Post Natal Care Flashcards
(33 cards)
Baby friendly care
- NICE recommendation on feeding
Baby friendly care
- NICE recommendation on feeding
- Six months just breast
- Continue with mixed diet
Baby friendly
- Maternity standards
Baby friendly
- Maternity standards
- Closeness and feeding
Baby friendly
- Neonatal standards
Baby friendly
- Neonatal standards
- Close relationship
- Breast milk
- Parents as partners in care
Protecting breast milk
- Legislation
Protecting breast milk
- Legislation
- International code of marketing breast milk substitutes
Breastfeeding
- Neonatal benefits
Breastfeeding
- Neonatal benefits
- Protects against obesity
Barriers to breast feeding
Barriers to breast feeding
- Thinking they don’t have enough
- Tiredness
- Pain
Blood spot test
- Timing
- Conditions
Blood spot test
- Timing
- Conditions
- Sickle
- CF
- Thyroid
- SCID
- 6 metabolics
what causes lactogenesis?
- prolactin
- oxytocin
- nipple stimulation
how does prolactin lead to lactogenesis?
- prolactin - responsible for milk production
- sudden drop in oestrogen and progesterone after birth triggers release of prolactin from the anterior pituitary which stimulates alveolar cells in the mammary glands to produce milk
how does oxytocin lead to lactogenesis?
- oxytocin - causes “let down” of milk
- causes myoepithelial cells surrounding the alveoli to contract, pushing milk into the ducts and towards the nipple
how does nipple stimulation lead to lactogenesis?
- suckling by the infant sends nerve signals to the brain triggering prolactin and oxytocin release
- the more frequent the breastfeeding the more milk is produced due to feedback
what is colostrum?
- colostrum - produced in the first few days after birth
- rich in antibodies especially immunoglobulin A and provides immune protection for the newborn
- also high in proteins, vitamins and minerals
what does mature milk contain?
- by days 3-5 postpartum milk becomes mature milk
- contains water, fats, carbs, proteins, vitamins, minerals and immune factors tailored to the baby’s needs
breast feeding
- problems
- low milk supply
- nipple pain (poor latch)
- blocked duck (milk bleb)
- nipple candidiasis
-> miconazole cream for mother, mystatin suspension for baby
when to treat mastitis
- systemically unwell
- nipple fissure present
- symptoms don’t improve after 12-24 hours of milk removal
- if culture indicates infection
Mx for mastitis if treated
flucloxacilin for 10-14 days
- breastfeeding or expressing should continue
complication of mastitis
abscess
maternal benefits breast feeding
- physical
- faster uterine involution
- natural birth control (lactational amenorrhoea)
- weight loss
- reduced risk of postpartum depression - releases oxytocin and prolactin
maternal benefits breast feeding
- emotional, psychological and economical
- bonding - release of oxytocin enhances mother-infant bonding
- confidence and satisfaction
- cost savings
- convenience
maternal benefits breast feeding
- long term
- can lower likelihood of developing type 2 diabetes
- can have protective effects on high blood pressure and cardiovascular conditions
- lowers risk of certain cancers
- reduces risk of osteoporosis
contraindications to breast feeding
- baby has galactosaemia
- viral infections: HIV
breastfeeding - drug contraindications
- antibiotics: ciprofloxacin, tetracycline, chloramphenical, sulphonamides
- psychiatric drugs: lithium, benzodiazepines
- aspirin
- carbimazole
- methotrexate
- sulfonylureas
- cytotoxic drugs
- amiodarone
screening test for postpartum depression
Edinburgh Postnatal Depression Scale
>13 = depressive illness
baby blues
- 3-7 days following birth and is more common in primips
- Mothers are characteristically anxious, tearful and irritable
