Breastfeeding Flashcards
(24 cards)
How long should babies be breastfed for?
6 months
List reasons why people do not breastfeed?
- Lack of support
- Personal issues
- Social pressures
- Returning to work
- Personal preference
Give advice for breastfeeding
First few days
- Skin to skin contact
- Colostrum
- Baby may want to feed very often (even every hour)
- Fewer feeds once breasts produce ‘mature milk’ after a few days
- The more a woman breastfeeds, the more milk is made
What is colostrum
- The first milk produced (contains antibodies & WBCs)
- High in carbs & proteins, low in fat
- Delivers nutrients in a very concentrated, low volume form
- Mild laxative effect
What is in ‘mature’ milk?
Carbs, proteins, fats, fluid, vitamins, minerals, WBC, stem cells, enzymes, growth factors, hormones, antibodies
How often should you breastfeed?
- More often in first few weeks (8 times/24h)
- Feed baby on demand
- Avoid feeding ‘schedules’
- Milk supply adjusts depending on baby’s needs
Can you overfeed a breastfed baby?
No
What are the two options of breastfeeding pumps?
Electric or manual
- Extract milk from the breast
What are patient factors to be aware of with medicines in BF?
- Age/weight of infant
- Pharmacokinetics (infants have lower drug clearance than adults)
- Allergies
- Co-morbidities
- Drug interactions
How does medication get to baby?
Enters breast milk via blood supply
What effects medication entering breast milk?
- Size (smaller molecule size means easier transfer to breast milk)
- Solubility in lipids (easier to transfer into milk)
- Half life (longer half life provides longer time frame for medication to transfer to milk - timing of dose is important)
Where to look for help?
- BNF (not much info)
- SPC (manufacturers often don’t recommend)
- Breastfeeding network
- UK Drugs in Lactation Advisory Service
- Lactmed
What OTC medications can be taken in BF?
- Colds/coughs > ibuprofen, paracetamol, throat sprays, lozenges, pholcodine, simple linctus
- Hayfever > sodium cromoglicate, non-sedating antihistamines
- Indigestion > PPIs, ranitidine
- Laxatives > bulk forming, osmotic
- Pain relief > ibuprofen, paracetamol
- Skin > emollients, topical corticosteroids
- Thrush > clotrimazole, fluconazole (150mg STAT dose)
What medications to avoid in BF?
Aspirin, chloramphenicol*, codeine, decongestants, guaifenesin
What POMs not to take in BF?
Amiodarone, aspirin, chemotherapy (including methotrexate), DMARDs, lithium, retinoids
What is mastitis?
Build up/blockage of milk
Symptoms of mastitis?
- One breast becomes swollen, hot or painful
- Lump/hard area in breast tissue
- Nipple discharge
- Flu-like symptoms
- Can be due to problems with breastfeeding positoning
What antibiotics used to treat mastitis?
Flucloxacillin
EHC in BF?
Levonorgestrel 1.5mg STAT licensed to take (stop BF for 8 hours) however safe in breastfeeding, minimal amount excreted (take after a feed)
EllaOne less likely (newer drug, less safety information) however BF avoided for 7 days
IUD also potential option
How long does lactational amenorrhoea last for?
6 months
What contraception options are there and how long after birth to start?
- Progesterone only
(pill - 3 weeks, injection - 6 weeks, implant - 4 weeks) - Combined pill (6 weeks)
- IUD (within 48 hours after birth or at least 4 weeks after)
Is drinking a couple of units when BF harmful?
Unlikely to cause harm, no need to ‘pump and dump’ anymore
Illicit drugs and BF?
Methadone and buprenorphine safe, monitor more and symptoms of baby
What should be done for women who breastfeed?
They should be supported and encouraged
“Breast is best”
