Breastfeeding Flashcards
what are the constituents of clolostrum
High levels of immunoglobulins particularly lactoferrin
High in Na and Kcl (Babies Na and Kcl deficient due to immature kidneys)
what are the actions of colostrum
Strong anti-inflammatory effect (reduces NEC)
Stimulates gut growth
Packed with HMO (human milk oligosaccharides so sets up the friendly bacteria)
Acts as a laxative (clears out meconium, Stimulates gut motility – reduces risk of neonatal jaundice)
Initiates acidic pH environment (inhibit growth of pathogenic bacteria)
what are the benefits of skin to skin contact
Triggers lactation and mothering hormones
Regulates temperature, heart rate and breathing in baby
Colonises baby with microbes from mother father and the environment they will be part of
Stimulates feeding behaviour
Reduces stress hormones in mother and baby.
what management for nipple trauma
Observe feed and review positioning and attachment/Check pump use
May need to rest and express if Mum cant stand to have baby on but revisit where nipple will be with effective attachment
Lanolin, barrier cream to aid moist wound healing
Pain relief
what can cause breast engorgement
Delay in first feed Ineffective positioning and attachment Restricted feeding Ineffective emptying Supplementation
what are the signs and symptoms of breast engorgement
The breasts look shiny because of the oedema and can be painful.
The milk does not flow well due to increased pressure in the breast.
The breast (s) may be red
The mother may be feverish.
breast will feel lumpy and painful
what is the management for engorgement
Effective drainage is urgently needed to prevent suppression of milk production.
Express prior to the feed to release the pressure in the breast
Hand expressing is ideal and less traumatic.
Warm baths or warm compresses prior to expressing/feeding are helpful and soothing.
Ensure good attachment and complete emptying of at least one breast per feed with the second side also softened by the baby feeding or by expressing fore milk.
Mild analgesia, e.g. Paracetamol or Ibruprofen will help discomfort and reduce the temperature.
Cold compresses, cold gel packs or cold, uncooked cabbage leaves can soothe and reduce oedema after or between feeds.
Antibiotics are unhelpful and may lead to Candida infections.
encourage to continue breastfeeding
what can cause mastitis
plugged milk duct breast infection Poor positioning and attachment Infrequent feeds Consistent breast pressure (bra, clothing) Dummies Supplementation Trauma
what is the pathogenesis of mastitis
blocked duct (small palpable lump, mother looks well) localised inflammation (increasind discomfort, redness, tenderness) systemic response (hard, red lobes, severe pain, mother feels ill with fever and flu like symptoms, nausea and vomiting) if untreated can form abscess
what antibiotics for mastitis
flucloxacillin 1g 4x per day
if allergic clindamycin
what is the treatment for a breast abscess
aspiration// surgical drainage
how can a breast abscess be differentiated from mastitis
abscess= more localised inflammation and the presence of a regularly-shaped lump
when should medications be taken in pregnancy
best taken as a single dose and should be administered before the baby’s longest sleep period
Breastfeeding is best done immediately before administering the dose and should be avoided for one to two hours after any dose of medication
