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General Information- breastfeeding > Wilson Clay Notes- study deck > Flashcards

Wilson Clay Notes- study deck Flashcards

1
Q

What OTC medication can mom take to help with early engorgement?

A

Ibuprofen taken 15 mins before reverse pressure softening or gentle pumping can help with inflammation and pain in relieving impacted breasts

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2
Q

What is peau d orange?

A

inflammatory breast cancer

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3
Q

What is the rate of milk production in hyper lactation?

A

A rate of milk production >60ml per hour

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4
Q

Name two conditions that can be the cause of excess milk production.

A

Postpartum thyroiditis and hyperthyroidism

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5
Q

A method of treating overproduction of Breastmilk if all other methods fail.

A

Give estrogen for 4-7 days. May cause some vaginal bleeding and NEVER given in the first 3 weeks post partum

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6
Q

How soon do most babies self latch after birth?

A

Within 60 minutes.

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7
Q

What is the most common causative agent for infectious mastitis.

A

Staph Aureus. Staph epidermis has the ability to form biofilms which results in antibiotic resistance. Stah E. is the leading cause of chronic mastitis

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8
Q

What is Lactobacillus fermentum?

A

Probiotic therapy as a possible alternative to antibiotic therapy promoting normal flora to override prolific concentration of step and staph

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9
Q

Name 5 things that may increase risk of mastitis

A 
1. Fatigue
2 Stress
3 Plugs
4 Changing number of feeds
5 Milk stasis
6. Household illness
7. Breast trauma
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10
Q

2 Symptoms of subclinical mastitis.

A

low milk supply and low grade breast pain

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11
Q

If a mother is treated with Dicloxacillin for a suspected staph aureus mastitis, how long before symptoms should improve

A

48 hours. IF not culture.

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12
Q

If mothers are diagnosed with staph aureus who is often in a carrier state

A

The infant with nasal staph aureus

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13
Q

BWClay recommends what method of treatment for cracked infected nipples

A

rinse nipples after feeds and clean daily with soap and water

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14
Q

What is a common organism found in bilateral mastitis

A

Strep

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15
Q

What is the most common type of abcess

A

Intramammary- unillocular. Make up 65% of abcess cases. Hi recurrence rate

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16
Q

How soon should a mother see a health care provider for a breast mass that is not showing any improvement

A

3 days

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17
Q

What is the proper dose of dicloxacillin for mastitis

A

500 mg qid x 10 days

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18
Q

What is the proper treatment for MRSA

A

Vancomycin IV

14,000 females in US experience MRSA

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19
Q

What is the percentage of abcesses that present without fever

A

25%

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20
Q

Describe a galactocele

A

sterile milk filled cyst that may be left alone if notgrowing rapidly, not painful and not impairing lactation

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21
Q

What is cellulitis?

A

mastitis of interlobular connective tissue

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22
Q

Is it likely that mothers may become depressed having a mastitis.

A

YES. inflammation is a key factor in depression and pro inflammatory cytokines cause chemical changes that have an effect on brain chemistry including increase of cortisol

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23
Q

What is HAMLET as it relates to breast cancer?

A

this is a milk complex of oleic acid and alpha lactalbumin that can result in tumor cell death.

24
Q

What are the two mechanisms that may be the cause of reduced breast cancer in a woman who breastfed?

A
  1. The reduction in lifetime ovulatory episodes -lactation amenorrhea
  2. Differentiation of breast tissue
25
Q

List symptoms where mother should be evaluated to rule out breast cancer

A
  1. 2nd or 3rd course ABX and not responding - order ultrasound
  2. red skin on breast without fever
  3. skin texture changes- peau d orange
  4. exaggerated hair follicle pits
  5. Fixed masses
  6. Copious, spontaneous clear or bloody nipple discharge
  7. Non resolving mastitis in the same area
26
Q

What is the most definitive test to determine cancer?

A

Biopsy -( ultrasound can guide)

27
Q

Inflammatory breast cancer is a concern because…..

