Lactation Education Questions & Answers

Lactation Education Questions & Answers U.S. Breastfeeding at one year rates 26.7% Factors leading to the decline in breastfeeding 1. Women became interested in having an impact outside their home. 2. Scientific and technological advances resulting in safer alternatives to breast milk. 3. Faith in science and technology 4. change in labor and delivery practices 5. Marketing of artificial infant milk. Historically breastfeeding was the norm for feeding infants 1. Biological evidence (humans are mammels) 2. Ethnographic evidence (Inference made from modern day hunter gatherer) 3. Historical evidence (breastfeeding was the norm) wet nurse The act of a woman nursing a baby other than her own. This dates back to 2000BC. Factors leading to the decline in breastfeeding. Impact outside of the home 1.During the 1700's women chose not to breast feed for social reasons. 2.Women wanted to work. There was no support for women who wanted to breastfeed. Factors leading to the decline in breastfeeding. Scientific and technological advances 1. Before 1800's there was no clean water. 2. Formula was created in 1760 by Jean Charles des Essartz 3. By 1865 Justus von Liebig was a chemist who made substitute for human milk 4. BY THE 1970'S BREASTFEEDING HAS REACHED AN ALL TIME LOW IN THE UNITED STATES WITH ONLY 24% changes in labor and delivery practices 1. Births went from delivering at home with midwives to being in hospital. this started the mothers to be separated with babies 2. During the 1900's anesthesia was used during birth and women were essentially nocked out. Marketing Aggressive marketing through commercial, doctors, and facilities greatly influence mothers to bottle feed. Supplement is anything that is not exclusively to breastfeeding complement is during the time of weaning after 6 months or more The rise of breastfeeding 1. Child birth movement in the 50's 2. the start of breathing techniques and to using medication 3.International code of Marketing of breast milk substitutes certified lactation consultant IBCL health care professional trained to provide CLINICAL expertise lactation educator provide basic breastfeeding education and support to women and their families True or false: lactation educator scope Educating a pregnant woman on how to get breastfeeding go off to a good start true True or false: lactation educator scope helping a mother with a 2 week old baby establish breastfeeding after her baby pediatrician has told her that the baby is not gaining enough weight. false True or false: lactation educator scope educating a pregnant or breastfeeding woman on ways to maintain her milk supply while separated from her baby true international breastfeeding promotion efforts 1. The international code of marketing of great milk substitutes 2. Innocenti declaration 3. the baby friendly hospital initiative 4. global strategy for infant and young children 5. 1000 days challenge statements by U.S. health organizations professional health organizations recommend that mothers EXCLUSIVELY breastfeed their babies for the first 6 months of life and at least until 12 months with complementary foods. policies that promote, protect and support breastfeeding at the federal level The Patient Protection and Affordable Care Act: provides for breastfeeding support and counseling services, pumps, and supplies. Provides mothers with reasonable break time during workday to express breast milk. coopers ligaments provide framework to support the tissue of breast. alveolus milk making cells that develops durning pregnancy milk ducts transports milk from alveoli through breast Montgomary gland also known as Montgomery tubercles are sebaceous glands located around the areola. Pimply appearance and secrete oily substance that serve as a lubricant and protective agent for the nipple. Skin remains pliable. myoepithelial cell Alveoli consist of epithelial cells (Lactocytes) encased in a dense basket like mesh work of smooth muscle. Is in the contractile unite. lactogenesis: Stage 1 Secretory differentiation: starts at the beginning of the third trimester of pregnancy. Epithelial cells are converted to a secretory state. Palma concentrations of LACTOSE, total proteins and immunogloblun increase. Substance needed for milk synthesis are drawn from the maternal bloodstream. lactogenesis stage 2 1.Secretory activation: occurs at 2 to 5 days of porstartum. 2. It is referred as the time when the colostral phase ends and TRANSITIONAL milk is produced. Blood flow within the breast increase, and copies milk secretion begins. 