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Flashcards in Nutrition During Lactation 2 Deck (14)
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1
Q

Identifying breastfeeding malnutrition

A

Normal weight loss for newborns approx 7% of birthweight in first week. Weight loss of 10% needs evaluation by health professional
Malnourished infants become sleepy, non responsive, have a week cry and wet few diapers
By day 5-7 infants should have 6 wet diapers and 3-4 soiled diapers

Tooth decay risk factor is frequent nursing at night after 1 year. All children should be seen by dentist 6 months after 1st tooth erupts or at 1 year of age

2
Q

Nutrient requirements for breastfeeding women

A

Differ depending on age
Veg and legumes/ beans: 7.5
Fruit: 2
Grains:9
Meat, poultry, fish, eggs: 2.5
Milk, yoghurt, cheese and alternatives 2.5
Additional 2-2.1MJ/ day assuming full breast feeding
Difficult to make a single recommendation due to differences in lactation storage, extent of weaning etc
Due to 0.78L/d milk production with energy content of milk 2.8kj/g in first six months
In second six months 0.60L/d but with depleted fat stores
Protein 14-18yo- 63g. 19-51yo- 67g

3
Q

Weight loss during pregnancy

A

Caloric RDI assumes loss of 0.8kg/ month
Most women do not reach prepreg weight by 1 year after birth
Modest or shirt term energy reductions do not decrease milk production

Exercise is safe. Modest energy restriction coupled with increased activity assists in weight loss and body fat, exercise does not inhibit milk production or inhibit growth
Vit and mineral supplements not needed in well noutished women’s
Women should drink 10 glasses water/d
Alternative diets- vegan, GF for coeliac

4
Q

Colic

A
Defined as crying for more than 3 hours a day with no medical cause
Components of maternal diet may be linked- more likely with mothers ingestion of:
Cows milk
Onions
Cabbage
Broccoli
Chocolate
Fodmaps?
5
Q

Factors influencing breastfeeding initiation and duration

A
Overweight and obesity prior to pregnancy and excess prenatal weight gain breastfeed for shorter duration 
Age
Education level
SES/income
Maternal employment 
Embarrassment 
Time and social constraints
Lack of support from family and friends 
Lack of confidence 
Concerns about diet and health 
fear of pain
6
Q

Breastfeeding promotion and support

A

Healthcare system plays an influential role: provides prenatal breastfeeding education and support- breast is best, effective in increasing number who choose to breastfeed.
Lactation support in hospitals and birthing centres- distribution of free formula samples is discouraged

Other
Social support networks
Positive media promotion 
Workplace support
Policies and legislation 
Paternal support
Community attitudes
Marketing by formula companies
Cultural perceptions
7
Q

Lactation support after discharge

A

First few days after delivery are critical and hospital practices are influential
Breastfeeding support is essential in the first few weeks after delivery as lactation is being established
As paediatrician, nurse or other knowledgable health care practitioner should see all breastfed infants at 2-4 days of age
Lactation consultants
Aus breast feeding association
- classes
- pump hits
- counselling
- breastfeeding helpline
- local support groups
Etc

8
Q

Nutrition during lactation conditions and interventions

A
Condition: low milk supply
common for cessation of breastfeeding (real or perceived) 
Causes: 
Insufficient breastfeeding or pumping
Ineffective emptying
Stress
Imposing feeding schedule
Forcing baby to sleep through night 

Management:
Nurse/ pump every 2-3 hours
Drugs or herbs may be prescribed- milk thistle, metoclopramide, fenugreek

Prohibited: cytotoxic or chemo drugs, abuse drugs, radioactive iodine

9
Q

Alcohol and breastfeeding

A

Level in plasma equal to breast milk
Peak occurs 30-60 mins after consumption or 60-90 with food

Alcohol decreases oxytocin and let down, affects odour of milk, decreases volume consumed by infant and interferes with sleep pattern
Recommendations: not drinking alcohol in first month
Limit to 2 standard drinks in 1 day
Takes approx 2 hours to clear 1 std drink
Express prior to alcohol

10
Q

Caffeine

A

Moderate intake- no problem
Level in breast milk only 1% of that in mothers plasma
May accumulate in infants younger than 3-4 months- varies from individuals
May interfere with sleep or cause hyperactivity and fussiness of infant

11
Q

Infant allergies

A

EBF for greater than 4 months protects against allergies, ectopic dermatitis and wheezing
Development of food allergies influenced by:
Genetics, duration of BF, intro of their food, maternal smoking, air pollution exposure to infectious disease, maternal diet and immune systems
Consumption of omega 3 fa may protect against allergies

12
Q

Food intolerances

A

Low allergen maternal diet associated with reduction in distressed behaviour (colic).
Allergen foods eliminated were cows milk, eggs, peanuts, tree nuts and fish
New research being done on fodmaps and lactation

13
Q

Human milk collection and storage guidelines

A

Freshly expressed in close container:

  • room temp 6-8 hours
  • 3-5 days in fridge
  • 3-6 months in separate freezer

Previously frozen, thawed in refrigerator:

  • took temp 4 or less hours
  • stored in refrigerator for 24 hours
  • do not freeze

Thawed outside refrigerator in warm water:

  • room temp for completion of feeding
  • refrigerate for 4 hours until next feed
  • do not refereeze

Infant begun feeding:
Only use for completion of feeding

14
Q

Milk banking

A

Human milk banks provide human milk to infants who cannot be breastfed by their mothers
Gives parents the choice of donated breast milk when the mothers own milk is not available
Screens, pasteurises and distributed donated human milk to infants and mothers in need