Lactation

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NurseFaith
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290133
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Lactation
Updated:
2014-12-02 01:20:27
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Lactation
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Lactation
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  1. Factors influencing feeding choices:
    • Attitudes, Beliefs, Behaviors
    • (partner's, mothers/in laws, peers, HCP)

    • Mother's Life experiences
    • (exposure to breastfeeding, previous attempts, birth experience)

    • Maternal attitudes and beliefs
    • (perceived pain/discomfort, embarrassment, "ties me down")

    Returning to work/school
  2. The breast is composed of glandular or secretory tissue and adipose tissue that is supported by a loose framework of fibrous connective tissue called:
    Cooper's Ligaments
  3. The average number of milk ducts per breast are ____ and are small, superficial and compressible
    5-9
  4. Placental Hormones
    • Progesterone
    • Estrogen
    • HCG
    • Human Placental Lactogen (HCL)
    • Other peptide hormones
  5. Hormone that stimulates that growth of breast tissue and prevents lactation until after the birth
    Progesterone (with estrogen)
  6. Hormone that plays part in development of fetus and helps the breast develop the glands that will be required for breastfeeding
    Human Chorionic Somatommaotropin (HCS) or Human Placental Lactogen (HPL)
  7. Causes alveolar cells to initiate milk secretion
    Prolactin during lactation
  8. During lactation, prolacting:
    Causes alveolar cells to initiate milk secretion

    Stimulate glandular production of colostrum

    Acts synergistically with cortisol to stimulate milk production

    Prolactin "surges" occur within 15 minutes of nipple stimulation
  9. Prolactin surges within ___ min of stimulation
    15min
  10. Primary function of oxytocin
    Milk Ejection
  11. Functions of Oxytocin:
    MILK EJECTION

    Contracts myoepithelial cells located around the alveolar cells and glandular ducts

    Milk expelled from alveoli into ducts and subareolar sinuses that lead to the nipple pore

    (produced in response to suckling effect)
  12. Infant's suckling creates impulses that stimulate:
    Posterior Pituitary Gland
  13. Oxytocin causes contraction of ____ that line the ducts of the breast
    Myoepithelial Cells
  14. By the ___ trimester, placental lactogen begins to stimulate the secretion of colostrum
    2nd
  15. Neural Reflex Arc
    Placental Corpus Luteum

    • Hypothalamus
    • Adenohypophysis
    • Breast

    Supportive Metabolic Hormones
  16. Neural Reflex Arc
  17. STAGE of lactation: Produced during pregnancy and first several days PP
    Colostrum
  18. STAGE of lactation: Thick, High in protein, Fat-Soluble Vitamins, Minerals, Immunoglobulins
    Colostrum
  19. STAGE of lactation: Provides Passive Immunity
    Colostrum
  20. STAGE of lactation: Aids in establishing normal flora in intestines, Laxative Effect
    Colostrum
  21. STAGE of lactation: lasts for 2 weeks
    Transitional Milk
  22. STAGE of lactation: High levels of fat, lactose, water-soluble vitamins (more calories)
    Transitional Milk
  23. STAGE of lactation: 14-21 days PP, Thin, bluish
    Mature Milk
  24. STAGE of lactation: Mature milk with high lactose content
    Premilk
  25. STAGE of lactation: Mature milk with high lipid content (3x more)
    Hindmilk
  26. STAGE of lactation: 90% water (hydrates infant) 10% carbs, proteins, fats
    Mature milk
  27. Milk found during beginning of feeding (mature milk) and contains water, vitamins, proteins
    Foremilk
  28. Milk that occurs after initial release of mature milk and contains higher levels of fat (necessary for weight gain)
    Hind-milk
  29. Promoted universal early initiation of breastfeeding to reduce infant mortality
    WHO (world health organization)
  30. Physiological Advantages to breastfeeding:
    Breast-milk protein is easy to digest

    Nutrients with high bioavailability

    Prevents hypothermia

    Reduces infections (GI, Resp, Ear)

    Reduces allergy risk

    Enhances Brain development
  31. Psychological Advantages for breastfeeding:
    Supports growth/survival through strengthened maternal infant bonding

    Stimulates infant social interaction

    Fosters sense of security

    Increases alertness, stronger arousal reactions
  32. Breastfeeding benefits for mother:
    Hormones (prolactin, oxytocin) induces maternal behavior

    Reduces PP hemorrhage

    Delays menstruation

    Conserves Iron Stores

    Protects against ovarian and breast cancer

    Economical form of infant nutrition

    Enhances bonding

    Convenience of feeding

    Reduces anxiety/stress/depression

    Increases relaxation and interaction with infant
  33. People who should NOT breastfeed
    Breast Cancer

