infection/inflammation in breast that occurs in 33% of breastfeeding women - may result from sore or cracked nipples, and missing a feeding

Lactation Conditions and Interventions Flashcards by Sydney Perry

what is the second highest reason mothers discontinue breastfeeding?

sore nipples

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early mild nipple discomfort is common, but usually subsides after ___________

first week to 1 month

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sore nipples can be prevented by ___________________

proper positioning of baby on breast

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list some main reasons for nipple pain

bad latch
improper release of suction
infection
wrong size flanges in pumping
oversupply

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what is flat nipple

nipple appears level with surrounding tissue

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what is inverted nipple

nipple drawn into the surrounding tissue

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does inverted nipple or flat nipple affect breastfeeding?

not if the latch is correct

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what is letdown failure?
treatment?

when milk does not eject from the breast
- very uncommon
- relaxation techniques
- oxytocin nasal spray

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what is hyperactive letdown?

streams of milk coming from the breast is too active, and maya use baby to choke/gulp/cough while nursing

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what is the management for hyperactive letdown?

wait for milk flow to slow down before putting the infant to the breast

express milk until flow is lower, then allow baby to latch

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what is hyperlaction?
management for hyper lactation?

milk volume exceeds intake of the baby

-reduce production through cabbage leaves or cold compress

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what is engorgement?

breasts are overfilled with milk
- results when supplies;y and demand process is not yet established and milk is abundant

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what is the prevention for engorgement?

nurse frequently
- newborns may nurse every hour and a half

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what is a plugged duct?

hard, often painful area of the breast, swollen with milk because of temporarily poor milk drainage

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how to treat plugged duct?

massage and warm compress
complete emptying of breasts and changing position while feeding

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what is mastitis?

infection/inflammation in breast that occurs in 33% of breastfeeding women

may result from sore or cracked nipples, and missing a feeding

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mastitis can be infective or non-infective and is most common at _____ weeks postpartum.

2 to 3 weeks

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what is the most common reason for cessation of breastfeeding

low milk supply

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a few causes we can consider when there is low milk supply?

insufficient breastfeeding or pumping
ineffective emptying
inadequate milk removal
suboptimal hormone balance

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how to manage low milk supply

assessing the pumping
try guided imagery while expressing milk
nutritional management

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many herbs like traditional ______ are not currently considered appropriate during lactation. avoid herbs such as ___, ____, _____, and ____.

galactogogues

castor bean
jasmine flower
fresh parsley
sage

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data on the specific herbs…
- echinacea
- ginseng root
- St. John’s wort
- Fenugreek
- Goat’s rue and milk thisle/blessed thistle

echinacea - insufficient data
ginseng root - not advisable
St. John’s wort - may reduce milk supply
Fenugreek - may increase milk supply,infants may have rxns
Goat’s rue and milk thistle - increasingly used as galactogue

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most maternal medications are likely to be prescribed to the nursing mother have ____ effect on milk supply or on infant well being

little

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radioactive compounds (_______), and street drugs are always _____

antimetabolites
contraindicated (should not be used)

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what is the ratio of the concentration of drug in milk to the concentration of the drug in maternal plasma

milk/plasma drug concentration ratio (M/P ratio)

what is the exposure index

average infant milk intake per kilogram body weight per day x 100

does oral contraceptives mess with milk ?

OC's may reduce milk volume

recommendation for OCs while breastfeeding

avoid use of combined Ocs from 6 weeks to 6 months postpartum progestin-only OCs ("mini pill")

level of alcohol in breastmilk is ____ peak plasma levels occur at _____ after consumption without food. _____ if with food

same as in maternal plasma 30-60 min 60-90 min

nicotine risks for infants include?

otitis media asthma respiratory infections GI dysregulation

recommendation for nicotine and breastfeeding

better to smoke and breastfeed than smoke and not breastfeed

affects of marijuana to baby from breastmilk include ?

may change DNA/RNA and proteins needed for growth

caffeine affect on infants from lactation

moderate intake causes no problems 1% in milk compared to blood plasma may accumulate in infants 3-4 months old may interfere with sleep or hyperactivity & fussiness

amphetamines, cocaine, heroin, and phencyclidine (angel dust, PCP) are classified by the _____ as drugs of abuse

AAP

opioids such as ____ and ____ should not be continued if breastfeeding

codeine tramadol

jaundice (_________) is a yellow color of the skin seen in about ____ of full term and ____ of preterm infants

hyperbilirubinemia 40% 80%

most frequent readmission for newborns is _____

jaundice

want jandice to be under ______

7 ml/dL

what is a form of brain damage caused by excessive jaundice

neonatal kernicterus

what is biliruben?

byproduct of the normal physiologic degradation of hemoglobin - a pigment produced as heme from RBC break down

after birth, released hemoglobin is broken down by ________________. production in neonate is double an adult because of _______

reticuloendothelial system breakdown of fetal erythrocytes

yellowing from jaundice should disappear from ____ first

feet

bilirubin is usually processed by ____ and excreted in babys stool

liver

why is jaundice so common

newborns liver not fully mature

Physiological newborn jaundice - time frame? - levels? - resolution? - cause?

- begins after 1st day of birth and rises with peak at day 5 - bilirubin less than 12 mg/dL - resolves withing a few days - normal heme breakdown

Pathological newborn jaundice - time frame? - levels? - resolution? - cause?

- begins within 1st day and rises rapidly and lasts longer - levels more than 8 mg/dL - medical intervention with phototherapy - various pathological conditions

bilirubin encephalopathy or kernicterus mortality rate is ______. May cause _______-

50% - cerebral palsy - hearing loss - paralysis of upward gaze - intellectual handicaps

early jaundice vs. late jandice

early - breast-nonfeeding jaundice - breastfeeding jaundice late - breast milk jaundice

breast-nonfeeding jaundice babies may occur because _________, usually resolves in _____ of birth

nursing infrequently or inefficiently 1-2 weeks

breast-milk jaundice syndrome become apparent after the _______. Some causes could invlove__________

3rd day - substance in most mothers milk that increases intestinal absorption - individual variations in the infants's ability to process bilirubin

The AAP guidelines recommend phototherapy using ______________ Light is absorbed in bilirubin changing it to ____________ that can be excreted via the _____ AAP guidelines encourage continuation of breastfeeding

fluorescent lights a water soluble product kidneys

main obsticle of breastfeeding multiples is _______

time and fatigue of the mother

exclusive breastfeeding for ≥4 months protects against ______ and _____

dermatitis and wheezing

evidence on gassy foods in mothers diet causing baby to have gas?

no relation

low allergin maternal diet can help resuce distressed behavior in ____

colic

Late preterm infants are born ____ weeks and may have subtle immaturity making _____ difficult. several complications include _____

breastfeeding - carido-respiratory instability - poor temoerature control - lower glycogen and fat stores - immature immune system - week suck-swallow coordination

in a preterm baby, they should be fed through _________ and should be _______ if they weigh less than_____

breastmilk fortified 1.5 kg

infant should not be brestfed if diagnosed with _______

galactosemia - genetic metabolic disorder

HIV ______ be transmitted to infant by breastmilk.

can be

transmission rates of HIV thru breastmilk is ________ depending on duration of breastfeeding

5-20%

breastfeeding during pregnancy is _____

safe and the mothers choice

Milk banking provides human milk to infants who_____________ ___________ infants are most likely to receive banked milk Women are carefully ______ before they can donate extra milk to milk bank

- cannot be breastfed by their mothers - Premature and sick - screened