Breastfeeding Flashcards
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
