W03: Infant Feeding & Labour Analgesia

Question 1

Significance of colostrum

Answer 1

Contains concentrated amounts of vitamins, nutrients, protective factors found in mature breast milk.

*less water content = protects immature kidneys
* laxative effect minimising jaundice
* proliferative influence on gut villi

Question 2

Microbiome changes during pregnancy

Answer 2

• lactobacilli more prevalent in mother’s vagina during pregnancy

+ skin-skin contact breast feeding and vaginal contact allows passing of microbial heritage to baby

+ human milk oligosacchs. feed microbs

Question 3

Epigenetics

Answer 3

environ. factors influencing genetic activation; passed down through maternal life

• Environmental factors can result in these changes. For example, studies carried out on populations following famine in the Netherlands showed that the effect could be seen three generations later. Childhood abuse has also been shown to affect DNA patterns which could explain the link between victims and ill health in adulthood.

Question 4

Stages of Lactation

Answer 4

Lactogenesis

(1) breast dev. & colostrum prod from ~16w gestation

(2) copious milk secr. 32-96hrs after birth

(3) Maintenance of milk production

Question 5

Montgomery’s Tubercule

Answer 5

Adaptation appearing on areola to secrete antiseptic sebum to lubricate the area

Question 6

Structure of breast ductal glands

Answer 6

Develop under influence of oestrogen, progesterone, and human placental lactogen

• alveolar sacs contain lactocytes
• myoepithelial cells surround alveolus to squeeze milk down ducts

Question 7

Hormones linked to milk prod.

Answer 7

Under the influence of touch, smell, and sight of baby, prolactin and oxytocin levels rise

Question 8

Prolactin R theory

Answer 8

Prolactin levels in the blood stream rise in response to touch and suckling by the baby. The more circulating prolactin (due to more frequent the contact and suckling), the greater the number of lactocytes are activated.

Question 9

Feedback Inhibitor of Lactation

Answer 9

Whey protein FIL slows down milk synthesis when there is ineffective milk removal from the breasts

Question 10

Analgesia in Labour: Drug Free

Answer 10

-Birthing ball

• Birthing pool
• Hypnobirth
• Aromatherapy

Question 11

Analgesia in Labour: Simple Drug

Answer 11

• ENTONOX: gas and air; deep breaths during start of contractions
• stop when pain stops
• commonly used, half of pregnancies
• quick action
  ! dizzy, dry mouth, vomit
• DIAMORPHINE: injection at top of leg
• 30 mins action set in
• helps cope with pain
  ! sick, sleepy, slow down breathing, similar effect on baby (reversible)
• REMIFENTANIL PCA
• morphine-like, short acting, press for delivery of drug upon pain/contraction
• 1 dose every 2 mins
• on O2, monitor dt slowed breathing
  ! drowsy, sick, itchy CI: 4hrs after diamorphine