Lecture 8

Question 1

Energy needs during lactation

Answer 1

Total energy cost of lactation derived from energy content of milk plus the energy required to produce it

Question 2

Estimated energy requirements of lactation
0-6 months postpartum:

Answer 2

2000 kJ above NPNL

Question 3

Estimated energy requirements of lactation
>6 months postpartum

Answer 3

1680 kJ above NPNL

Question 4

Breastfeeding and weight loss: Studies suggest that in the first 3 months postpartum

Answer 4

the rate of weight loss is similar in lactating and non lactating women

Question 5

Breastfeeding and weight loss:
Several studies have reported that women who lactate

Answer 5

longer and more intensively lose weight more rapidly between 3 and 6 months postpartum than women who exclusively bottle-feed or those who lactate less fully or for a shorter duration

Question 6

Exclusive breastfeeding
Before 2001 recommendation:

Answer 6

Recommended EBF for 4-6months

Question 7

Exclusive breastfeeding
After 2001 recommendation:

Answer 7

Recommend EBF for the first 6 months

Question 8

The review concluded that infants EBF to 6 months experienced

Answer 8

less morbidity from gastrointestinal infection but there were no differences in growth between EBF periods

Question 9

Recommended after 6 moths of EBF

Answer 9

Thereafter, infants should receive complementary foods with continued breastfeeding up to 2 years of age or beyond

Question 10

Ozfits vs first foods ????

Answer 10

First foods is better for initiated breastfeeding, exclusive breastfeeding, any breastmilk (5-6mo) and any breastmilk (10-11mo)

Question 11

breastfeeding practices

Answer 11

vary widely across regions some regions face greater challenges than others

Question 12

Human infants and young chilren are most likely to ……….. when breastfed

Answer 12

Most likely to survive, grow and develop to their full potential when breastfed

Question 13

When the increase of fluids anything other than breastmilk then the more percent chance

Answer 13

there is going to be problems with breastfeeding

Question 14

Exclusive breastfeeding means

Answer 14

That from birth the babu receives only breast milk (from the breast or expressed) and prescribed medicines, where necessary.

Question 15

Partial breastfeeding means

Answer 15

That the baby receives some breast milk (from the breast or expressed) and some infant formula or other solid food

Question 16

Benefits of breastfeeding for the baby:

Reductions in infant morbidity and mortality

Answer 16

• Protects against gastrointestinal infections
  -Protects against respiratory illnesses
  -Reduced otitis media infections
  -Reduced risk of SUDI

Question 17

Benefits of breastfeeding for the baby:

Reductions in chronic disease

Answer 17

-Allergic disease
-Type 2 diabetes
-Obesity in childhood

Increased cognitive function

Question 18

Benefits of breastfeeding for the mother

Answer 18

Protects mothers health
- Helps reduces risk of uterine bleeding and helps the uterus to return to its previous size
-reduces risk of breast and ovarian cancer
-Reduced risk of postpartum depression

Helps delay a new pregnancy

Helps a mother return to pre-pregnancy weight more rapidly

Question 19

So why are EBF rates low then

Answer 19

• Marketing of breast milk substitutes
• Lack of workplace support
• Lack of attendance or availability to antenatal care
  -lack of accessible lactation/breastfeeding support
  -societal or cultural beliefs

Question 20

Globally what is the percentage of EBF infants ages 0-6 months

Answer 20

48%

Question 21

what is the global target by 2030 with EBF

Answer 21

Increase the rate of exclusive breastfeeding in the first 6 months up to at least 70%

Question 22

services to support breastfeeding

Answer 22

Plunket- breastfeeding has been on the top 4 of most frequently asked questions

Question 23

National -La Leche League

Answer 23

-established in 1964
-Currently 140 Leaders and 50 groups

Question 24

International Baby friendly Hospital Initiative (BFHI)

Answer 24

BFHI launched in 1993 established by UNICEF and the world health Organisation to ensure that all maternities, whether free standing or in a hospital, become centres of breastfeeding support

Question 25

A maternity facility can be designated 'baby friendly' when

Answer 25

it does not accept free or low cost breast milk substitutes, feeding bottles or treats, and has implemented 10 specific steps to support successful BF

Question 26

The Ten steps to successful BF (first 5)

Answer 26

1- Have a written BF policy that is routinely communicated to all health care staff 2- train all health care staff in skills necessary to implement this policy 3-Inform all pregnant women about the benefits and management of BF 4-Help mothers initiate BF within a half-hour of birth 5-Show mothers how BF, and how to maintain lactation even if they should be separated from their infants

Question 27

The Ten steps to successful BF (second 5)

Answer 27

6- Give newborn infants no food or drink other than breastmilk, unless medically indicated 7-Practice rooming in allow mothers and infants to remain together 24h a day 8-Encourage breastfeeding on demand 9-Give no artificial teats or pacifiers to BF infants 10-Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic

Question 28

Definition of a baby Friendly Hospital

Answer 28

A health car facility where the practitioners who provide care for women and babies adopt practices that aim to protect, promote and support exclusive breastfeeding from birth

Question 29

Purpose of BFHI is

Answer 29

1- To actively protecy, promote, encourage and support breastfeeding through education of health care workers in maternity and neonatal services 2-To accredit hospitals that demonstrate that they meet the WHO/UNICEF criteria as a baby friendly hospital

Question 30

International Code of Marketing of Breast-milk Substitutes who was the founder and when?

Answer 30

-Organised by Dr Manuel Carballo and established in 1981 by the general assembly of the WHO

Question 31

International Code of Marketing of Breast-milk Substitutes Meaning...

Answer 31

Restrict the marketing of breast milk substitutes, such as infant formula, to ensure that mothers are not discouraged from breast-feeding and that substitutes are used safely if needed

Question 32

International code has ...... key points ??????

Answer 32

10 key points

Question 33

Breastfeeding and alcohol consumption

Answer 33

Breastfeeding women should avoid drinking alcohol as there is no safe amount of alcohol that breastfeeding women can drink. A babys developing brain is more sensitive to damage from alcohol than an adults brain is. Alcohol crosses easily into breast milk and passes through the breast milk to the baby