Breast feeding

Question 1

What is the puerperium?

Answer 1

time after childbirth lasting 6-8 weeks

Question 2

What is meant by involution of the uterus

Answer 2

Uterus returns to pre-pregnant state

Question 3

From what point can the fundus no longer be palpated

Answer 3

10 days (reduced to size below pubis symphysis)

Question 4

How does the myometrium change during involution

Answer 4

Returns to normal thickness by ischaemia, autolysis and phagocytosis

Question 5

How does the decidua change during involution?

Answer 5

Lining shed as locia, regeneration of endometrium

Question 6

What happens during ischaemia of the myometrium

Answer 6

Contraction of empty uterus and apposition of uterine walls applying pressure to placental site
Reduction of blood supply to uterus
Resulting deoxygenation

Question 7

What happens during autolysis of myometrium

Answer 7

Self-ingestion of myometrial cells by proteolytic enzymes resulting in reduction in size
Removal of reducant actin and myosin muscle fibre

Question 8

What happens during phagocytosis of myometrium

Answer 8

Phagocytes engulf and remove waste products of autolysis which are eliminated by kidneys

Question 9

What is lochia

Answer 9

Vaginal loss during the puerperium

Question 10

How long is lochia red for?

Answer 10

3 days

Question 11

How long is lochia pink for?

Answer 11

10 days

Question 12

How long is lochia yellow for?

Answer 12

3-6 weeks

Question 13

How does plasma volume change?

Answer 13

Reduction in plasma volume within 10 days

Question 14

How does cardiac output, heart rate and stroke volume change?

Answer 14

Reduction to pre labour value after 24-72 hours

Decline to non-pregnant value 6-8 weeks

Question 15

Why are women no longer short of breath after giving birth?

Answer 15

Reduction in compression of lungs due to reduction in uterine size leading to full inflation

Question 16

Why do women no longer hyperventilate after giving birth?

Answer 16

Less oxygen demand as reduction in cardiac work and circulatory volume

Question 17

How does sensitivity of central and peripheral nervous system change after giving birth

Answer 17

Increased sensitivity experienced during pregnancy but returns to normal 36 hours post partum

Question 18

What hormone is responsible for hyperpigmentation of certain parts of the body?

Answer 18

Melanocyte

Question 19

What hormone is responsible of ligamentous relaxation during pregnancy, leading to lordosis

Answer 19

Relaxin

Question 20

How long before relaxin levels return to normal

Answer 20

5 months

Question 21

How many lobes and lobules is breast made up of?

Answer 21

15-25 lobes

20-40 lobules

Question 22

Define mamogenesis

Answer 22

Mammary duct gland growth and development

Question 23

Define lactogenesis

Answer 23

Initiation of milk secretion in alveoli

Question 24

Define galactokinesis

Answer 24

Removal of milk from gland

Question 25

How does oestrogen affect breasts?

Answer 25

Growth of lactigerous ducts and tubules and increase in breast size

Question 26

How does progesterone, prolactin and HPL affect breasts?

Answer 26

Proliferation and enlargement of alveoli | Promote fat deposition and stimulates development of lobes and lobules

Question 27

What is happening to breasts at week 12

Answer 27

Nipple and areola become more pigmented

Question 28

What is happening to breast at week 16

Answer 28

Colostrum formed

Question 29

What happens in lactogenesis 1?

Answer 29

Initiation of milk secretion in breast tissue during

Question 30

What happens in lactogenesis 2?

Answer 30

Production of colostrum and transitional milk followin fall im plasma progesterone

Question 31

What happens in lactogenesis 3?

Answer 31

Maintenance of established lactation and removal of milk by baby

Question 32

Where is prolactin secreted

Answer 32

Anterior pituitary gland

Question 33

Where is oxytocin secreted

Answer 33

Posterior pituitary gland

Question 34

Advantages for baby breast feeding

Answer 34

``` Protection from infectious diseases Less chance of vomiting Fewer chest and ear infections Balanced nutrients Reduced allergy incidence Free Temperature ```

Question 35

Advantages of breast feeding for mother

Answer 35

Lowers risk of getting breast and ovarian cancer Saves money Strong physical and emotional bond Lose weight

Question 36

Disadvantages of breast feeding

Answer 36

Father unable to feed Some women find it stressful Sometimes difficult to wean baby of breast

Question 37

Why do some women have sore nipples during lactation

Answer 37

Incorrect positioning ttachment- friction

Question 38

What is engorgement

Answer 38

Build up of milk in ducts Feels hard and lumpy Caused by insufficient emptying breast

Question 39

What is mastisis

Answer 39

Milk stasis and ifnection- if milk is not removed will back track