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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
List symptoms where mother should be evaluated to rule out breast cancer
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
What is the most definitive test to determine cancer?
Biopsy -( ultrasound can guide)
27
Inflammatory breast cancer is a concern because.....
It has a high mortality rate
28
Symptom of Inflammatory breast cancer are
Warm red breast, heavy breast , pen d orange, exaggerated hair follicle pits ( afro american higher risk
29
Can a women nurse on the unaffected breast during chemotherapy treatment
NO. No breastfeeding during chemo
30
Describe breast cancer staging
1. Tumor- no lymph 2. Small tumor and lymph or LARGE tumor - no lymph 3. Large tumor and lymph 4. Metastasis
31
What country has the highest rate of spontaneous twinning
Aftrica
32
One of the best ways to increase milk volume for twins and decrease amount of time until Lll after a delivery
Initiation of milk expression within 1 hours of birth
33
How is breast milk protective for NEC?
Breast milk has trophic peptides. Baby <1500 gms is at a higher risk. Treatment is remove part of intestine
34
What is the determining factor to identify discordant twins.?
Weight differentiation >10%.
35
When feeding twins, should each baby have his own breast?
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
What is serratia marcescens?
A mold pathogen found in pump tubing that can turn milk pink
37
If tube feeding and nursing a baby, what is the latest time the baby should be tube fed if mother plans to nurse.
At least a 30 minute interval.
38
According to the KORAN , what are milk siblings and how does it affect their relationship?
Milk siblings - mothers who shared milk or breastfed each others children. These children cannot marry each other.
39
Describe "epigenetic mechanism"
The biochemical alteration to DNA that influences the way a gene may be expressed
40
What are exosomes?
They contain micro RNA which effect gene expression
41
How does epigenetics relate to breastfeeding?
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
Before donating milk to the milk bank , milk is screened for the following......
HIV ( 1 and 2), HTLV ( 1 &2), Hep B, Hep C, TB, Syphilis
43
Name other reasons a woman may not be able to donate milk to a milk bank.
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
Describe the reason for denying women's donated milk if they lived in the UK.
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
Can a mother donate milk if she is using birth control?
YES as long as it is progesterone only pill or a low dose of estrogen (<20 mg)
46
What is the minimum number of oz mom should have available when donating to a milk bank.
100 oz
47
Which type of donor milk do HMB process and store separately?
Milk from mothers who deliver prematurely and those on a dairy-free diet.
48
How long does preterm milk have higher protein levels.
about 4 weeks after birth
49
how are human milk fortifiers created
Using concentrated pasteurized donor milk and add ing vitamins and minerals. ( others are bovine or plant based)
50
The holder method of pasteurization does not affect the concentration of which milk compound.
Oligosaccharides. ( sugar that provide food for beneficial gut flora to thrive)
51
What milk treatment method affects the cytomegalovirus?
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
What 2 facial muscles do breastfed babies use more then bottle fed babies
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
What is the main tongue muscle and nerve
Genioglossus ( pulls down during negative pressure and innervated by hypoglossal
54
What nerve innervates the masseter muscle
Trigeminal nerve - jaw movement
55
What muscle closes the jaw
Temporalis - tigeminal nerve
56
What muscle helps the milk bolus move down towards the pharynx
Palatopharyngeus innervated by the vagus nerve
57
How many muscles and nerves are involved in suck swallow function
26 muscles and 6 nerves

General Information- breastfeeding (10 decks)

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