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NM 705 Postpartum and Newborn > Module 5 BBB > Flashcards

Module 5 BBB Flashcards

1
Q

What is the alveolus? Why is it important?

A

The functional unit of the breast that is responsible for secreting milk.
(P&P p423)

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2
Q

What is colostrum?

A

The first milk that comes in. It is high in protein and fat. Has antibodies; especially IgA, that helps with gut closure. Has an immunologic effect.
(P&P p423)

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3
Q

What are the coopers ligaments?

A

Connects the breast tissue to the chest
(P&P p423)

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4
Q

What are the lactiferous duct/ule?

A

Transports milk from the alveolus to the nipple
(P&P p423)

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5
Q

What is lactogenesis 1? When does it occur?

A

Milk production is related to the high production of progesterone in pregnancy. Starts around 16 weeks and continues until postpertum.
(P&P p423)

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6
Q

What is lactogenesis 2? When does it occur?

A

Begins with the drop in progesterone from the delivery of the placenta. Begins around day 2-4 postpartum. This is when the “milk comes in.”
(P&P p423)

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7
Q

What is lactogenesis 3? When does it occur?

A

This is the maintenance/galactopoietic of milk production. It is baby driven and autocrine-controlled (aka locally controlled-**NOT via the blood stream)
(P&P p423)

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8
Q

What is mammary hypoplasia?

A

(P&P p423)

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9
Q

What is the milk ejection reflex?

A

(P&P p423)

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10
Q

What are the montogomary glands?

A

These are the small bumps on the areola that secrete oil to protect the nipples from trauma.
(P&P p423)

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11
Q

What is the tail of spense?

A

This is the area of the breast that goes out toward the armpits. Some people can get swelling in that area during let down.
(P&P p423)

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12
Q

What is galactopoesis?

A

(P&P p423)

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13
Q

What could delay lactogenesis 2?

A

Retained placenta or products, C/S, PCOS, premies, GDM

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14
Q

What sensation can mom’s feel with letdown?

A

Tingly

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15
Q

What sensation can mom’s feel with letdown?

A

Tingly

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16
Q

What are the benefits for baby with breastfeeding?

A

-Protect baby by passing antibodies (esp. IgA causes gut closure and prevents antigens from entering the baby’s system)
-Is a laxative-helps pass bilirubin through the meconium
-Can increase test scores by a small amount
-Passes hormone of calm and peacefulness (oxytocin)

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17
Q

What supplements should we recommend for a breastfeeding person?

A

-Vit D supplement/drops to baby 400 IU
OR
-Vit D supplement for mom 6400 IU

If she is vegan-recommend B12

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18
Q

What is the recommended duration for breastfeeding?

A

Exclusive for 6 months and then continue nonexclusive for 2 years

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19
Q

What does breastfeeding lower the medical risk of for baby?

A

-Asthma
-Obesity
-AOM
-GI complications (NEC)
-Allergies
-Resp. Infections
-DM
-SIDS

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20
Q

What does breastfeeding lower the medical risk of for mom?

A

-PP Bleeding
-Breast CA
-Ovarian CA
-DM
-HTN/Cardiovascular disease

21
Q

What are some contraindications to BF?

A

-Galactosemia
-Active untreated TB
-Radioactive isotopes/chemo
-Drugs of abuse/anything that affects cognition
-Active HSV on breast (can pump)
-HIV if there is access to clean water (in underdeveloped countries the risk of unsafe water is higher than risk of HIV)

22
Q

What positions can be used with breastfeeding?

A

-Cradle
-Cross cradle
-Football
-Laid back/ventral
-Side lying

23
Q

Describe a “good” latch.

A

-Nose at the level of the nipple, chin touching breast
-Mouth wide open-corner angle 160
-Lips flanges
-Complete seal-no popping/dimples/clicking
-Document swallowing

24
Q

What may happen to the BF person and infant if there is an improper latch?

