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Breastfeeding > UNICEF AUDIT > Flashcards

UNICEF AUDIT Flashcards

1
Q

What are the 3 breastfeeding hormones, and what do they do?

A

Prolactin = switches on milk producing cells.

Oxytocin = works on muscle cells, causing them to contract , producing the “let down reflex”.

Feedback inhibitor of Lactation (FIL) = protein in milk which alerts milk producing cells to stop producing milk when breasts are full.

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2
Q

How can a women optimise breastfeeding physiology when expressing milk?

A

Frequent, regular expressing helps to increase production and remove FIL (prolactin/FIL)

Quiet and private place where the woman can relax (oxytocin)

Visit baby/initiate kangaroo care ASAP promoting bonding (oxytocin)

Pictures/smells of baby when expressing releases oxytocin, facilitating the “let down reflex”

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3
Q

What is responsive bottle feeding?

A

waiting for cues to feed

holding baby close/eye contact

limit number of people feeding baby

pace feeds, let baby control flow and volume

dont force baby to complete feed

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4
Q

Name some of the breastfeeding positions

A

Cradle

Football/rugby hold

laid back

sidelying

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5
Q

How do you attach baby to the breast?

A

Wide open mouth

chin leads

bottom lip touches breast, well away from base of nipple

nipple towards rear of roof of baby’s mouth

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6
Q

What practical measures can be taken to get breastfeeding off to a good start?

A

unhurried skin to skin contact at birth, resulting in a breastfeed (Oxytocin)

early, frequent, effective feeds (prolactin, removal of FIL)

Keep baby close (oxytocin)

Talking to mum about feeding cues and how to be responsive to needs (oxytocin and prolatin)

Avoiding unnecessary supplementation

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7
Q

What are the benefits of skin to skin?

A

Keeps baby warm

good start to breastfeeding

bonding

calms both mother and baby

regulates heartrate and breathing

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8
Q

What are the signs of ineffective attachment?

A

Painful for mother

mouth not widely open

chin away from breast, nose indenting breast

cheeks sucked in

areola visible below babies bottom lip

baby is fussy - coming on and off the breast

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9
Q

When would hand expressing be beneficial?

A

To get some colostrum to tempt a sleepy baby

to soften full breasts and enable baby to attach

to help clear a blocked duct

when separated from baby

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10
Q

Which hormones regulate breastfeeding and how to they work?

A

Prolactin is produced in the pituitary gland and produces the milk when baby sucks on breast frequently

Oxytocin is produced by the hypothalamus and helps milk ejection and bonding. Triggered by skin to skin, smell/vision of baby and thoughts of baby.

FIL - produced by alveoli, regulates milk, triggered by lack of milk drainage.

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11
Q

In breast milk, what benefit do transfer factors have?

A

Absorption

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12
Q

In breastmilk, what benefit do growth factors have?

A

growth and development of the gut

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13
Q

in breastmilk, what benefits do enzymes have?

A

they aid digestion and destroy bacteria

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14
Q

In breastmilk, what benefits do oligosaccarides have?

A

the prevent bacteria in the gut.

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15
Q

In breastmilk what benefits do bifidus factor have?

A

create an acid PH in the gut

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16
Q

in breastmilk, what benefits do lactoferrin have?

A

absorption of iron

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17
Q

in breastmilk, what benefits do IgA antibodies have?

A

protection and immunity

18
Q

In breastmilk, what benefits do white cells have?

A

they destroy bacteria

19
Q

in breastmilk, what benefits do nucleotides have?

A

cell repair

20
Q

What is lactogenesis 1?

A

during pregnancy, the alveoli in the breasts develop and prepare. Colostrum may be present.

21
Q

What is lactogenesis 2?

A

after birth, hormones increase to produce copious amounts of milk in the first 32-92 hours.

22
Q

What is lactogenesis 3?

A

Feeding frequently over the first few weeks ensure development of the receptors on the breast to ensure long term milk production.

23
Q

Why is feeding overnight important?

A

Prolactin produced at night time produces milk for the next feed. skipped feeds at night may reduce levels of milk the following day. If breasts don’t empty at night, FIL builds up resulting in reduced milk production.

24
Q

How can loving relationships and bonding be encouraged?