3. Occurs right after delivery. It can be delayed if placenta is not fully taken out. 4. progesterone rapidly drops 5. prolactin rapidly increases lactogenesis stage 3: Galactopiesis Marks the establishment and maintenance of mature milk production. It accuse 8-10 days of postpartum and is maintained by frequent milk removal, either by the infant nursing or by milk expression. Autocrune control ( driven by local control not hormones) Involution at this time breast slowly return to near pre-pregnant state. occurs on average 40 days after last breastfeeding everted nipple common nipple inverted appearing nipple when stimulated it pops out retracted nipple right to left for this process at rest appears everted, however when stimulated it retracts and becomes inverted mammogenisis begins to develop at FETAL stage factors that can impair lactogenesis 2 cesarean delivery excessive blood loss after birth retained placental fragments hypothyroid obesity type 1 diabetes breast surgery factors needed to establish and continues milk production 1. breast stimulation and frequent milk removal 2. Sufficiency glandular tissue intact nerve pathways and milk ducts Prolactin 1. produced in the placenta and anterior pituitary gland in the brain 2. produces milk oxytocin 1. produced in the hypothalamus and travels though the posterior pituitary gland gland 2. stimulates to eject the milk 3. allows for milk letdown 4. uterine contractions which stage of breast development is triggered by the endocrine system (hormones) lactogenesis 1 and lactogenesis 2 when does the body begin to make colostrum lactogenesis 1 when do secretory epithelial cells apoptosis ( cell death) involution which is consisted the phase that milk production is established galactopoesis the body begins to secrete large amounts of milk and is referred to as secretory activation lactogenisis 2 this occurs during puberty but is developed during the fetal stage mamogenisis this occurs approximately 9 days postpartum glactopoesis this occurs between 2-8 days postpartum lactogenisis 2 occurs mid pregnancy through 2 days postpartum lactogenisis 1 health enhancing behaviors positive health behaviors 1. Lung cancer: smoking cessation 2. heart disease: consuming a low fat diet 3. HIV: using condoms health damaging behaviors negative health behaviors 1. lung cancer- smoking 2. heart disease- poor diet 3. HIV- not using condoms common breastfeeding barriers 1. embarrassment of public breastfeeding 2. fear of pain 3. time and social constraints 4. lack of support 5. lack of confidence regarding milk production what are health behavior constructs 1. social norms 2. perceived behavioral control 3. decisional balance Type of breastfeeding barrier: I know breastfeeding is best for my baby, but i am embarrassed to breastfeed in public embarrassment Type of breastfeeding barrier: I've heard that breastfeeding hurts fear of pain Type of breastfeeding barrier: if i breastfeed, I won't be able to work, go to school, or go out with my friends time and social constrains Type of breastfeeding barrier: My partner said that he was not breastfeed and he turned out fine lack of support Type of breastfeeding barrier: I'm afraid i won't have any milk just like my mother milk production Dispelling common breastfeeding myths and misconceptions: My breast are very small. Therefore, I am afraid I will not be able to produce enough milk to feed my baby. Mothers with small breast cannot breastfeed. False Size of breast has nothing to do with producing enough milk. Milk production is based upon supply and demand. Storage capacity is how much milk a breast will be able to hold when it is "Full". Dispelling common breastfeeding myths and misconceptions: I smoke. Therefore, I am afraid breastfeeding will harm my baby. Mothers who smoke can't breastfeed False Nicotine does get into breast milk, but it is still recommend that mothers who smoke breastfeed. Dispelling common breastfeeding myths and misconceptions: My work is very stressful. Therefore, I am afraid that my milk would be bad for my baby Mothers who are stressed out can't breastfeed False Breastfeeding actually reduces stress. Dispelling common breastfeeding myths and misconceptions: I don't have the perfect diet. Therefore I am worried that my breastmilk will be poor in nutritional quality Mothers with poor eating habits can't breastfeed. False Mothers Diet does not affect milks nutrients. However if mother is very malnourished then the quality of milk is reduced. Dispelling common breastfeeding myths and misconceptions: I tend to get frequent colds so i don't think it will be a good idea for me to breastfeed my baby Mothers who have a cold or the flue can't breastfeed