and non breastfeeding jaundice

47
Q

What practices are incompatible with breastfeeding?

A 
Smoking
Alcohol
Medicinal Drugs
Illicit drugs
Environmental contaminants
Excess caffeine
Herbal remedies
48
Q

What does successful lactation require?

A

Proper latching of baby on breast
Adequate nutrition and rest
Help and support: certified lactation consultant

49
Q

What are the factors that need to be considered for the care of lactating women?

A 
giving birth is exhausting
-type of birth
-meds used
First kids
Nursing on. request
If mom has priorities to feed and care for herself
50
Q

What is milk baking?

A

Breastmilk is good for infants even if not from its mom
-can pasteurize donor milk

Some women produce more than needed and can store for later

51
Q

What are Canadas recommendations for alternate breastmilk?

A

Cow milk based, Fe fortified formulas until 9-12 months

Pasturized wholesaled cow milk at 9months

52
Q

What are considerations that we need to be aware of when using infant formulas?

A

Safety and sanitary conditions:

  • Reliable/pure water supply
  • Boiling water
  • Clean and sterilize bottles and nipples
  • Prepare according to instructions

FN 2241 (12 decks)

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