A

Talking to baby in pregnancy

Skin to skin contact

Looking into babies eyes

being responsive to cues, soothing and comforting baby when they are distressed

not leaving baby to cry for long periods

not possible to spoil baby

25
Q

9 Signs of effective feeding

A

appropriate wet nappies

appropriate soiled nappies

active/alert and no jaundice

at least 8-10 feeds in 24H

baby feeds for 5-30 mins at most feeds

nipple shape normal after a feed

signs of effective attachment present

no dummies or formula used

weight loss and weight gain normal

26
Q

How many soiled nappies for newborn per day?

A

within 24 hours - meconium

day 3-4 - 2 x green stools

day 5 - 2 or more yellow runny stools

27
Q

How many wet nappies per day for newborn?

A

Increase with days of age of life until day 6, then x6 per day

28
Q

8 signs of ineffective feeding?

A

less than recommended wet nappies or none at all

still passing meconium after day 3 or no stools

sleepy, difficult to wake and unsettled (jaundice)

less than 8 feeds in 24 hours or constant feeding

consistently feeding for less than 5 mins or more than 40 mins

sore/damaged/misshapen nipples after a feed

engorged breasts or early signs of mastitis

use of bottles or dummies

29
Q

What is responsive breastfeeding?

A

Responding to feeding cues (rooting, opening mouth, rapid eye movement)

Feeding when baby in distress or in need of comfort

When breasts are full/engorged (mothers comfort)

for mums emotional comfort/relaxation

for mums convenience, to fit around lifestyle

30
Q

What are 6 reasons that loving relationships between parents and baby are important?

A

Encourage high levels of oxytocin

encourage low levels of cortisol

optimises brain development

supports secure attachment

helps mum and babies emotional development

improving short and long term outcomes

31
Q

What are 6 signs of good attachment at the breast?

A

pain free for mother

mouth wide open

chin indents breast, nose away from breast

cheeks full and round

more areola visible above baby top lip

content baby, stays on breast

32
Q

How to formula feed safely?

A

Hold baby semi-upright

place teat gently around lips

hold bottle horizontally, slightly tipped ensuring milk fills teat

33
Q

5 signs that baby has had enough formula?

A

splaying fingers and toes

milk spilling out of mouth

pushing teat away

stopped sucking

turning head

34
Q

How to prepare bottle feeds safely?

A

wash bottles and sterlise

make feeds as needed

boil tap water, let it cool to 70 before adding scoops

don’t overfill scoop

check temperature of milk before feeding, cool down by running under cold water

discard leftovers

avoid use of prep machine

35
Q

Why is skin to skin contact important at birth?

A

stimulates earlier birth of placenta

reduces bleeding

increases milk ejection reflex

lowers mum and babies stress levels

initiates bonding

keeps baby warm

regulates mum and baby heart rates/breathing rates

encourages feeding behaviours

36
Q

What are the breastfeeding rates in the UK?

A

some of the lowest in the world.

81% initiate breastfeeding

8/10 stop before planned

there has been an increase in babies being exclusively breast fed at age 6 months

last survey in scotland in 2017

37
Q

What is the Code?

A

it is the code of marketing, which regulates the marketing of breastmilk substitutes to protect breastfeeding. publishing 1981.

38
Q

How would you support a mother whose baby is reluctant to feed?

A

Gently handing/patience

revisit position and attachment

check for illness or underlying causes

keep baby close so cues can be responded to timely

suggest switching breasts

breast compressions

39
Q

why should supplements be avoided?

A

supplements interfere with physiology of breastfeeding

formula changes gut flora in baby

undermines mothers confidence to feed

nipple/teat confusion

40
Q

How can you support a baby at risk of hypoglycaemia?

A

skin to skin and encourage breastfeeds

frequent feeds using a cup or syringe if required

keep baby warm

complete obs regularly

check blood glucose levels regularly

41
Q

How can engorgement be prevented?

A

good positioning and attachment

frequent feeding

avoid formula feeds

avoid dummies

42
Q

Best communication skills when talking to mothers

A

opened ended questions

sensitive/compassion in discussion

validate points raised by mum

seek consent

reflect back

build on mums current knowledge

non judgement

non biased

Breastfeeding (1 decks)

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