A

It has a high mortality rate

28
Q

Symptom of Inflammatory breast cancer are

A

Warm red breast, heavy breast , pen d orange, exaggerated hair follicle pits ( afro american higher risk

29
Q

Can a women nurse on the unaffected breast during chemotherapy treatment

A

NO. No breastfeeding during chemo

30
Q

Describe breast cancer staging

A
  1. Tumor- no lymph
  2. Small tumor and lymph or LARGE tumor - no lymph
  3. Large tumor and lymph
  4. Metastasis
31
Q

What country has the highest rate of spontaneous twinning

A

Aftrica

32
Q

One of the best ways to increase milk volume for twins and decrease amount of time until Lll after a delivery

A

Initiation of milk expression within 1 hours of birth

33
Q

How is breast milk protective for NEC?

A

Breast milk has trophic peptides. Baby <1500 gms is at a higher risk. Treatment is remove part of intestine

34
Q

What is the determining factor to identify discordant twins.?

A

Weight differentiation >10%.

35
Q

When feeding twins, should each baby have his own breast?

A

No switching breasts a better choice for stimulation. If one baby a poor feeder Switch MID FEED for better feeder to stimulate milk production.

36
Q

What is serratia marcescens?

A

A mold pathogen found in pump tubing that can turn milk pink

37
Q

If tube feeding and nursing a baby, what is the latest time the baby should be tube fed if mother plans to nurse.

A

At least a 30 minute interval.

38
Q

According to the KORAN , what are milk siblings and how does it affect their relationship?

A

Milk siblings - mothers who shared milk or breastfed each others children. These children cannot marry each other.

39
Q

Describe “epigenetic mechanism”

A

The biochemical alteration to DNA that influences the way a gene may be expressed

40
Q

What are exosomes?

A

They contain micro RNA which effect gene expression

41
Q

How does epigenetics relate to breastfeeding?

A

Genetic material is identifiable and transmissible from human milk. Human milk may be a way to serve as a non invasive source of genetic information. In addition using breastmilk from another source may modify childs genes and DNA

42
Q

Before donating milk to the milk bank , milk is screened for the following……

A

HIV ( 1 and 2), HTLV ( 1 &2), Hep B, Hep C, TB, Syphilis

43
Q

Name other reasons a woman may not be able to donate milk to a milk bank.

A
  1. Currently nursing a baby <1 year old
  2. No more then 2 alcoholic beverages a day
  3. Non smoker
  4. No herbs or drugs
  5. No tatoo in the past year
  6. IF she or HER PARTNER , is at risk for HIV
44
Q

Describe the reason for denying women’s donated milk if they lived in the UK.

A

Women who lived in the UK for more then 3 mos prior to 1996 OR lived in some areas of Europe for more then 5 years between 1980-1986 cannot donate (mad cow disease aka Creutzfeldt jacob disease)

45
Q

Can a mother donate milk if she is using birth control?

A

YES as long as it is progesterone only pill or a low dose of estrogen (<20 mg)

46
Q

What is the minimum number of oz mom should have available when donating to a milk bank.

A

100 oz

47
Q

Which type of donor milk do HMB process and store separately?

A

Milk from mothers who deliver prematurely and those on a dairy-free diet.

48
Q

How long does preterm milk have higher protein levels.

A

about 4 weeks after birth

49
Q

how are human milk fortifiers created

A

Using concentrated pasteurized donor milk and add ing vitamins and minerals. ( others are bovine or plant based)

50
Q

The holder method of pasteurization does not affect the concentration of which milk compound.

A

Oligosaccharides. ( sugar that provide food for beneficial gut flora to thrive)

51
Q

What milk treatment method affects the cytomegalovirus?

A

Heat treatment will kill the virus, ( this is why mothers with CMV can donate and why mothers are not screened for his illness- due to pasteurization of all donated milk)
Freezing can only diminish the viral load

52
Q

What 2 facial muscles do breastfed babies use more then bottle fed babies

A
  1. Buccinators ( cheek muscle innervated by facial nerve
  2. Orbicularis Oris ( lip muscle innervated by facial nerve
    Bottlefed us Mentalis ( protrude lower lip and Masseter jaw muscle)
53
Q

What is the main tongue muscle and nerve

A

Genioglossus ( pulls down during negative pressure and innervated by hypoglossal

54
Q

What nerve innervates the masseter muscle

A

Trigeminal nerve - jaw movement

55
Q

What muscle closes the jaw

A

Temporalis - tigeminal nerve

56
Q

What muscle helps the milk bolus move down towards the pharynx

A

Palatopharyngeus innervated by the vagus nerve

57
Q

How many muscles and nerves are involved in suck swallow function

A

26 muscles and 6 nerves

General Information- breastfeeding (10 decks)

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