infant feeding Flashcards

Question

special features of colostrum

Answer 1

``` protective factors concentrated nutrition strong anti-inflamamtory factors stimulates gut growth - helps cells and villi proliferate small volumes - intentional laxative effect ```

Answer 2

to clear meconium | helps minimise jaundice

Answer 3

colostrum is smaller volumes and more concentrated new born babies would find the XS water in mature breast milk difficult to process (immature kidneys) healthy term babies don't become dehydrated - surfeit of interstitial fluid they need to process in the first few days

Answer 4

``` gastroenteritis resp infections allergies - mixed evidence obesity T1 and 2 DM SIDS NEC ``` exclusive BF gives best protection but some is greater than none

Answer 5

breast cancer ovarian cancer hip fractures heart disease

Answer 6

may recieve exposure to maternal microbes in the womb lactobacilli more prevalent in the vagina during pregnancy (friendly bacteria) as they pass through the vagina at birth vaginal birth, skin to skin and breast feeding through the mother's milk in the postnatal period and beyond

Answer 7

generate our energy needs produce enzymes to digest food manufacture vitamines B, K and nicotinic acid regulate fat storage manufacture amino acids help w/ iron absorption create our individual immune system and help immune cells reproduce train our immune system on what is safe and what to reject

Answer 8

live constituents in the milk develop the process of setting up the microbiome w/ high levels of bifidobacteria and oligosaccharides

Answer 9

children with insufficient bifidobacteria in their gut in the first year of life have an increased risk of obesity in later life.

Answer 10

miss out on vaginal transfer of microbes | prolonged skin to skin contact and breast feeding

Answer 11

breastfeeding may result in epigenetic changes which impact on: brain development baby's immune system baby's metabolic system

Answer 12

additional info that may be layered on top of the sequence of molecules that make up our DNA epigenome attaches to and modifies the original gene

Answer 13

changes to our genes can be passed down to future generations via maternal line e.g. famine in the netherlands - effect could be seen 3 gens later childhood abuse has been shown to affect DNA patterns - link between victims and ill health in adulthood

Answer 14

in utero - 3yrs alters the way our organs and our predisposition to certain diseases develop

Answer 15

maternal environment during pregnancy | infant's first recieved nutrition

Answer 16

breastmilk has the ability to turn on/off certain epigenetic changes e.g. gene for leptin appetite is influenced by breastmilk babies who are breastfed have higher levels of leptin at 1mth of age formula milk may dampen leptin production and is associated with higher levels of obesity

Answer 17

broncho-mammary pathway: pathogens inhaled entero-mammary pathway: pathogens ingested antibodies produced and sent to breasts antibodies incorporated into breast milk

Answer 18

mother's body works to monitor her environment and produce antibodies to current infections that she detects in her lungs/gut antibodies are passed directly to the breastmilk so baby is provided with protection with as little delay as possible mother and baby need to be together for this to work

Answer 19

international code of marketing of breastmilk substitutes - the code UK law - hasn't yet fully implemented the code professional accountability

Answer 20

prohibits all promotion of bottle feeding and sets out requirements for labelling and information on infant feeding. Any activity which undermines breastfeeding also violates the aim and spirit of the Code. The Code is not an anti-bottle feeding measure. It is as keen to make sure bottle feeding is done as safely as possible as it is to ensure the protection and promotion of breastfeeding.

Answer 21

promote their products in hospitals, shops or to the general public give free samples to mothers or free/subsidised supplies to hospitals or maternity wards give gifts to health workers or mothers promote their products to health workers: any information provided by companies must contain only scientific and factual content promote foods or drinks for babies give misleading information have direct contact with mothers.

Answer 22

intended to ‘regulate labelling and restrict advertising and presentation of infant and follow-on formula so as not to discourage breastfeeding.’ not as robust as the Code and companies are able to find ways around the law. One of the biggest weaknesses is that, while the Code considers follow-on formula (i.e. milk intended for babies over six months) to be a breastmilk substitute, the UK law does not. This allows the companies to promote their brand name and logos via advertising of follow-on milks.

Answer 23

Sponsored study days / smaller education sessions / meetings offered for staff or parents on public service premises Staff attending sponsored study days Individual staff engaging with the companies e.g. by speaking at sponsored events, writing articles, blogs etc. for the companies Awards and other gifts being made to individual staff by the companies or by a separate organisation which is being sponsored by the companies.

