Breast feeding and labour Flashcards
Advantages of breast feeding- health
Breastfeeding reduced the risk of: Gastroenteritis, chest infection, ear infections, urinary infections, diabetes, allergies, childhood cancers and SIDS, heart disease
Breast feeding reduces the risk of (mother): breast cancer, ovarian cancer, hip fractures
Formula milk
- Water
- Protein- cow milk protein and soy, 3 times as much protein as breastmilk, can cause weight gain in later years
- Carbohydrate- Lactose
- Fats- usually vegetable based, fat content in breast milk varies during feeds but in formula its static
- Additives are added, unsure how long term this will affect health
- A nutritionally adequate breast milk substitute
What do we need to discuss with mothers who choose to formular feed
- Making up feeds correctly
- Sterilisation of feeding equipment
- First stage milks for first year
- Amounts to give – link stomach size
- Responsive bottle feeding
How to support a mother with breastfeeding
- Keep mother and baby together – Room in.
- Help mothers to recognise feeding cues
- Allow unrestricted, frequent feeds
- Support mothers to breastfeed at night, refer to ‘Caring for your baby at night Guide for parents’ Leaflet (Unicef.)
- Avoid supplements
- Avoid dummies
- Support should start antenatally and continue through the postnatal period
- One-to-one support from trained personnel at a time when the mother needs or is expecting it
Maternal standards
- Ensuring pregnant women are prepared
- Supporting closeness and feeding straight after birth
- Ensuring breastfeeding off to a good start
Informed decisions re other food for babies - Encouraging close and loving relationships
How are maternity standards provided
There is a breastfeeding assessment at 5 days. Within the first 7 days a minimum of 2 assessments are carried out. Specialist services can be provided to some mothers. Mothers should be signposted to social support in their local area
Formular- when giving feeds its encouraged to hold the baby close and give the majority of feeds themselvex
Benefits of breast feeding for the baby
- Ideal food for newborns
- Reduced risk of diarrhoea and vomiting
- Reduced risk ear infections and chest infection
- Less likelihood of becoming obese and T2 diabetes later in life
- Breastmilk changes in composition and quality according to the baby’s needs – it is unique for that baby
Benefits of breast feeding for the mother
- Reduces risk of breast cancer and ovarian cancer
- Helps with weight loss (weight gained in pregnancy) as uses approx 500 extra calories per day for milk production
- Less costly than formula feeding
Cons of breast feeding
- It may be painful – sore and/or cracked nipples
- Not enough milk leading to baby either losing weight or not gaining weight
- Breast engorgement
- Baby not effectively latching onto breast
- Blocked milk duct
- Mastitis
- Breast abscess
Pros of formula feeding
- It is difficult to identify any established scientific benefits of formula feeding. Most of the pros highlight the potential benefit of:
- Family members sharing the feeding
- Mothers don’t have to alter their diet with regards to alcohol and caffeine
- More confident when feeding in public
Cons of formular feeding
- Formula milk can be costly
- It is not a ‘living’ product and cannot replicate all the qualities of human milk eg antibodies, enzymes, hormones, living cells etc
- Risk of dehydration if not made correctly
- Risk of weight loss if not made correctly (diluted)
- Where access to clean water and/or boiled water formula feeding can cause major health problems.
How breastfeeding works
- When the baby suckles this stimulates nerve impulses which stimulate the pituitary gland
- Hormones are released causing milk let down
Prolcatin- hormone
- Triggered by suckling
- Acts on acini cells to make milk
- Peaks 90 minutes after a feed
- Suppresses ovulation
- Needs to be stimulated early and frequently to be effective long term
Setting up milk production
- Delivery of placenta opens prolactin receptor sites on acini cells
- Prolactin surges ‘prime’ sites to begin milk production
- Receptor sites start to close if not primed
- Skin contact and lots of feeds in early days increase potential for long-term milk production
Oxytocin
- Triggered by suckling and positive thoughts
- Acts in the myoepithelial cells to eject milk
- Largest peak occurs early in the feed
- Effect may be felt as tingling
- Basal levels are higher when the baby is near
- Can be temporarily inhibited by stress
Prolactin and oxytocin
Work together to trigger feeling of love and mothering behaviour, induce calmness and a feeling of well being. Enhance the mother baby bond.
Colostrum
- Produced from 16 weeks gestation, continues for 3-4 days postpartum
- Yellow-orange thick fluid: concentrated form of breast milk
- Lower levels of carbohydrate and fat
- Newborns have immature kidneys and only able to cope with small volumes of fluid
- Having small amount of colostrum allows infant to learn co-ordination of sucking, swallowing and breathing.
- Has a laxative effect – aids passage of meconium from the gut
Contents of colostrum
- Rich in growth factors
- White cells and antibodies (especially IgA)
- Fat soluble vitamins (especially vitamin A)
- Protein minerals
What’s contained in breast milk- fat and protein
- Fat- main source of energy, half of all calories. Mainly triglycerides. Long chain fatty acids aid brain and eye development, nervous and vascular system
- Protein- about 40% casein (carry calcium and phosphate) and 60% whey (contains anti-infective proteins). Lactoferrin binds to iron. Bifidus factor inhibits growth of harmful bacteria in the gut. Taurine is required for conjugation of bile salts and absorption of fats.
