Module 15 breastfeeding

Question 1

Recommendations of time breastfeeding

Answer 1

exclusively for the first 6 months

continued in combo with other nutrients for at least first year

Question 2

Healthy people 2020 breastfeeding goals

Answer 2

• 81.9% of mothers will initiate breastfeeding in the neonatal period.
• 60.6% will be breastfeeding at 6 months and 34.1% at 1 year old
• 56.2% will exclusively breastfeed through 3 months and 25.5% at 6 months

Question 3

Focus interventions from provider for successful breastfeeding

Answer 3

• support mother’s self-efficacy to breastfeed
• provide lactation support to mother and family
• increase lactation education for both mother and providers

Question 4

Breast milk is rich in

Answer 4

vitamins
minerals
fat
proteins: including immunoglobulins and antibodies
carbs
enzymes and cellular components
- macrophages and lymphocytes

Question 5

initiation of breastfeeding at time of birth allows

Answer 5

growth of protective bacteria for healthy microbiome

Question 6

continuation of breastfeeding promotes

Answer 6

further growth of bacteria
immunoglobulin A secretion
decreased inflammation in the intestinal epithelial cells and tissues

Question 7

breastfeeding leads to lower risk of

Answer 7

nonspecific bacterial infections
necrotizing enterocolitis
acute otitis media in childhood
asthma
excessive wt gain
T2DM 
SIDS

Question 8

Breastfeeding benefits for mothers

Answer 8

strong bond associated with successful nursing
dec. risk for breast and ovarian cancer
protect against:
- CV risks associated with metabolic syndrome, HTN, and CV disease

Question 9

Contraindications to breastfeeding

Answer 9

• infant with classic galactosemia
• maternal dx of T-cell lymphotropic virus
• maternal dx of untreated brucellosis
• maternal dx of cancer and treatment
• maternal HIV infection
• Herpetic lesions on the mothers breast
• Maternal use of drugs

Question 10

Special situations with breastfeeding management

Answer 10

• significant maternal or infant illness affecting ability to feed
• invasive breast surgery: esp. reduction in which areaola is removed and reattached
• Hx of milk supply problems
• maternal smoking -> dec. milk supply

Question 11

production of breast milk triggered by

Answer 11

• fall in progesterone concentration after birth

- suckling is essential to establish and maintain lactation

Question 12

indications of successful breast feeding

Answer 12

Infant weight gain

• should be back to birth wt by 2-4 weeks
• gain 4-7oz per week initially
• usually dbl birth wt by 4-6 months old
• triple birth wt by 1 year

Question 13

characteristics of a healthy breastfed infant

Answer 13

• active and alert state
• developmentally appropriate
• age-appropriate ht and head circumference
• appropriate skin turgor and color
• at least 6 wet diapers and several stools per day
• content and satisfied after feeding

Question 14

Maternal nutritional needs during breastfeeding

Answer 14

• daily caloric intake of 300 extra calories
• water intake of 3.4 L/day
• inc. fruit, veggies, whole grains, calcium, protein, legumes
• Ca, zinc, folate, Mg, Vit B6, Vit D
• No foods need to be routinely excluded from the maternal diet
• moderate intake of caffeine is okay

Question 15

meds for breastfeeding mothers

Answer 15

• give Rx that are safe for infants or have been tested in infants
• avoid long-acting forms
• schedule feeding times when drug is at lowest level (right after taking med)
• observe infant for changes: feeding patterns, fussy, V/D, rash
• select Rx with lowest level in breast milk
• avoid Rx that inhibit prolactin: estrogen, antihistamines, ergot
• cautious with herbal preparations

Question 16

barriers to breastfeeding

Answer 16

lack of knowledge
lactation problems
poor family and social support
health services
embarrassment
employment and child care
social norms