COUNSELOR) FINAL EXAM
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QUESTIONS AND WELL
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The more time spent breastfeeding in the first 48 hours, the less chance there is for
engorgement.
Bras for breastfeeding individuals
For all breastfeeding individuals, bras are essential for comfort during lactation.
Impact of breast surgery
, Breast surgery can potentially impact breastfeeding.
Peri-areolar incisions
Least significantly associated with milk insufficiency.
Breastfeeding likelihood after chest masculinization and breast reduction surgery
Unknown.
Close nutritional follow up
Key when considering chest masculinization and breast reduction surgery.
Nutrition assurance for infants
Important when considering breast surgery.
Suboptimal breast anatomy
Can potentially impact breastfeeding and should be seen as a 'red flag' for close assessment
and follow up.
Hypoplastic breasts
Do not always make ample milk.
Breast implant on one side
Could indicate history of discrepant breast size.
Flat and inverted nipples
Lead to inadequate production of milk-making hormones.
Prolactin and nipple stretching
Prolactin involves nipple stroking while oxytocin involves nipple stretching.
Nipple stretching in baby's mouth
Stretches to 2x its length according to Smith's research.
Everted nipple necessity
Necessary for babies to attach to the breast.
Breast surgery counseling considerations
Include if the milk ducts are patent, if the nipple pores are patent, and the need to monitor the
baby's weight gain very closely.
Grade 3 inverted nipples
Difficult or impossible to pull out/evert.
Nipple function at rest
Cannot be determined by looking at a nipple at rest.
, Concern about Grade 3 inverted nipples
Involves prolactin levels (decreased nipple stroking/stretching).
Prevalence of Grade 3 inverted nipples
Almost all mothers do not have grade 3 inverted nipples.
Prenatal nipple preparation recommendation
Should not be recommended for all women as no research supports it.
Jo Alexander's research on inverted nipples
Indicates that 1 out of 5 women have inverted nipples.
Inverted nipples prevalence
3/5 mothers have inverted nipples.
Inverted nipple preparation
Doing nothing to the nipple during pregnancy
Breast shell usage
CDC
The Centers for Disease Control, which currently collects the most comprehensive
breastfeeding statistics in the United States.
Prolactin
A hormone that causes milk to be made.
Nipple stretching with appropriate latch-on
A mechanism that causes oxytocin to be released.
Lactogenesis III
Requires frequent milk removal and nipple stimulation to succeed.
Adequate rest
One of the factors for Lactogenesis III, along with alternating starting breast at each feed.
Adequate protein and carbohydrates
Nutritional requirements for the mother to support Lactogenesis III.
Adequate maternal hydration
A necessary condition for Lactogenesis III, along with lack of maternal stress.
Frequent milk removal and nipple stimulation
A method to ensure effective breastfeeding.
Factors determining fat content of milk
, The number of feedings in 24 hours, the speed/efficiency with which the baby removes milk,
the amount of fat in the mother's diet, and the amount of liquid in the mother's diet.
Most effective at increasing gastrin and CCK
Feeding with species-specific milk.
Weight loss in breastfeeding newborn
Weight loss of more than 7% from birth weight indicates possible breastfeeding problems.
Effect of extra energy supplementation in undernourished mothers
Responded to their infants more appropriately.
Harmful bacteria in breastfed infants' gut
The composition of breastmilk fosters the growth of good bacteria that crowd out other
organisms.
Colostrum production
Colostrum is made after there is a complete delivery of the placenta.
Lactogenesis 2
Occurs after the complete delivery of the placenta.
Lactogenesis 3
Also called galactopoiesis.
False statement about Lactogenesis 3
It is driven by the nursing parent's fluid intake.
Engorgement
Physiologically normal and is a marker for an excellent future of milk supply.
Breastfeeding duration and engorgement
The women who used a breast shell had the best breastfeeding outcomes at 6 weeks in the
Alexander study.
Alexander study implications
Sometimes true
Anemia and milk supply
Anemia is a marker for an ample milk supply.
Anemia prevalence in mothers
1 in 5 mothers may be anemic.
Sheehan's syndrome