NSPN 7150 (Breast Feeding Experience)
FINAL STUDY GUIDE SUMMARISED AND
RATED A.
Effects of weaning the infant?
Optimal development of the cerebellum is stimulated by motion.
Colic is nearly absent in hunter gather societies where mothers carry their
infants consistently
How to help the infant feed better?
-Increases frequency and duration
-Skin to skin
-Stimulate the infant to stay awake while feeding
-Offer both breasts
-Quiet environment
-Relieving pain from teething
-Different feeding positions
What to feed?
Breastmilk, expressed breastmilk, pasteurized donor milk, formula
Calculations for amount of milk needed for 24 hours?
weight in Kg x 150
Considerations when determining how much to feed?
-Time (in first 24 hours does not feed much, but needs opportunities to feed)
-Gestation of infant (late preterm may need more milk than able to get from
breast, hand expression after feeding)
-Health and birth experience of the infant (low blood sugar can be resolved
with small amounts of colostrum)
-How well breastfeeding?
-Are the breasts filling?
,Alternative methods to feed infants?
Dropper/syringe, spoon, cup, feeding tube at breast, bottle
Teaching for informed decisions
-How to establish and maintain milk production while supplements are
provided
-The importance of breastfeeding for the infant, mother, family and
community
-Health consequences for mother and infant of not breastfeeding
-Risks and costs of artificial substitutes and how to safely prepare, use and
store them
-Difficulty of reversing the decision once breastfeeding is stopped
Acceptable infant medical reasons for supplementation
Galactosemia, Maple syrup urine disease, phenlketonuriavery, low birth
weight ( <1500g)born before 32 weeks, risk for hypoglycaemia, significant
weight loss with no milk establishment, fail to regain birth weight by two
weeks after birth, & indications of insufficient milk intake
Acceptable maternal medical reasons for supplementation
severe illness (sepsis), HIV+, herpes simplex virus 1 when active lesions are on
breast, medications (sedating psychotherapeutics, radioactive iodine, cytotoxic
chemo)breast abscess, hep b and c, mastitis, nicotine, alcohol, illicit drugs
How to help infant increase the demand
Increase frequency and duration of feedings, improve latch, skin to skin
contact, stimulate infants during feeding, breast compression while
breastfeeding, & offer both breasts
Reasons to hand express
-Protects from engorgement, plugged ducts and mastitis
-Positive effect on milk supply and establishment early on
-Helps promote exclusive BF
Hand expression vs breast pump
,Hand expression promotes exclusive BF, not everyone has access to pumps
Ways to help the dyad learn to breastfeed?
-work on the techniques of latch and position
-skin to skin contact
-be gentile and dont force anything
-increase the amount of time gradually
-positive environment
-calm mother and infant dyad
-use innate reflexes (wait for alertness, rooting, gaping)
Infants behaviour interpretation
Shake head back and forth at breast-seeking breast
Anchor chin on breast
On and off the breast-needs a bigger mouthful
Arching away from the breast-cant find breast/distressed/disorganized Calm
him and try again
Reasons newborns have issues latching?
Poor mechanics, flat or inverted nipples, pain, oral aversion d/t negative birth
experience, tongue tie, and sleepy infant
Reasons older infants have difficulty latching?
Pain, illness, distracted, oral aversion d/t abundant milk supply
Flat or inverted nipples treatment?
-Stimulation
-Breast shells & nipple rolling do not appear to be effective
-Nipple everters but unclear how effective
Components of 3 rules
Feed the infant (early frequent breastfeeding, effective latch, exclusive
breastmilk)move the milk(hand expression and pumping)help the dyad learn
(understanding infant behaviours, reassure mothers)
, Causes of perceived low milk supply?
-Reassure mother d/t cluster feeding
-Frequent feeds during a growth spurt
-Parents expect infants to sleep through the night
-Not able to express or pump extra
-Purple crying
-Needing physical closeness
-Softer feeling breasts
Nursing implications for perceived low milk supply
Do feeding assessment when mom is ready to learn.
Ask about big picture/relationship Evaluate the effectiveness of feeding
Point out signs of adequate intake Enhance latch and transfer
Causes of secondary low milk supply
infrequent feeds (separation, clock watching, missed cues)ineffective feedings
(ram style breastfeeding, tight latch/nipple pain/finger feeding), low milk
removal
3 E's of BF
Early and often
Effective
Exclusive
Causes of maternal primary low milk supply
Primary insufficiency, hormonal issues, thyroid problems, retained placenta,
medications, smoking, breast surgery/reduction
Causes of infant primary low milk supply
Tongue tie, jaundice, thyroid, illness, neurological disorders, congenital issues,
SGA
Traditional Galactogogues
FINAL STUDY GUIDE SUMMARISED AND
RATED A.
