Baby Monitoring

Question 1

After term baby is born and resuscitated what is the next step ?

Answer 1

He has cried then check :
Baby will be kept on abdomen to prevent hypothermia and baby finds breast (inherent reflex ) and starts feeding .
Apgar score
KMC is mostly for low birth weight baby
Breast feed within half hr , c section within 2 hrs - skin to skin contact and breast crawl .
Breathing
Tone
Pulse

Question 2

What is exclusive breast feed ?

Answer 2

Only breast milk
No water
No honey
Even in extreme summers no water .

Question 3

Advantages of breast feeding ?

Answer 3

Immunity
Antibodies from mother to baby igA
Lysozymes , immunological factors
Micronutrients and macronutrients are sufficient for the baby .
Lactational amenorrhoea
Involution of uterus and decrease risk of pph
Mother protected against breast and ovarian cancer
Helps is myelination of brain and their iq is higher
Emotional bonding

Question 4

Milk is stored in

Answer 4

Lactiferous sinuses and baby needs to suck through atrial also .

Question 5

Prolactin is milk producing reflex

Answer 5

Produced during night , ask the mother not to skip night feed because there is more production of prl in night .
More baby sucks and more release of prolactin .
Good attachment is recommended .

Question 6

Levels of prolactin decreased by ?

Answer 6

Top feeds

Question 7

Max production of prolactin

Answer 7

30 mins after sucking

Question 8

Oxytocin

Answer 8

Touch sound thought induces oxytocin
Decrease by stress anxiety self doubt .

Question 9

What are the breast feeding reflexes in baby ?

Answer 9

Rooting reflex
Sucking reflex
Swallowing reflex

Question 10

Normal coordination

Answer 10

Suck suck suck swallow

Question 11

If baby is preterm and 33 weeks , and his reflex of breast feeding are not developed ?

Answer 11

Iv fluids not given it’s given in <28 weeks
Breast feeding not given
Spoon feed is given 32-34 weeks because baby can suck swallow but not COORDINATED .

Question 12

Baby is 30 weeks how to give feed ?

Answer 12

Ng tube or oral gastric tube
Pallad feed

Question 13

Rooting reflex ?

Answer 13

Develops by 28-30 weeks

Question 14

Sucking reflex ?

Answer 14

Squeeze the lactiferous sinus to be ejected in baby mouth

Question 15

Swallowing reflex ?

Answer 15

32-34 weeks

Question 16

Types of breast milk

Answer 16

Colostrum is the first 1-3 days
Transition milk 3 days - 2 weeks .
Mature milk
Fully mature milk

Question 17

Colostrum

Answer 17

Yellow , highly rich in immunoglobulins , epidermal growth factor , chloride , magnesium , wbc, laxatives , decrease the risk of diarrhoea and pneumonia , rich in proteins .

Question 18

Mature milk

Answer 18

Growth factors , lactose ,

Question 19

Types of breast milk ?

Answer 19

Cold milk at starting and hind milk at end .
Donot put to other breast until the breast is empty .
Cold has sugar and water , thin
Hind milk has dietary nutrition , low fat high proteins minerals calories .
So baby will not gain weight with cold milk . Always check the technique of breast milk in baby who is not gaining weight .

Question 20

Composition

Answer 20

Preterm - prow twins cats amino acids
Term - potassium and calcium .
Energy 67
Protein is lactalbumin
Whey proteins

Question 21

What is not there in breast milk ?

Answer 21

Vitamin D
And after 4-6 weeks iron
Iron is less but absorption and bioavailability is more .

Question 22

Protein

Answer 22

Whey protein lactalbumin taurine cysteine for brain development lactoferrin

Question 23

Lactose

Answer 23

Glucose and galactose. Human milk and oligosaccharide
Helps enhance calcium absorption , antimicrobial .

Question 24

Fats

Answer 24

Omega 3 and omega 6

Question 25

Minerals

Answer 25

Maternal intake has little effect on concentration of calcium magnesium

Question 26

Immunofactors inbreast milk

Question 27

Positioning and attachment

Answer 27

Body (position ) Responses Emotional Anatomy (mastitis , mastalgia ) Sucking Time spent sucking (10-15 mins )

Question 28

Position of breast milk

Answer 28

Any position in which mother is comfortable Baby’s whole body is supported and not head Baby head and body in line Baby abdomen should touch mother abdomen Baby nose to areola Mouth wide open Areola in baby mouth as much as possible Lower lip everted Cheeks should be full See this for complaints of dudh ghat aa reha hai

Question 29

C/I to breast feeding

Answer 29

Lactose intolerance Mastitis Breast abscess Breast engorgement Sore nipples Inverted nipples Chemotherapy - anticancer drug’s Opioids , cocaine taking mother Radioactive isotopes Anti thyroid drugs Galactosemia in baby

Question 30

In HIV IS BABY BREAST FED ?

Answer 30

Yes in India , because intrapartum risk of hiv is more Baby and mother both on art Zidovudine / neveripine low risk only nevirapine High risk zidovudine and nevirapine

Question 31

Afaas - decide formula feeds given or not

Answer 31

affordable Feasibility Accessibility Availability Safety Checked in baby of mother with hiv, otherwise baby will die of infections , malnutrition

Question 33

In pulmonary tuberculosis can mother breast feed ?

Answer 33

Relative contraindication In highly infectious and untreated TB only it is contraindicated All cases of pulmonary TB the mother has to breastfeed . Active case of pulmonary TB wait for 2 weeks But she can express the breast milk and baby can have spoon feed

Question 35

Relative ci

Answer 35

Chicken pox until the rash

Question 36

Baby friendly hospital initiative ? Is Rajindra hospital bfhi?