Shared Flashcard Set

Details

Breastfeeding Support
Support for breastfeeding women in postpartum
56
Nursing
Not Applicable
07/22/2011

Additional Nursing Flashcards

 


 

Cards

Term
Optimal length of time before first breastfeeding
Definition
Within one hour after birth
Term
Three procedures that may be delayed to enable skin-to-skin and first breastfeeding to be uninterrupted
Definition

Vitamin K injection

Bath

Eye antibiotics

Term
One immunological reason to breastfeed
Definition

Protects against almost every infant infection

 

 

Term
Infants who are breastfed have a ___ lower risk of dying during their first year
Definition
21%.   (increases to 38% if babies are breastfed for at least 3 months or more)
Term
Chronic diseases which breastfeeding can help prevent (name 3)
Definition

Type 1 Diabetes mellitus

Lymphoma

All childhood cancers

Crohn's Disease

Ulcerative colitis

Cardiovascular disease

Breast cancer

 Obesity

Term
Two factors which are most predictive of the degree to which breastfeeding can protect against infection and disease in both mother and infant
Definition

Exclusivity of breastfeeding

Duration of breastfeeding

Term
Women who do not breastfeed are at higher risk for:(name 2)
Definition

Breast and ovarian cancer

Osteoporosis

Short intervals between pregnancies

Obesity

High blood pressure

urinary tract infections

Term
According to a UCLA study, 75% of women who received this intervention were likely to breastfeed, as opposed to 43% of women who did not receive this intervention.   What is the intervention?
Definition
Prenatal and postpartum encouragement by physician and nurses to breastfeed
Term
Labor/birth factors that can negatively impact breastfeeding (name 2)
Definition

Systemic medications

Epidurals

Long/difficult/traumatic birth

Cesarean delivery

 

Term
Advantages to skin-to-skin immediately following birth and throughout early postpartum period (Name 2)
Definition

Helps infants stabilize body temperature

Helps begin the process of colonization of infant skin, gut and respiratory system to enhance immune capabilities

Helps establish breastfeeding relationship

Term
Two key hormones involved in milk production
Definition

Prolactin

Oxytocin

Term
Prolactin's primary role in breastfeeding is primarily to _________.
Definition
Stimulate the breasts to produce milk
Term
Oxytocin's primary role in breastfeeding is to _________________.
Definition
Cause contractions in the alveoli of the breast to eject milk into ducts and make it available for the baby.
Term
Pacifier use and formula supplementation of healthy newborns in the first 24-48 hours is associated with what two negative impacts on breastfeeding?
Definition

Delayed onset of lactogenesis II

Abnormal sucking patterns in infants

Term

Possible responses to the mother who says:

I'm too tired to keep the baby with me.

Please take the baby so I can get some sleep

Please just give the baby a bottle tonight

(name 3)
Definition

Provide facts about advantages of rooming-in

information about nipple confusioin/preference

Possible consequences of even one formula feed

Taking advantage of time to learn

Missing feeding cues

Missing out on special time with baby

Term
Key factors in feeding position for Mother (name 4)
Definition

Comfort

Back and arms supported

Feet supported

Knees slightly higher than hips

Pillows as needed

Term
Key factors for baby in all feeding positions (name 3)
Definition

Baby at level of nipple

Chest, abdomena nd knees are facing and touching mother's body, tucked in close

Head is facing forward, slightly extended, not arched or turned

Ear, shoulder and hip all in a straight line

 

Term
What are is the comon factor in a mother's hand position for all breastfeeding holds?
Definition
Mother's fingers are parallel to the baby's lips.
Term
The straddle position may be useful in the what situations? (name 2)
Definition

Small baby

Small breasts

Reflux

Some craniofacila or neurological challenges

Term
The cross cradle hold is useful in what situations? (name 2)
Definition

Baby just learning to feed

Preterm infants

Down's syndrome infants

Anytime more feeding support is needed

Term
Whare are four common breastfeeding positions for the baby?
Definition

Cradle hold

Cross cradle hold

Under the arm (football)

Straddle

Side-lying

Term
Which breastfeeding position could be suggested when mother is tired, has had surgery or has a swollen/sore perineum?
Definition
Side-lying or lying down
Term
Whare are some suggestions for positioning with large breasted women? Name 3)
Definition

