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Flashcards in Lactation Ch 6 (SG) Deck (20)
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1

Describe the action of hormones involved with lactation (oxytocin and prolactin).

1. prolactin: stimulates milk production
-released when suckling, stress, sleep
-↓ ovulation & likelihood of getting prego again
2. oxytocin: stimulates the letdown (release of milk fm the breast)
-helps uterus to get back to norm (uterus contracts/shrink)

2

Identify main characteristics in colostrum.

COLOSTRUM:
:1st milk secreted during the 1st few days postpartum (3-5 days)
-mature milk day 15
-transition milk: 5-15 days
-immunity: high in proteins (IgA&lactoferrin)

3

Identify main characteristics in mature human milk (foremilk and hindmilk).

1. FOREMILK:
-1st milk baby starts getting
-> watery (helps w/ hydration)
-↓ lipid content
-some CHO (esp lactose)
2. hindmilk (2nd half of milk; end of feeding)
-rich in lipids (for energy)
-> CHO (oligosaccharides)
*empty 1 breast before the other to get fore&hindmilk

4

What are the benefits of breastfeeding to the mother? (3)

1. hormonal benefits
-↑ oxytocin stimulates uterus to return to pre-prego
2. physical benefits
-prolactin: delay on monthly ovulation ∴longer intervals between pregnancies
3. psychological benefits
-↑ self-confidence & bonding w/ infant

5

What are the benefits of breastfeeding to the infants?

1. IMMUNOLOGICAL benefits
-↓ infant mortality in developing countries (sanitation)
- reduce acute illnesses
2. REDUCTIONS IN CHRONIC ILLNESSES
- reduce risk of celiac disease, IBS (irritable bond syndrome), leukemia
- reduce risk of allergies and asthmatic disease
- peanut allergies during prego/breastfeeding
= ↓ risk of allergies
3. BREASTFEEDIDNG & CHILDHOOD OVERWT
- typically breastfed infants are leaner @ 1 yr of age
4. COGNITIVE BENEFITS
-Studies: ↑ in cognitive ability even after
adjusting for family environment
-edu & socioeconomic status (related to presence of DHA-cognitive ability)
5. ANALGESIC EFFECTS of BM
- Reduction of infant pain when BF
6. Socioeconomic benefits
- ↓ illness = ↓ need for medical care
- < likely of kid being ill = ↓ days missed at work
-formula is expensive, affect cost of families

6

What factors influence milk production/supply?
:milk synthesis

Milk synthesis is related to:
1. How vigorously an infant nurses
2. How much time the infant is at the breast
3. How many times per day infant nurses
*demand of how much milk is being removed from the breast = > milk will be produced
-*important to empty one breast before the other
*demand is going to ↑ the production

7

what are the nutritional benefits of BF for infants? (8)

1. widely recognized
2. HMS use HM as a standard
3. nutrients are balanced
4. HM is isosmotic = help w/ hydration
5. meet infant's protein needs w/o overloading kidney
6. > digestible
-has soft, easily digestible curd
7. provides generous amounts of the right lipids
- >energy dense
8. minerals are > bioavail
(formula mimiks HM)

8

?What are some of the common problems/concerns new mothers have when breastfeeding?

1. Main worry: worry not providing BM to infant
2. can the woman make enough milk?
3. will breast size will affect ability to breastfeed
4. feeding frequency related to amount of milk a woman makes?

9

What factors influence milk production/supply?
:Does breast size limit a woman's ability to nurse?

NO, the size of the breast does NOT limit a woman’s ability to nurse
-adipose storage is the difference
-smaller breast may hold < milk, BUT milk production is the SAME

10

What factors influence milk production/supply?
:Is feeding frequency related to the amount of milk a woman makes?

Rate of milk synthesis is variable between breasts & between feedings
-smaller breast may have to feed > frequently bc can store less in breast

11

What behaviors indicate the infant readiness to feed (hunger cues)?

HUNGER is signaled by infant:
1. Bringing hands to mouth, sucking on fingers, & moving head from side to side
2. Crying is late sign of hunger

Allow infant to nurse on 1 breast as long as they want to ensure they get foremilk & hindmilk w/ its ↑ fat content that provides satiety

*Note: High lactose content of foremilk may cause diarrhea

12

How would you evaluate breastfeeding malnutrition?

Evaluate at mom & infant - what is the cause?
MATERNAL CAUSES:
1. Poor production of milk:
Mom have poor energy intake? <1500 cals?/day
-illness?
Poor letdown
-smoking? latching? stimulation from bb?

infant causes:
POOR INTAKE
-sucking inefficiencies or mouth
-excess times between feedings
ILLNESS: vomiting, diarrhea, infection
↑ ENERGY NEEDS: baby may need additional supply besides BM

13

Identifying Breastfeeding Malnutrition: generalization facts

Normal weight loss for newborns
-~7% of birthweight in 1st week / 1st 5days
-Weight loss of 10% or > needs evaluation by lactation consultant
- not enough nutrients

14

Identifying Breastfeeding Malnutrition: signs of malnutrition (4)

Malnourished infants become sleepy, non-responsive, have a weak cry, & wet few diapers
-By day 5 to 7, infants should have 6 wet diapers & 3-4 solid diapers per day -towards end of 1st wk (start happening around day 5)

amount of wet diapers will give you an idea of how much milk they're intaking

15

Describe vitamin supplement recommendations for breastfeeding infants.

Bbs exclusively breastfed don't usually develop deficiencies
Vitamin K (bleeding): all U.S. infants receive vitaK injections at birth
-5% births in US
-but parents can opt out
Vitamin D: exclusively breastfed infants need supplements @ 2 months
No recommendations for fluoride or iron

Ricketts: childhood bone disorder where bones soften & become prone to fractures and deformity. ( ) legs

1st 6 months of infants lives off iron storage
-emphasize iron rich food when 1st introduce infant w/ solids

16

What are the basic maternal diet recommendations for breastfeeding women?

MyPlate Food Guide has been adapted for prego & breastfeeding women
DIETARY GUIDELINES
-Moderate wt reduction can be achieved w/o
compromising the wt gain of the infant
Diets formed around a MyPlate food plan for prego & breastfeeding women provide
-Healthy assortment of nutrients at specified calorie levels for each stage of breastfeeding

17

What are the recommendations for post-partum weight loss during breastfeeding?

Wt loss during breastfeeding
-caloric DRI assume a loss of 0.8 kg/month
-Most women do not reach prepregnancy wt by 1 yr after birth
-Modest or short-term energy reductions do not ↓ milk production (~500 kcal, but not <1500 kcal/d)
-ie: 2300+500-500, if want to lose wt

18

What are the current breastfeeding recommendations?

Breastfeeding Goals for the United States:
-Healthy People 2020 breas4eeding objectives:
-↑ proportion of infants breastfed
-↑ duration of breastfeeding
-↑ worksite lactation programs
-↓ formula supplementation in first 2 days of life
-↑ births in facilities providing recommended care for breastfeeding mothers

19

Discuss barriers to breastfeeding initiation.

1. Embarrassment
-mom can train body for < frequency, but > volume
2. Time & social constraints
3. Lack of support from family & friends
4. Lack of confidence
5. Concerns about diet & health
6. Fear of pain: not done properly & pain (esp in 1st wk)

20

Discuss barriers to breastfeeding at the workplace.

1. Barriers exist such as lack of on-site day care
2. Insufficiently paid maternity leave
3. Rigid work schedules
4. Lack of understanding/knowledge by employers
5. Legislation is in progress to support breastfeeding or pumping in the workplace