What is the Healthy People 2010 goal for breastfeeding?

The goal is for breastfeeding initiation rates to reach 75% CONTINUANCE RATES AT
6 MONTHS TO REACH 50% and that at least 25% of infants will still be breastfeeding
at 1 year of age.
What does the American Academy of Peds say about breasfeeding?
They say that babies should be exclusively breastfed for 6 months (which means
should not be given anything else) and breastfeeding should continue for at least 12
months.
How is feeding behavior different between bottlefed and breastfed
babies?
Media advertises that correct position for feeding infants. Brestfeeding does not
assume that same position. Breastfed babies would have to turn their necks and
swallow-not easy to do.
What are the benefits to the mother that breastfeeds?
Sucking stimulates pituitary to contract uterus so there is a decrease in PP bleeding
increases child spacing helps lose pregnancy weight-earlier return to pre-pregnancy
weight decreases the risk of breast and ovarian cancer decreased risk of
osteoporosis after menopause.
What are mothers that do not breastfeed at an increased risk for?

Slower healing after childbirth

PP blood loss and anemia after childbirth
increased risk for ovarian and breast cancer
decreased child spacing
osteoporosis

How does breasfeeding benefit the baby?

fewer ear infections

less allergies-asthma/eczema
less Upper Respiratory Infection
fewer hospital visits
lessened chance of childhood obesity
decreased necrotizing enterocolitis among preterm infants(seen in NICU)-less
GI disturbances-diarrhea
less risk of getting type 1 diabetes
enhanced cognitive development-higher IQ scores

How can you tell the baby is ready to breastfeed?

ALWAYS wait until the baby is ready to feed-make sure NB has normal breathing
pattern nor labored breathing, active bowel sounds, no abdominal distension.
Infant cues include:

hand movements-hand to mouth or hand to hand

tongue movements-mouthing, sucking, rooting crying
NB usually feed within the first hour after birth

What is a late sign of hunger in a NB?

Crying
What causes milk to be produced and then let down?

There is a drop in estrogen and progesterone that releases prolactin from the
anterior pituitary this causes milk production.
Then the posterior pituitary produces oxyticin which signals the milk to be let
down.
So- Prolactin tells breast to make milk and oxytoxin tells breasts to let down
milk.

How much milk does a NB need?

A NB needs 110kcal/kg/day
Breastmilk has 20 kcal/oz-the greates amount of energy is provided by the fat
content of breast milk.

What nutrients are in breast milk?

Protein-the protein requirement per unit of body weight is greater in the NB than at
any other time of life.-Source of amino acids for growth. The immunologic properties
effects against diarrhea and other infectious illnesses.
Fat-at least 15% of the calories provided must come from fat. The greatest
concentration of fat is in the hind milk-fat in breastmilk is easily digested. Fatty
acids are important in the development of cellular memebranes and are particularly
important in eye and brain development.
Carbs should provide at least 40% to 50% of the total calories in the diet.
What is the difference between foremilk and hind milk?

Foremilk comes first-thinner milk (skim milk). Then comes hind milk-has a lot of fat.
(whole milk-creamy)

Breast milk is low in iron. The composition of the milk changes as the baby ages.
Formula has corn syrup and a high carb proportion. Babies prefer the sweet taste.
Breast milk also contains antibodies that last 3 months-passive immunity.
What are some barriers to breastfeeding mothers?

diet, medications, smoking (nicotine does go into breast milk) fatigue

if mother had previous breast surgery
flat/inverted nipples
contraceptives that are estrogen based will decrease estrogen supply-delay
giving to woman until 6 weeks and then give minipill
mom has anxiety

What are some barriers that cause infants not to breastfeed?

baby is premature-doesnt have strength to suck

baby is ill or disabled-sluggish
hypoglycemia
jaundiced babies dont feed as well

What mothers should not breastfeed?

If mom has

Hep B or C
drug addiction
HIV
active herpes near nipple
medications
PKU-breastfeed partially and have supplement with formula
if NB has severe illness or metabolic disorder

How does the mother know that her baby is getting enough breastmilk?
(EXAM-Know what to teach parents)

If baby feeds at least 8X in 24 hours-Q 2-3 hours

If baby has at least 3 stools/day after day 1, then 4 stools per day by day 5

If baby has at least 6 wet diapers per day by day 5

If baby appears content and is satisfied after most feedings

If you hear or see baby swallowing

If baby loses less than 10% of birth weight and then is back to birth weight by
2 weeks.

How does the mother prevent cracked/sore nipples?

Pain with breastfeeding is normal in the first few weeks. But pain should not
go on any longer than when the baby first latches on.
Make sure the baby is positioned correctly-number one way to get sore
nipples
use cabbage leaves(not too long-they will dry up milk as well) and caffeine
tea bags.
Describe Mastitis.
o The sudden onset of flulike symptoms such as fever, chills, body aches,
and headache. Localized breast pain and tenderness is usually
accompanied by a warm, reddened area on the brest.
Antibiotics will be prescribed as ordered

Factors that cause mastitis:

plugged ducts
sudden decrease in number of feedings
abrupt weaning
wearing under wire bras
sore cracked nipples cause a portal of entry for bacteria

How does the mother prevent engorgement?

Engorgement causes breasts to be so full and painful.

The mother should feed frequently and avoid supplementing wear a good
supportive bra
To comfort engorgement have woman apply warmth (towels, shower)and
gentle massage before nursing. Get milk out so breasts are empty.

How does woman handle engorgement if not nursing?

Tell her to do nothing to stimulate her breasts. Dont want to put warm water on
breasts. Use ice. Wear a tight bra.
How long is breast milk good for?

Keep milk at room temp-will be good for 24 hours

If put in fridge-milk goos for 3-4 days

If put in freezer-good for 6 months

Describe colostrums (first 2-3 day)

Colostrums is filled with antibodies,immunoglobulins, and vitamins
Describe transitional milk (7-10 days)
Milk has decreased antibodies and immunoglobulins than colostrums. But milk has
increased fat and calories. Engorgement ceases and feedings become more regular.
Describe mature milk (11-14 days)
Milk has increased water, fats, and carbs (lactose) as well as antibodies. Breasts
begin producing supply to meet babys demands.
What are the goals for effective breastfeeding?

baby will latch on and feed effectively 8 to 12 times per day.

baby will gain weight appropriately
baby will remain well hydrated-have 6 to 8 wet diapers and 3 to 6 BM every
24 hours after day 4.
sleep/ seem content between feedings

How many calories should a breastfeeding mother consume?

About 2700 cal per day-equal to 500 calories more than a nonpregnant woman.
Should a woman wash her breasts with soap?
No it can have a drying effect on the nipples.