Effects of weaning the infant?
Optimal development of the cerebellum is stimulated by motion.
Colic is nearly absent in hunter gather societies where mothers carry their
infants consistently
How to help the infant feed better?
-Increases frequency and duration
-Skin to skin
-Stimulate the infant to stay awake while feeding
-Offer both breasts
-Quiet environment
-Relieving pain from teething
-Different feeding positions
What to feed?
Breastmilk, expressed breastmilk, pasteurized donor milk, formula
Calculations for amount of milk needed for 24 hours?
weight in Kg x 150
Considerations when determining how much to feed?
-Time (in first 24 hours does not feed much, but needs opportunities to feed)
-Gestation of infant (late preterm may need more milk than able to get from
breast, hand expression after feeding)
-Health and birth experience of the infant (low blood sugar can be resolved
with small amounts of colostrum)
-How well breastfeeding?
-Are the breasts filling?
,Alternative methods to feed infants?
Dropper/syringe, spoon, cup, feeding tube at breast, bottle
Teaching for informed decisions
-How to establish and maintain milk production while supplements are
provided
-The importance of breastfeeding for the infant, mother, family and
community
-Health consequences for mother and infant of not breastfeeding
-Risks and costs of artificial substitutes and how to safely prepare, use and
store them
-Difficulty of reversing the decision once breastfeeding is stopped
Acceptable infant medical reasons for supplementation
Galactosemia, Maple syrup urine disease, phenlketonuriavery, low birth
weight ( <1500g)born before 32 weeks, risk for hypoglycaemia, significant
weight loss with no milk establishment, fail to regain birth weight by two
weeks after birth, & indications of insufficient milk intake
Acceptable maternal medical reasons for supplementation
severe illness (sepsis), HIV+, herpes simplex virus 1 when active lesions are on
breast, medications (sedating psychotherapeutics, radioactive iodine, cytotoxic
chemo)breast abscess, hep b and c, mastitis, nicotine, alcohol, illicit drugs
How to help infant increase the demand
Increase frequency and duration of feedings, improve latch, skin to skin
contact, stimulate infants during feeding, breast compression while
breastfeeding, & offer both breasts
Reasons to hand express
-Protects from engorgement, plugged ducts and mastitis
-Positive effect on milk supply and establishment early on
-Helps promote exclusive BF
Hand expression vs breast pump
,Hand expression promotes exclusive BF, not everyone has access to pumps
Ways to help the dyad learn to breastfeed?
-work on the techniques of latch and position
-skin to skin contact
-be gentile and dont force anything
-increase the amount of time gradually
-positive environment
-calm mother and infant dyad
-use innate reflexes (wait for alertness, rooting, gaping)
Infants behaviour interpretation
Shake head back and forth at breast-seeking breast
Anchor chin on breast
On and off the breast-needs a bigger mouthful
Arching away from the breast-cant find breast/distressed/disorganized Calm
him and try again
Reasons newborns have issues latching?
Poor mechanics, flat or inverted nipples, pain, oral aversion d/t negative birth
experience, tongue tie, and sleepy infant
Reasons older infants have difficulty latching?
Pain, illness, distracted, oral aversion d/t abundant milk supply
Flat or inverted nipples treatment?
-Stimulation
-Breast shells & nipple rolling do not appear to be effective
-Nipple everters but unclear how effective
Components of 3 rules
Feed the infant (early frequent breastfeeding, effective latch, exclusive
breastmilk)move the milk(hand expression and pumping)help the dyad learn
(understanding infant behaviours, reassure mothers)
, Causes of perceived low milk supply?
-Reassure mother d/t cluster feeding
-Frequent feeds during a growth spurt
-Parents expect infants to sleep through the night
-Not able to express or pump extra
-Purple crying
-Needing physical closeness
-Softer feeling breasts
Nursing implications for perceived low milk supply
Do feeding assessment when mom is ready to learn.
Ask about big picture/relationship Evaluate the effectiveness of feeding
Point out signs of adequate intake Enhance latch and transfer
Causes of secondary low milk supply
infrequent feeds (separation, clock watching, missed cues)ineffective feedings
(ram style breastfeeding, tight latch/nipple pain/finger feeding), low milk
removal
3 E's of BF
Early and often
Effective
Exclusive
Causes of maternal primary low milk supply
Primary insufficiency, hormonal issues, thyroid problems, retained placenta,
medications, smoking, breast surgery/reduction
Causes of infant primary low milk supply
Tongue tie, jaundice, thyroid, illness, neurological disorders, congenital issues,
SGA
Traditional Galactogogues