A

Baby: can get dehydrated, lose weight/obstructed milk transfer
Mom: Nipple trauma (cracked/bleeding/blisters), pain, stop BF, risk for mastitis, yeast infection

25
Q

Why is it important to know different BF positions?

A

It allows the baby to drain the breast from different angles

26
Q

What are things the patient can do to help with painful BF?

A

Pay attention to baby’s hunger cues and feed before the baby is hangry, try different positions, and start feeding on the non-painful side

27
Q

What are the 5 components of the LATCH tool?

A

Latch, Audible swallow, Type of nipple, Comfort, Hold

28
Q

What output is normal for each day of the first week of baby’s life?

A

1-2 days: 2 wet, 3 stool (mec)
3 days: 3 wet, 3 stool (green/brown)
4 days: 5 wet, 4 stool (green/brown)
5 days: 6 wet, 4-5 stool (loose yellow seedy-BF)
6-7 days: 7 wet, 6 stool

29
Q

How much weight loss in baby is normal PP?

A

5-7%

30
Q

When does baby begin to regain weight? When should they be back to birth weight?

A

-4 days (this is when milk comes in)
-2 weeks

31
Q

What percent of babies void in the first 24 hours?

A

95%

32
Q

What are warning signs of voiding and stooling in the first week of life?

A

-No void in 24 hours of life
-<4 stools on day 4 indicates delayed lactogenesis
-<3-5 stools by day 5-7 or if stools are still green/brown

33
Q

What is the difference between fore-milk and hind-milk?

A

Fore-milk is higher in water and hind milk is higher in fat

34
Q

What do we think causes cluster feedings?

A

Growth spurt

35
Q

How long can a patient experience pain with BF and it be normal?

A

First two weeks for 30-60 seconds of latching. This is the baby elongating the nipple.

36
Q

When we are getting affective milk transfer, what will we observe?

A

Swallowing

37
Q

How often should a baby feed?

A

8-12 feeds in 24 hours for 20-30 minutes

38
Q

What are warning signs we should teach the BF PP mom to report about herself?

A

Fever, flu like symptoms, red/sore breasts, hard lumps on breast, inability to feed

39
Q

What are warning signs we should teach the BF PP mom to report about baby?

A

lethary, crying >2-3hours, signs of jaundice, not meeting diaper counts, sunken fontanels, red stained diaper

40
Q

How long is milk good for once it has been exposed to baby’s mouth?

A

1-2 hours. Anything left over should be discarded due to the risk of infection to the baby

41
Q

Does nutrition significantly effect breast milk content?

A

No, the mother would have to be significantly malnourished. Differences in cultural diets do not make a difference.

42
Q

How does exercise affect BF?

A

Moderate exercise is ok. 150m/week of exercise is ok and will not affect milk production

43
Q

What aspects of BF affect amenorrhea? Aka: if these factors are present, they are likely not ovulating

A

BF around the clock, less than 6 months PP and have not had a menstrual cycle.

44
Q

How can we advise patients that would like to drink alcohol while BF?

A

**Feed baby before drinking. Alcohol peaks in milk at about 2 hours, 1 glass/hour, can pump and dump

45
Q

If a patient is smoking, how can it affect the breastmilk?

A

Nicotine is 3 times higher in milk circulation than maternal, can affect the taste, can cause babies to sleep less, and can lower milk supply.

46
Q

**What aspects of medications are preferred for patients who are BF?

A

Shorter half-life, high molecular weight, bound to protein, lower bioavailability, drugs enter CNS with difficulty

47
Q

How would you counsel your client if they want to continue to BF and return to work?

A

The law requires the employer must supply a clean space for patients to pump/feed. Recommend pumping beginning at 4 weeks, should still pump every 2-3 hours.

48
Q

What are the signs of inadequate milk supply?

A

If the baby is not gaining weight, having more hunger cues, and breasts are not feeling full

NM 705 Postpartum and Newborn (13 decks)

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