Lecture 8: Maternal Energy Needs (Lactation) Flashcards
BMR of lactating vs non-lactating women
Very similar - Energy cost of lactation is from the energy content of milk plus energy required to produce it
What are the estimated energy requirements of lactation from 0-6 months?
2000 kJ/d above NPNL
What is the mean milk volume per day?
780mL/day
What is the energy density of BM?
2.8kJ/g
What is the milk synthesis efficiency conversion (conversion of maternal dietary energy to milk energy)?
Conversion of 80%
What are the estimated energy requirements adjusted for?
Weight loss post-partum; to account for energy mobilisation from adipose tissue stores
What is the estimated energy requirements of lactation over 6 months postpartum?
1680 kJ above NPNL
Why do energy requirements decrease after 6 months?
- Reduced milk production
- Reduced maternal weight loss
What is the average weight loss per month during 0-6 months for the mother?
0.8kg/month
When is the most rapid weight loss postpartum seen?
Between 3 and 6 months
Why is it recommended not to use bottles initially when breastfeeding?
It is faster out of a bottle therefore the babies need to learn to take it from the breast before moving to bottles
What is exclusive breastfeeding defined as?
No other food or drink, not even water, except breast milk (including milk expressed or from a wet nurse) for 6 months of life
What are the only things infants are allowed when exclusively breastfed?
ORS, Drops and Syrups (vitamins, minerals and medicines)
What percent of babies are breastfed within 1 hour of birth globally?
47%
How many babies are given fluids other than breastmilk in the first 3 days?
1 in 3
What is partial breastfeeding?
Baby receives some BM and some infant formula or other solid food
What are the benefits of BF for the BABY?
- Reduced infant morbidity and mortality
- Reduced chronic disease
- Increased cognitive function
What forms of infant morbidity and mortality does BF reduce?
- GI infections
- Respiratory illnesses
- Otitis media infections
- SUDI
What forms of chronic disease in infants does BF reduce?
- Allergies
- Type 2 diabetes
- Childhood obesity
What are the benefits of BF for the MOTHER?
- Protects mothers health
- Helps delay a new pregnancy (lactational amenorrhea)
- Helps weight loss
What is lactational amenorrhea?
temporary absence of menstrual periods (amenorrhea) due to the hormonal changes associated with breastfeeding
What are the specific ways a mothers health is protected from BF?
- Reduces uterine bleeding
- Contracts uterus back
- Reduced risk of ovarian and breast cancer
- Reduced postpartum depression
Why are EBF rates low?
- Marketing of substitutes
- Lack of workplace support
- Lack of antenatal care attendance
- Lack of lactation support
- Societal or cultural beliefs
Globally, how many infants aged 0-6 months of age are EBF?
48%
What is the global nutrition target for breastfeeding by 2030?
Increase rate of EBF in first 6 months to at least 70%
What is BFHI?
Baby Friendly Hospital Initiative
What is the Baby Friendly Hospital Initiative?
To ensure that all maternities, whether free standing or in a hospital, become centers of breastfeeding support
How can a maternity facility be designated ‘baby friendly’?
- No free or low-cost breast milk substitutes
- No feeding bottles or teats, - Implemented ‘10 specific steps to support successful BF’
What do baby friendly hospitals aim to do?
Aim to protect, promote and support EBF from birth
What are the first 5 steps to support successful BF?
- Written BF policy communicated to all staff
- Train all staff to implement this policy
- Inform all women of benefits
- Help mothers initiate BF within half-hour of birth
- Show mothers how to BF
What are the second 5 steps (6-10) to support successful BF?
- No food or drink other than BM
- Practice rooming in
- Encourage BF on demand
- No artificial teats or pacifiers
- Encourage further BF support
How many DHB’s are meeting the BFHI standard in NZ?
15/20 - 75%
What is the international code of marketing of Breast-milk substitutes?
Restriction of the marketing of BM substitutes - to ensure mothers are not discouraged
What does the Marketing code of BM substitutes in NZ aim to do?
Creates an enviornment where:
- Mothers can make the best possible choice
- Provided with impartial information
- Free from commercial influences
What are the general rules of BF substitute marketing?
- No advertisement/promotion
- No samples/gifts to mothers or healthcare professionals
- Material for health workers only to contain scientific info
- All material to support and state benefits of BF
Why was Nestle boycotted in 1977?
They were pushing and promoting their own formula
What is the recommendation for BF women and alcohol?
There is no safe amount
What hormone does alcohol inhibit in BF women?
Oxytocin
