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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
9 Signs of effective feeding
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
How many soiled nappies for newborn per day?
within 24 hours - meconium day 3-4 - 2 x green stools day 5 - 2 or more yellow runny stools
27
How many wet nappies per day for newborn?
Increase with days of age of life until day 6, then x6 per day
28
8 signs of ineffective feeding?
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
What is responsive breastfeeding?
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
What are 6 reasons that loving relationships between parents and baby are important?
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
What are 6 signs of good attachment at the breast?
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
How to formula feed safely?
Hold baby semi-upright place teat gently around lips hold bottle horizontally, slightly tipped ensuring milk fills teat
33
5 signs that baby has had enough formula?
splaying fingers and toes milk spilling out of mouth pushing teat away stopped sucking turning head
34
How to prepare bottle feeds safely?
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
Why is skin to skin contact important at birth?
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
What are the breastfeeding rates in the UK?
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
What is the Code?
it is the code of marketing, which regulates the marketing of breastmilk substitutes to protect breastfeeding. publishing 1981.
38
How would you support a mother whose baby is reluctant to feed?
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
why should supplements be avoided?
supplements interfere with physiology of breastfeeding formula changes gut flora in baby undermines mothers confidence to feed nipple/teat confusion
40
How can you support a baby at risk of hypoglycaemia?
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
How can engorgement be prevented?
good positioning and attachment frequent feeding avoid formula feeds avoid dummies
42
Best communication skills when talking to mothers
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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