false When a nursing mother is sick, her breastmilk will develop antibodies to fight off the infection and increase babies immune system. Dispelling common breastfeeding myths and misconceptions: I had prior breast surgery. Therefore i am afraid that i will not be able to produce enough milk to feed my baby. Mothers with implants/Past breast surgery can't breastfeed It depends. there are many factors to consider. The main one how much nerve damage has been done to the breast. If breast are not able to get stimulated or produce milk then a mother cannot breastfeed. It is recommend to speak with the doctor on how the procedure was done. Dispelling common breastfeeding myths and misconceptions: I am pregnant with twins and am concerned that my body will not make enough milk to feed both of my babies Mothers of multiples can't breastfeed False Milk production is based on supply and demand. The more a mother breastfeeds the more milkier body will make enough for both her children. Dispelling common breastfeeding myths and misconceptions: I am currently breastfeeding my 6 month old baby and just found to that i am pregnant. I heard that if i continue breastfeeding my older boy, i will harm my developing baby Mothers who are pregnant and breastfeeding an older child can't breastfeed It depends In most cases a mother can breastfeed a 6 month old while being pregnant. However due to oxytocin causing the uterus to contract it may cause for a preterm baby. Dispelling common breastfeeding myths and misconceptions: I heard that mothers who drink alcohol can't breastfeed Mothers who drink alcohol can't breastfeed It depends Mothers can drink alcohol, however it is recommend that mothers pump an hour before they are about to drink. It is not recommend for a mother to drink alcohol and immediately nurse a baby. Alcohol does get into the milk. Dispelling common breastfeeding myths and misconceptions: I have TB and hear that mothers with TB can't breastfeed It depends It is fine if mother is already taking antibiotics for 2 weeks and in not contagious Dispelling common breastfeeding myths and misconceptions: Mothers undergoing chemotherapy can't breastfeed true Dispelling common breastfeeding myths and misconceptions: Mothers with nipple rings can't breastfeed it depends, but for the most part they can Dispelling common breastfeeding myths and misconceptions: Mothers with HIV can't breastfeed It depends In first world countries no. Others with no clean water yes. contraindications to breastfeeding 1. HIV 2. Untreated TB 3. developed varicella 5 days before through 2 days after delivery 4. Infected with human T-Cell lymphotropic virus 5. has herpes simples session on breast 6. chemotherapy 7. diagnostic or therapeutic radioactive isotopes 8. infant who has galactosemina conditions that are not contraindications to breastfeeding 1. hepatitis B 2. Hepatitis C 3. Cytomegalovirous (CMV) expect with premature or immune compromised babies 4. Smoking preparations for breastfeeding 1. breast care 2. planning a nursing area 3. clothing suggesting 4. selecting a nursing bra ( no underwire) 5. sleeping arrangements pitocin synthetic oxytocin which helps contractions and help dual ate the cervix. analgesia 1. Used to reduce pain 2. Given through IV 3. Used during early Labor 4. Affects sucking reflex anesthesia 1. Spinal 2. Epidural episiotomy to enlarge the perineum oral aversion baby develops this when it associated discomfort of suctioning with breastfeeding. delayed suctioning is caused by the impact of anesthesia mechanical devices cause the baby to be uncomfortable to breastfeed in certain positions positions mother can hold baby 1. football hold 2. cross cradle hold 3. cradle hold 4. laid back breastfeeding position sidling position football hold cross cradle hold effective latch 1. Mouth wide open 2. lips flared out 3. large amount of breast in mouth 4. more areola above baby lip than below and jaw moving 6. actively sucking and swallowing 7. feel a strong tug that is not painful mother lead breastfeeding 1. sit comfortable with feed supported 2. hold baby tummy to tummy 3. tickle baby upper lip sign of suckling effectiveness and milk transfer le swallowing (cuh sound) 2. no dimpling or puckering of baby cheeks 3. no smoking or clicking sounds 4. baby spontaneously unlatches and is satiated baby lead breastfeeding lean back and relax place baby on chest baby will self attach signs of hunger open mouth sucking movements hand to mouth moving or fidgeting rooting for a breast crying feeding norm 8-12 times a day. stomach size of newborn day 1: shooter marble day 3: ping pong ball day 10: large egg