Answer 24

``` 1st milks for 1st yr - no need for follow on all brands are similar information on prep and sterilising cow's milk from 1yr responsive bottle feeding ```

Answer 25

baby is held close and feeds are paced | important to reduce overfeeding and obesity

Answer 26

lactogenesis 1 - breast development and colostrum production from ~16wks gestation 2 - onset of copious milk secretion occurring between 32 and 96hrs after birth 3 - maintenance of milk production

Answer 27

differentiation of alveolar epithelial cells into lactocytes that secrete colostrum from ~3-4mths of pregnancy

Answer 28

occurs in response to risk in prolactin and a decrease in pregnancy hormones milk will come in regardless of whether a woman wants to breastfeed or not

Answer 29

appear on the areola to secrete an antiseptic sebum to lubricate the area sebum also creates a scent to entice the baby to begin to search in the area for their first feed

Answer 30

oestrogen and progesterone levels drop prolactin and oxytocin levels rise in response to touch, smell and sight of baby baby begins spontaneous breast seeking behaviour mothering behaviours initiated

Answer 31

the more early, frequent surges of prolactin there are, the greater the number of receptor sites that become primes max number of receptor sites = max numbers of functioning lactocytes from that point onwards, max triggering of the mothering response

Answer 32

responsible for milk production responsive to touch and stimulation levels higher at night frequent contact/feeds sets up for long term production

Answer 33

responsible for milk delivery acts on muscle cells in pulsatile action levels higher when baby is near stress can temporarily delay 'let down'

Answer 34

increase the most in the immediate postpartum period rise and fall in proprotion to the frequency, intensity and duration of nipple stimulation concentration in the blood doubles in response to suckling and peaks ~45mins after the beginning of a breastfeeding session levels fall ~50% in the first week after birth in breasfeeding women if women don't breastfeed, levels reach non-pregnant levels by 7 days postpartum

Answer 35

levels will remain high as long as baby is kept close and milk will start to be release in response to early feeding of behaviour clues if baby is away from mum these early clues might be missed, if mum can only respond when her baby is crying and distressed her own cortisol levels will be raised and compete w/ oxytocin

Answer 36

prolactin and oxytocin work together to help a new mother feel calm yet protective of her baby oxytocin helps form a bond between mother and baby

Answer 37

Circulating prolactin within bloodstream controls milk production especially in the early weeks post birth. Volumes can be irregular at first so mothers may experience full breasts and leaking as the supply and demand establishes itself. As breasts become very full either through ineffective milk removal or long spacing of feeds a whey protein in the milk called FIL slows down synthesis by signalling to the cells to stop production. In addition it is believed that the down regulation (reduced milk production) is also caused by pressure within the full breast flattening and expanding the cells and the receptor sites, making it difficult for prolactin to attach to and enter the cells.

Answer 38

``` works on feeling and emotions lowers BP and improves sleep reduces stress levels by 'taking on' cortisol reduces pain sensitivity boosts immune system ```

Answer 39

all mothers have skin to skin contact w/ baby after birth at least until after the first feed and for as long as they wish all mothers are encouraged to offer the first feed in skin contact when the baby shows signs of readiness to feed mothers and babies who are unable to have skin contact immediately after birth are encouraged to commence skin contact as soon as they are able

Answer 40

triggers lactation and mothering hormones regulates temp, HR and breathing in baby colonises baby w/ microbes from mother, father and their environment stimulates feeding behaviour reduces stress hormones in mother and baby

Answer 41

triggers mothering hormones regulates temp, HR and breathing in baby colonises baby w/ microbes - esp important if not recieving breastmilk reduces stress hormones in mother and baby starts mother-baby bond

Answer 42

``` birth cry relaxation awakening activity rest crawling familiarisation suckling sleeping ```

Answer 43

after birth | distinctive cry familiar to midwives as baby expands his lungs

Answer 44

after birth cry no mouth movement hands and body totally relaxed

Answer 45

2-4 mins after birth small thrusting movements of head and body eyes beginning to open some shoulder movement

Answer 46

4-12 mins after birth | stable open eyes, rooting, salivating, hand to mouth, hand to breast to mouth, tongue protrusion

Answer 47

frequent after birth | lots of rest periods after activity

Answer 48

18-54 mins after birth crawling, sliding, leaping and drawing up knees to push forward lots of rooting searching

Answer 49

29-62 mins after birth VERY important stage - can last 20 mins or more licking nipple, touching, massaging breast begins to interact with mum and dad stimulating mum's hormones

Answer 50

49-90 mins | self attaches after working out best approach and begins to feed

Answer 51

90-120 mins

Answer 52

raised after birth - help support transition to extra uterine life these decrease when baby begins to feel safe in a known environment as levels drop baby begins to display activity and becomes more awake and interested in their environment

Answer 53

enables baby to consolidate and integrate what they have already experienced all to do with imprinting and shouldn't be rushed

Answer 54

helps baby move closer to the breast | massages mother's uterus, helping it to contract - important for oxytocin release but also helps prevent PPH

Answer 55

baby approaches mother's breast, spends time imprinting and working out how best to approach and attach for feeding if rushed by staff (putting baby onto the breast) this can result in baby struggling to attach at subsequent feeds - biggest reason many mothers stop breastfeeding in the early weeks

Answer 56

term baby separated for 6 hrs has increased stress pre-term baby receiving high-tech care has greatly increased stress one hour of skin contact can reduce stress hormone levels by 75%

Answer 57

attachment challenges - overhelped, pain and discomfort boosting milk supply unsettled babies and mothers breast refusal postnatal depression or low mood - oxytocin and prolactin and released which are both mood boosters, baby will also feel nurtured and safe just because it feels good - mums and dads

infant feeding Flashcards

(81 cards)