    Hep B (except those whose babies have had Hep B immune globulin and vaccine)

    Hep C

    HIV+ (except where death from diarrhea/diseases in infants >50%)

    IV drug abusers
  34. Helping Mothers get a good start breastfeeding:
    • Skin-to-Skin
    • Breastfeed as soon as possible after birth (first 24 hours)

    Keep the baby with mom as much as possible

    Breastfeed "on demand"

    Breasfeed often without a time limit (8-12 times/24 hours)

    Avoid formula or pacifier until milk supply is well established

    Ask for help!!!
  35. Nipple Types
    • Protruding
    • Inverted
    • Flat
  36. Ways to improve latch on for different nipple types
    • Nipple Role
    • Breast Pump
    • Nipple Shield
  37. Signs of Hunger:
    • Rooting
    • Suckling
    • Hands-to-Mouth
    • Felxion of arms
    • Legs moving as though riding bike
    • Tense/Clenched Fists
    • Crying (LATE SIGN)
  38. Best time to try to breastfeed?
    Quiet, Alert State (don't wait until crying)
  39. Signs that baby is full
    Audible swallowing during feeding

    Longer pauses between suckling bursts

    Increased non-nutritive sucking

    Infant pulls off breast

    Absence of hunger cues

    Posture/Affect

    Arms/Legs relaxed

    Drowsy/Sleepy
  40. Ways to help baby latch:
    Hold baby with only diaper against mom's bare chest

    Hold baby upright with head under mom's chin

    Place blanket across baby's back and bring bedcovers over both mom and baby (mom's skin with rise to warm the baby)

    Position nose-to-nipple

    Allow infant to open mouth

    Avoid pushing infant head

    Encourage mom to quickly pull him on breast by pulling toward her with arm that is holding baby

    Baby's gums bypass the nipple and cover 1 inch of areaola

    Baby's lips should be everted

    If lower lip is turned in, press on baby's chin to evert lip
  41. Most common contributors to sore nipples
    Poor Latch
  42. Signs of a good latch
    Well positioned baby with mouth filled

    Tounge cupped under breast

    Hearing/Seeing baby swallowing

    Baby's lip turns out not in

    Baby's chin touches breast
  43. Newborn Suckling Styles
    • Barracudas
    • Excited Ineffectives
    • Procrastinators
    • Gourmets
    • Resters or Snackers

    Aids the mother to recognize her infant individuality 

    Different sucking styles result in different amounts of time to empty the breast


    Discourages Clock Watching
  44. Signs of Ineffective Suckling (visual cues)
    Jaw has choppy motion

    Gumming the nipple or areola

    Clicking/Smacking

    Lack of swallowing
  45. Evaluation of Breastfeeding...the Nurse is responsible for:
    Observing and recording intake and output

    Intervening if intake or output is inadequate
  46. Evaluation of Breastfeeding:
    • Intake:
    • -Audible Swallowing (initial 2-3 days)
    • -Sucks up to 20 times before enough volume stimulates swallow, which is then quiet
    • -By day 4, swallowing every suck

    *Mother feels cramping while nursing
  47. Parent Education Needs for Breastfeeding:
    • Health Promoting behaviors
    • Breast Care
    • Feeding Option
    • Developmental stages of breast milk
    • Infant feeding styles
    • Changes in infant elimination
    • Returning to work
    • Milk Storage
  48. Health promotion for lactation:
    Don't drink alcohol

    Don't take meds unless ok by MD

    Don't smoke

    No illegal drugs

    Don't get into environmental contaminants

    Don't have caffeine
  49. Breast Care for Mother: (SUPPORT)
    • Bra 24 hours
    • Proper fit (if too tight, increases risk for plugged duct and mastitis)
  50. Breast Care for Mothers (HYGIENE)
    • Avoid soap
    • Wash once/day sufficient
    • Change nursing pads when wet
    • **Wash hands prior to each feeding
  51. "Should I feed from Both Sides"???
    Okay to nurse from one side per feeding

    Avoid timing feeding (ensures receiving hindmilk)

    Offer second breast if infant awake and not showing signs of fullness (dinner/dessert)

    Start next feeding on breast that received least
  52. Biggest way to prevent problems from breastfeeding?
    Implementing proper feeding techniques and applying breast care strategies
  53. Nursing Interventions for Sore Nipples during feedings:
    • Assess Attachment
    • Reassure improves when milk arrives
    • Offer least sore breast first
    • Alternate feeding positions
  54. Transient physiologic causes of sore nipples:
    initial limited milk volume

    infrequent infant swallowing to relieve sucking pressure

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