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VERIFIED ANSWERS | LATEST VERSION
Why is breastfeeding so difficult that mothers need help? top two reasons: -
------------------------------------1) unrealistic expectations (lack of preparation
for what the newborn period would look like)
2) lack of timely interventions (mother's problems at 3-7 days posed the
greatest risk to stopping, fastest drop off is in the 10 days following d/c from
hospital)
The international code of marketing of breastmilk substitutes -------------------
------------------international health policy that regulates the marketing of
breastmilk substitutes in order to protect breastfeeding. published by WHO
and internationally agreed voluntary code of practice.
The Code -------------------------------------regulates marketing of breastmilk
substitutes which includes infant formulas, feeding bottles and teats
-sets standards for labeling and quality of products and how the law should
be implemented and monitored within countries\
-helps to make sure parents choices are made based on full information vs
false marketing claims
What contributes to low rates of EBF globally? -------------------------------------
Caregiver and societal beliefs favoring mixed feeding, hospital and
healthcare practicies and policies that are not supportive of BF, lack of
adequate skills and support, aggressive promotion of infant formula and
other breastmilk substitutes, inadequate maternity/paternity leave
legislation, workplace policies, lack of knowledge about dangers of not
exclusively BF and proper BF techniques
,How to support EBF -------------------------------------increase hospital and
health systrem capacity regardign baby friendly hospital initiative
-provide community based strategies including campaigns tailored to local
context
-strengthen monitoring and enforcement of the code
-enact at least 6 months paid maternity leave
-invest in training and capacity building in protection, promotion, support
Racial disparities in US & breast feeding -------------------------------------Black
mothers less likely to breastfeed due to hospital in neighborhoods with
black residents do less to promote nursing than those in areas with more
white residents -systemic racism
Healthy People 2020 added BF targets -------------------------------------
worksite lactation programs, reduce percentage of BF infants who receive
formula before DOL2
The US report card on how we are doing on the innocenti declaration is
prepared by the -------------------------------------Healthy Children Project
Messages from the breast travel through the ____ to the brain -----------------
--------------------nervous system
Hormones travel to the breast via the ___ -------------------------------------
bloodstream
,What are green/shiny stools a sign of? --------------------------------------sign of
overproduction leading to less fat in milk, faster digestion causing not
enough time for lactase to digest the lactose in milk. An improved latch
could allow for more fat flow
Signs of oversupply -------------------------------------Rapid weight gain in infant,
unsettled baby after feeding, recurrent plugged ducts and mastitis, painful
feedings, voluminous (huge volumes of) stools- often green & shiny
What causes nipple pain? -------------------------------------Improper latch-->
need lactation support to help with proper latch on, good seal
True/false: baby should be pulled into breast. -------------------------------------
False! Do not pull baby into breast, let baby tilt head back for optimal latch.
Hand on back of baby's head can interfere baby's interoral function by
restricting the movement of the cranio-cervical spine--> causes nipple
trauma. Make sure crook of arm in cradle position does not block baby from
being able to fully tilt back.
Should a latch be symmetric or asymmetric? -------------------------------------
Asymmetric! A baby should form a teat with breast tissue underneath the
nipple as part of a latch
What is a symmetric latch -------------------------------------Not a good latch,
causes nipple damage
Asymmetric latch -------------------------------------Optimal attachment to the
breast, where the baby's lips are not centered in relationship to the areolar,
, but rather vertically off-centered with the baby's chin and lower lip closer to
the edge of the areola than the baby's upper lip. A baby should form a teat
with breast tissue underneath the nipple as part of a latch
Do nipple creams work? -------------------------------------Continued questions
of effectiveness, fear of ingestion by baby
Should a frenotomy be suggested for tongue tie? ----------------------------------
---No study was able to report that frenotomy led to better long term
breastfeeding
Tongue tied breastfeeder --------------------------------------complete feeding
assessment and suggest ways to optimize latch.
-refer onward for diagnosis (have PCP diagnose TT)
-provide support
What is a fissure straight down the nipple evidence of? --------------------------
-----------A symmetric latch. Top lip needs to have good seal, moist part of
lip should be touching nipple, can roll out top lip, to reduce injury during BF
Is there a deep latch with nipple stretching? -------------------------------------If
nipple not stretched deeply into mouth, less oxytocin flows, less fat is in
mix. With less fat, milk digested quicker = not enough time for baby to
make enough lactase to digest lactose in milk.
What to do for oversupply? -------------------------------------Decrease additional
stimulation/milk removal if possible
Consider block feeding (only nursing on one side only per feeding)