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NURS 372 > Week 11 - Infant Nutrition > Flashcards

Week 11 - Infant Nutrition Flashcards

1
Q

Ontario Human Rights Commission on breastfeeding

A

have right to breastfeed child in a public area

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2
Q

Gold standard

A

human milk

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3
Q

WHO and Unicef global recommendations (2)

A

1) exclusive breastfeeding for the first 6 months

2) continued breastfeeding for a minimum of 2 years and beyond

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4
Q

Exclusive breastfeeding

A

ONLY receiving human breast milk

plus Vitamin D supplement

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5
Q

When to introduce solids

A

6 months

food sources high in iron

while continuing to receive breast milk

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6
Q

T or F: Benefits of breast milk are dose dependent

A

TRUE

benefits for baby AND mom

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7
Q

Chestfeeding

A

term used by many masculine-identified trans people to describe the act of feeding their baby from their chest,

regardless of whether they have had chest/top surgery (to alter or remove mammary tissue)

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8
Q

Colactation

A

when more than one parent breast/chestfeeds their child

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9
Q

Induced lactation

A

can take hormones that simulate hormones during pregnancy, to induce lactation

often able to produce some breast milk but not enough to meet all of the infant’s needs

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10
Q

T or F: Clients with small breasts will produce less breastmilk compared to clients with larger breasts

A

FALSE

storage capacity slightly different

but production the same

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11
Q

T or F: Clients with flat nipples cannot breastfeed

A

FALSE

but may be more difficulty latching

but baby should get the hang of it

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12
Q

T or F: Clients that have undergone a breast augmentation may still breastfeed

A

TRUE

as long as it hasn’t affected nerve endings

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13
Q

Effect of a breast reduction

A

may have diminished capacity

prolactin sensors - around the areola, may be more disruption

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14
Q

T or F: Clients can breastfeed during pregnancy

A

TRUE

in most cases ok

few cases where it is not:
-threatened preterm labour
-cervical insufficiency

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15
Q

Mammary glands make up of…

A

15 - 20 lobes

divided into lobules

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16
Q

Lobules

A

clusters of alveolus that merge to form larger ducts that drain the lobe

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17
Q

Function of milk/lactifeerous ducts

A

TRANSPORT milk through the breast and end at the nipple

think of a duck waddling

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18
Q

Function of mammary glands

A

SECRETE milk

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19
Q

Areola

A

darker area that gets even darker during pregnancy, helps infants find source of food

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20
Q

Myoepithelial cells

A

contractile epithelial cells lining the mammary glands

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21
Q

Cooper’s ligaments

A

connective tissue - collagen and elastin

forms ligament to anchor to chest wall

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22
Q

Montgomery glands

A

lubricate the nipple

antibacterial properties

scent for baby

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23
Q

Breast assessment main components (2)

A

1) inspection

2) palpation

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24
Q

Breast inspection components (3)

