NURS 306 OB - Final Exam Study Guide 2023 (Complete to Score 100%)

NURS 306 OB - Final Exam Study Guide 2023 (Complete to Score 100%) Drug and medication safety in breastfeeding o Dr. Hale’s Lactation Risk o Categories  L1 Safest  L2 Safer  L3 Moderately Safe  L4 Potentially Hazardous  L5 Contraindicated - Maternal advantages of breastfeeding o Helps the uterus after birth to control postpartum bleeding (releases oxytocin) o It’s available whenever your baby needs feeding o Naturally uses 500 calories o Reduces the risk for depression o Saves money o Right temperature o Stimulates maternal instincts o Reduces risk of osteoporosis o Reduces risk of breast and ovarian cancer o Strong bond with baby - Infant advantages to breastfeeding o Decreased risk of infant diarrhea o Decreased risk of respiratory infections o Decreased risk of being hospitalized for respiratory syncytial virus o Decreased risk of otitis media o Decreased risk of necrotizing enterocolitis (infant’s intestine) o Decreased risk of childhood obesity o Decreased cost - Disadvantages to breastfeeding o Mother must be available for feeding or to provide pumped milk if she is absent o Mother must pump if feeding is missed o Early breastfeeding may be uncomfortable o Certain medications can interrupt breastfeeding - Composition and stages of human milk o *Made up of proteins, carbohydrates and fats that are synthesized in the alveolar glands of the breast.  Protein is easier to digest than in formula.  Lactose is the main carbohydrate.  Cholesterol is essential for brain development o Contains other vitamins and minerals o Contains antibodies which decreases the risk for neonatal infections o Stages 1  Colostrum  A yellowish breast fluid that is present for 2-3 days after birth o Higher levels of protein and lower levels of fat, carbs, and calories than mature human milk o High in immunoglobulin G and A o Acts as a laxative and assists in the passage of meconium o Stage 2  Transitional milk – consists of colostrum and milk  Stage lasts from day 3 to day 10 o Decreasing levels of protein and increasing levels of fats, carbs, and calories o Stage 3  Mature milk  After day 10  Content of carbohydrate, protein, and fat changes due to babies saliva giving feedback o Thick and creamy mixture o High in fat and calories o Fore milk  Quenches baby’s thirst – higher levels of water content  Contains lactose and protein  Not high in calories and fat o Hind milk- gets released after foremilk  Milk produced during the feeding session and released at the end of the session  Higher level of fat content - Milk production o Lactation: The production of milk. o Milk: Produced in the alveolar glands and transported through the lactiferous ducts to the nipple.  Influenced by hormones and suckling o Prolactin: Simulates milk production.  Produced when progesterone levels fall after placenta is delivered.  If placenta pieces are remained, may cause you to not produce.  Stimulation of the nipple (newborn sucking) increases prolactin levels.  The more milk the infant takes in, the more milk produced (supplydemand) o Colostrum: First milk produced: thick, creamy, yellow fluid composed of protein, sugar, fat, water, minerals, vitamins and maternal antibodies--digestible.  Has laxative effect to aid baby to excrete meconium. - Let Down Reflex o As infant sucks, oxytocin is released from the posterior pituitary.  Produces let-down reflex o Let-down reflex- stimulation of baby at breast, sound of baby.  Foremilk is expressed from baby crying o Stimulated during sex and orgasm o Can be inhibited by stress, anxiety, pain, fatigue o Occurs multiple times while breastfeeding o Hind milk is formed after the let-down reflex.  Higher in fat and calories - Hunger cues rooting – stroking cheek o Feed every 2-3 hours & on-demand  *Cluster feedings – not too much, until baby feels full  Place the baby until the breast is emptying - Breastfeeding techniques o Relaxing shoulder o Sit up o Use boppi especially helpful if you have hemorrhoids - Breastfeeding positions - Latch score o The lower the score, the higher the need for support. o Consider referral to lactation consultant  How well the latch is onto the mom?  Total of 10 points  Low latch score  sleepy, nipples inverted/cracked, discomfort o Needs lactations consultant  High latch score  nipples are everted, baby sucking – good o 5 components: latch, audible swallowing, type of nipple, comfort (breast/nipple), hold (positioning) - Breastfeeding problems o Sore nipples– poor latch-on  Lanolin ointment for cracked nipples  Instruct woman to wash her boobs with only water, avoid soaps and alcohol o Supplemental feedings  With water, cereal, etc.  decrease milk supply because no nipple stimulation (breasts stay full so doesn’t produce more milk) o Working outside of the home o Weaning- gradual replacement from breastfeeding  formula  Reducing the amount of time on the breast (including supplementation) - Engorgement o When breasts are super full o 1 st  Pump or feed the baby – hand express the milk out  Use heat packs to help the milk flow  Go underwater  Treat pain and swelling