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Flashcards in Breastfeeding and Newborn Nutrition Deck (31)
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Golden Hour

- Time right after birth
- Great time for bonding and breastfeeding
- Also Q15 vitals for 1st hour and assessment of fundus and lochia (drainage from placental site)


AAP Breastfeeding Recommendations

- Exclusive breastfeeding for first 6 months of life
- Continue breastfeeding for at least 12 months



- The first milk
- Contains higher amounts of WBCs and antibodies
- High in IgA (coats baby's intestines and prevents invasion of germs)
- Secretory IgA protects infants from viruses, bacteria, food allergies


Breastfeeding Benefits to Mother

- Promotes weight loss from burning calories (should consume 500 extra calories/day)
- Releases oxytocin: helps uterus return to normal size
- Delays ovulation: prevents becoming pregnant too soon
- Reduces future development of osteoporosis
- Improves health of diabetic women and protects infant from juvenile diabetes
- Reduces chance of developing breast, uterine, endometrial, ovarian cancer


Breastfeeding Benefits to Baby

- Protective immunity from maternal antibodies
- Lower incidence of ear infections, respiratory infections and asthma
- SIDS risk is 56% lower in breastfeeding infants
- Long term benefits against certain chronic illnesses (diabetes, childhood obesity, HTN, GI disease)


Breastfeeding Benefits to Family/Society

- Convenient
- No bottles necessary
- Less expensive
- Decrease work absence
- Reduce annual health costs
- Reduced environmental burden


Baby Feeding Cues

- Hand to mouth
- Sucking motions
- Rooting
- Mouthing
- Pay close attention to these! Crying is a late sign



- Cradle, seated, cross-cradle, side-lying
- How to choose the right position: maximize comfort and facilitate latch
- Side-lying promotes maternal rest



- Placement of infant mouth over the nipple, areola, and breast
- Crete adequate suction for milk removal
- Facilitates better emptying of the breast


Role of Healthcare Provider in Breastfeeding

- Endorse and encourage breastfeeding because it is best for mom and baby
- Provide positive statements about breastfeeding
- Offer confirmatory words from all office staff
- Distribute appropriate education materials
- Be supportive no matter what the woman plans
- Establish positive attitudes in pregnancy
- Address medical issues/physical obstacles
- Encourage nursing immediately after delivery
- Provide post-partum support
- Explain nutritional needs
- Ask about previous experience


Sore Nipples

- May result from improper latch on or disengagement: Areola must be placed in infant's mouth, Must place finger in infant's mouth to break suction
- May result from use of abrasive soaps or alcohol: rinse nipples with water and air dry after nursing
- Burning throughout breast: may be caused by yeast infection and treated with Mycostatin


Engorged Breasts

- Usually occurs 2-3 days post partum from increased blood flow and milk supply
- Wear a supportive nursing bra that isn't too tight
- Nurse frequently: every 1-3 hours
- Take a warm shower before breastfeeding


Symptoms of Mastitis

- Breast pain
- Swelling
- Flu-like symptoms
- Headache
- Fever


Causes of Mastitis

- Coagulase-positive Staph auerus
- Clogged ducts, cracked nipples, feeding on one breast only
- Tight bra, wet breast pads, infrequent feeding
- Anemia, fatigue, stress


Treatment of Mastitis

- Nurse frequently, on unaffected breast first
- Apply moist heat before nursing
- Rest, wear comfy bra, change breast pads often
- May require antibiotics
- Ibuprofen and acetaminophen


Milk Ejection Reflex

- Let down reflex
- Oxytocin release


Nipple Variations

- Grade 1: everted with stimulation and maintains projection
- Grade 2: flat but comes out with stimulation but not as easily as Grade 1
- Grade 3: inverted, very difficult to evert and promptly retracts after stimulation


Signs of Ineffective Breastfeeding

- Less than 6 wet diapers per day after day 4
- Less than 3 stools per day after day 4
- Meconium after day 4
- Painful nipples during feeding
- Damaged nipples
- Milk not in by day 4
- Baby is feeding constantly
- Gaining less than 0.5 ounce/day after day 4
- Baby has not regained birth weight by day 10


Milk Storage and Prep

- Store in hard containers
- Room temp: 8 hours
- Fridge: 5 days
- Freezer: 6 months
- Deep freezer: 12 months
- Thawing: fridge, warm water, shake
- Warming: Warm water, no microwave


Factors that may impede breastfeeding

- Poor support system
- Demographic factors: maternal education level, being single, socioeconomic status
- Postpartum depression


Use of meds/drugs during breastfeeding

- Consider risks vs benefits
- Most meds that are applied to skin, inhaled, applied to eyes/nose are safe when breastfeeding
- Most vaccines are safe (flu, DTAP)


Caffeine in breastfeeding

Moderate amounts (no more than 2 cups/day) is probably not harmful to infant


Alcohol in breastfeeding

- Freely distributes into milk and will be ingested by infants
- Pump and dump


Cigarette smoking in breastfeeding

- Not recommended
- Nicotine and byproducts are detectable in milk


Drugs that will dry up breast milk

- Antihistamines
- Sedating meds
- Decongestants
- Weight loss meds
- Diuretics
- High doses of vitamin B6
- Hormonal contraceptives containing estrogen
- Nicotine


Ways to dry up breast milk

- Tight fitting bra/binding the breast
- Cabbage leaves
- Do not stimulate breast
- No meds are given to dry up milk


Candidiasis Thrush

- Yeast infection of the breasts
- Both parties need to be treated with anti-fungal
- Painful, sore nipples
- Feels like broken glass


Formula Feeding

- Start first feeding after transition
- Infant should appear stable
- Pattern: 10-15 ml/feed at 24-48 hours, increase to 90-150 ml/feed after 2 weeks
- 3-4 times/day
- Appetite increases at 10 days, 3 weeks, 3 months
- Technique: sit comfortably, hold infant close, semi-upright, good head support, don't prop bottle, keep nipple full


Spitting up from formula feed

- Decrease amount
- Feed small and often
- Vomiting 1/3 of feed or projectile vomiting should be reported


Bottles and Nipples

- Wash with warm soapy water
- Angled nipples are better