Breastfeeding Flashcards
(29 cards)
exclusive breastfeeding rates
Globally 38%
Sub Sahara 31%
South Africa 8%
why are low rates of BF a problem
Risk of diarrhoea, malnutrition & pneumonia increases with decreased rates of breastfeeding.
how HIV mother breastfeed?
National Department of Health resolves that South Africa promotes, protects and supports exclusive breastfeeding and adopts the WHO guidelines on HIV and infant feeding
This recommends that all HIV-infected mothers should breastfeed AND receive antiretroviral drugs to prevent HIV transmission
what does the data show in terms of rates
Rates of exclusively breastfed babies decrease as the babies increase in age
Consistently see an amount of about 20% of babies who are never initiated on breastmilk
Decreased duration of breastfeeding from 16.6 months to 5.9 months
Consistently high rates of mixed feeding
MBFI Ten Steps to successful breastfeeding
- written breastfeeding policy that is updated and communicated to staff
- train HCW in skills to implement the policy
- inform women about the management and benefits during antenatal care
- help mothers to initiate an hour after birth and practice skin to skin for an hour unhurried
- show mothers how to breastfeed, maintain lactation and even if separation is necessary
- do not give the infant anything else
- practice rooming for 24 hours a day
- encourage breastfeeding on demand
- don’t give artificial teats
- Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.
which law is used for formula companies
Compliance with the International Code of Marketing of Breastmilk Substitutes & Regulations relating to Foodstuffs for Infants and Young Children (SA)
MDGs that breastfeeding aligns with
- sustainable foot security
- under nutrition reflects gender bias
- contributes to development and capacity
- can reduce mortality by 13%
- role in safe motherhood
- doesn’t require any other resources - natural
- breastfeeding and ARTs are safe
- fosters multi-sectorial collab
mammogenesis
prep breasts
lactogenesis
synthesis and secretion from breast alveoli
galactokinesis
milk ejection
galactopoesis
maintenance of lactation
lactation control
suckling –> hypothalamus –> pituitary –> prolactin = milk production and oxytocin = milk release
Prolactin: secreted AFTER the feed to produce the NEXT feed; sensory impulses from nipple get sent to the anterior pituitary to produce prolactin; more prolactin secreted at night; it also suppresses ovulation
Oxytocin: works BEFORE or DURING the feed to make milk FLOW; sensory impulses from nipple to posterior pituitary; also makes uterus contract
what is in breastmilk?
Fat
Carbohydrate (lactose)
Protein
Vitamins: Fat soluble vitamins (A, D, E & K) & Water-soluble vitamins : Vitamin C
Minerals and trace element: Zinc & Calcium
Anti-infective factors: Immunoglobulin, Lysozyme, Lactoferrin, Bifidus factor, Hormones and growth factors
Water
Calories
Sodium
frequency of feeds according to?
weight
<1.5kg
12 feeds per 24hr
Via tube / cup as tolerated
1.5-2.5kg
8 feeds/24hr
Via tube / cup as tolerated
2.5kg and >1 month
6 feeds/24hr
Oral
benefits of breastfeeding
Provides all nutrients for growth, development & immunity
- Protection against infections & illnesses
Contributes to birth spacing
Helps the mother’s uterus to contract, reducing risk of postpartum haemorrhage
Lowers rate of breast & ovarian cancer in mothers
Promotes weight loss in mothers
Promotes emotional relationship/bonding between mother and infant
Requires no preparation; correct temperature; always available; cost-saving
Short term: reduced risk of gastrointestinal and respiratory infections & allergy
Long term: reducing the risk of diabetes, obesity and cardiovascular disease
how breastfeeding and PrEP affects HIV risk
Exclusive Breast
6 wks – 6 months
None
4%
Mixed
Breast/Formula
6 wks – 6 months
None
8%
Mixed Breast / solid foods
6wks – 6 months
None
UP TO 40%
Exclusive Breast
6 wks – 6 months
NVP
2.6%
Exclusive Breast
6 wks – 6 months
Mother ART
1.1 %
effective breastfeeding
Initiate immediate skin-to-skin contact
Rooting
Positioning & attachment
Effective suckling
Exclusive breastfeeding
correct position
Head & whole body well supported & held close to mother
Bring baby towards breast, NOT breast to baby
Face & stomach face the mother
Ear & shoulder are in one straight line, neck is not twisted
correct attachment and why ?
Mouth covers most of areola (dark part of the nipple) with some of the areola visible above the mouth
Mouth is wide open
Chin touches the breast
Lower lip is turned outwards
–> Correct attachment position is vital to achieve adequate seal, sufficient negative pressure and an adequate sucking mechanism for effective milk transition
how do you know there is effective suckling?
Slow, deep firm sucks alternating with bursts of suckling
No other sounds except swallowing sounds are heard
common problems with breastfeeding
> inadequate lactation
engorged breasts and blocked milk ducts
cracked or fissured nipples
mastitis and breast abscess
mx for inadequate lactation
Can gauge if actually insufficient by checking baby’s weight gain/loss, and ensuring baby passing sufficient “wet” nappies per day (on average 6/day is sufficient)
Manage by educating hunger cues, breast feed on demand, mom to drink enough fluids and get enough rest.
identifying engorged vs full breasts
FULL BREASTS
- full
- hot not painful
- heavy
- milk flows
- no fever
ENGORGED BREATHS
- overfull
- hot and painful
- heavy and oedema
- hard areola that is shining and red
- no milk
- fever