A

1) size

2) symmetry
-a little is normal

3) shape

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25
Want the nipple to be...
protruding when baby latches, further elongates the nippled
26
What to use for flat or inverted nipple
nipple shield for breastfeeding
27
Stages of lactation (5)
1) Mammogenesis 2) Lactogenesis Stage I 3) Lactogenesis Stage II 4) Galactopoiesis 5) Involution
28
Mammogenesis
complete development of mammary function most change happens during first pregnancy
29
Lactogenesis, Stage I
mid-pregnancy to day 2 postpartum differentiation of alveolar cells from secretory cells prolactin stimulates epithelial cells to produce milk can be leaking of colostrum
30
Main hormonal changes needed to start milk production (3)
1) estrogen -falls sharply after birth -after placenta is delivered 2) progesterone -rapidly falls after birth 3) prolactin -increases initially -rises and falls in proportion to breastfeeding 4) oxytocin
31
Prolactin
released from the anterior pituitary stimulates milk production stimulated by sucking
32
Oxytocin
released from the posterior pituitary gland works on muscles to contract them milk ejection also contracts uterus to reduce bleeding
33
Lactatogenesis, Stage II
closure of the tight junctions in the aveolar cells triggered by a rapid drop in progesterone level pnset of copious milk switches from the endocrine to autocrine system
34
Galactopoiesis
day 9 to the beginning of involution controlled by supply & demand breast size decreases between 6 and 9 months postpartum
35
Involution
average 40 days after last breastfeeding additions of regular supplementation decreased milk secretion from build-up of inhibiting peptides high sodium levels
36
Benefits of Human Milk (many)
protects against certain diseases protection from infection -resp, GI, ear, meningitis maturation of GI tract lower incidence of certain allergies reduced SIDS risk short-term IQ benefits analgeisc
37
Benefits of lactation (many)
promotes uterine involution decreased risk of PPH return to pre-pregnancy weight more quickly decreased risk of ovarian and uterine cancer protects against osteoporosis bonding experience convenient and cost-effective -but still a cost!
38
T or F: Formula feeding does not impact the risk of asthma
FALSE reduces risk of asthma
39
T or F: Breastfeeding reduces the risk of childhood obesity
TRUE
40
T or F: Breastfeeding decreases the risk of breast cancer
TRUE
41
T or F: Formula feeding reduces natural child spacing
TRUE breastfeeding helps with spacing
42
T or F: Most parents in Canada start off breastfeeding
TRUE
43
Top 2 reasons for stopping breastfeeding before 6 months
1) difficulties related to feeding*** -PAIN 2) not enough (perceived) breast milk
44
The Baby Friendly Initiative
International program developed by WHO/UNICEF Initiative to protect, promote and support breastfeeding throughout the world The WHO has developed 10 integrated steps that are recommended in the hospital and community settings
45
Breastfeeding should begin within....
1st hour of life
46
Breastfeeding frequency and duration should be...
infant driven!!
47
Breastfeeding frequency
at least 8-12 feedings in 24 hours including night time! elevated prolactin
48
Breastfeeding duration
variable usually 20-30 minutes
49
Breastfeeding technique
sniffing position mouth all the way around the nipple lips phalanged out "fish lips" awake hand between shoulders (NOT ON NECK)
50
How nurse should provide instruction on breastfeeding to client
verbally don't be hands on
51
Colostrum
end of pregnancy, early postpartum period (2-3 days) thick, yellowish appearance small amounts 5-10cc/feed, adequate volume for a healthy term infant rich in PROTEINS and IMMUNOLOGICAL FACTORS lower in calories, carbohydrates, fats, and some vitamins
52
Transitional milk
milk production starts to increase between day 2-4 breasts become fuller, giving the sense of “milk coming in” transitional milk is a combination of colostrum and mature milk duration 1-2 weeks higher in fat, lactose and calories
53
Mature Milk
fat content of the milk is primarily determined by the degree of breast EMPTINESS milk gradually increases in fat content as the feeding progresses
54
Mature milk at beginning of feed
foremilk higher water content to promote hydration supplies vitamins and proteins lower in fat
55
Mature milk at the end of the feed
hindmilk higher in fat
56
Strategies to increase milk production
breastfeed on cue; at least 8-16 sessions per day ensure breasts are empty no long periods without milk removal (>5 hours) massage breasts gently stop hormonal medications check endocrine levels use lactation-enhancing medications as a last resort
57
Common challenges
prematurity, illness or birth injuries epidural anesthesia or analgesia facial or jaw asymmetry facial anomalies (tongue-tie, cleft lip or palate) nipple pain engorgement mastitis candidiasis
58
How to describe abrasion on nipple
using clock face description e.g. abrasion between 1 and 3 o’clock position
59
Treatment for nipple trauma
breastmilk OTC nipple creams prescription all purpose nipple cream (steroid, anti fungal, antibiotic) shield
60
Viruses for which breastfeeding would NOT be permitted
HIV HTLV-1 acute Cytomegalovirus

NURS 372 (12 decks)

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