Rolled soft cloth under breast for support

Baby at level of nipple, which may mean on the lap

Support breast with hand

May work best with lying down/side-lying

Term
What are some suggestions for positions with small-breasted women? (Name 2)
Definition

Straddle hold may work best

Use as many pillows as needed to get baby to level of breast

Reassure her that her breasts are perfectly adequate to feed her baby (explain breast anatomy if needed)

Term
What are possible tools/techniques for working with a mother with flat or inverted nipples? (name 3)
Definition

Remember that the baby only knows the nipple that is offered

Enhance nipple protrusion using: fingers, pump, Hoffman's maneuvers, nipple everters, breast shells, nipple shields.

May take several people to get baby on

Provide reassurance to mother that most mothers and babies figure this out

Term
When you are assessing Latch, what are the factors that you can SEE? (Name 3)
Definition

Nipple disappears

Nose and chin are close to breast

Cheeks are round and full

Angle of the lips is about 120 degrees

Term
What are the factors that you can HEAR when you asses latch? (Name 3)
Definition
Quiet, drawing sound;
swallowing.
No clicking or "smacking."
Breaths ocur refularly, usually after every 1-3rd suck.
Use stethoscope to assess if you can't hear the swallows.
Term
What are the the things that can be FELT when assessing latch? (name 2)
Definition
Ask the mother how she feels:
should feel a deep, firm pull but not pain.
If latch is secure, nipple will not slip out when baby's head falls back slightly.
Term
What are the terms in the acronym LATCH?
Definition
Latch,
Audible swallowing,
Type of nipple,
Comfort of breast and nipple,
Hold (positioning)
Term
What is normal milk intake for a baby aged 1-24 hours?
Definition

7 ml/feed or an average of 37 ml/day

 

Term
What are some key  messages for parents about frequency and length of early feedings? (name 3)
Definition

Feed every few hours day and night.

No rules about length of feeding as long as the baby is correctly latched

No rules about one or two breasts.

Baby's don't overeat as long as they control the feeding.

Term
Whare are some possible ways to wake a sleepy baby? (name 3)
Definition

Change environment

Undress

Skin-to-skin without trying to force a feeding

Spoon feed expressed milk

Change positions

Term
What techniques can be used to elicit milk flow BEFORE trying to latch? (name 3)
Definition

Breast massage

Heat

Hand expression

Pump

Term
What are some techniques that can be used to entice the baby to feed? Name 3
Definition

Drip milk or water on to nipple

Spoon feed expressed milk

Syringe feed

Tube next to nipple

Term
What are the two things that a baby must create for an effective feeding?
Definition

Suction for latch

Suction and compression for milk transfer

Term
What are several alternative feeding techniques? (name 6)
Definition

Nipple shield if baby is able to latch and suck

Spoon

Syringe

Dropper

Finger feeding

SNS

Lactaid

Cup

Haberman/bottles

Term
A general plan for the management of jaundice may consist of what approaches? (name 4)
Definition

Do not interrupt breastfeeding

Do not supplement with water

Visilize assessment to avoid further problems or improve feedings

If the baby can eat, it should be breastmilk

if the baby can feed, it should be at the breast

If there isn't enough breastmilk, supplement with formula (nutramigen may be an option)

Term
What are several non-pharmacologic strategies for increasing milk supply? (name 6)
Definition

Feed early and often

Climb into bed to snuggle with baby

Skin-to-skin

Food and nurturing for mother

Massage, heat before and during feeds

Feed during the night

Pump after feedings

Acupuncture

Term
Name two pharmacologic galactogogues to increase milk supply.
Definition

Raglan

Domperidone

Term
List several situations that DO NOT warrant formula supplementation.
Definition

A sleepy baby who has had only a few feedings during the first 48 hours

Bilirubin levels between 12 and 20 mg/dl after 72 hours (NOTE:   This assumes that infant is feeding well, having more than 4 yellow stools per day, and has no hemolysis or other signs of pathology.

Nighttime fussiness or constant feeding for several hours where baby is content and satisfied while on the breast and fussy if off the breast

Growth Spurts or Mother's choice

Term
List four medical indications for supplementation.
Definition

Birthweight less than 1500 grams or gestational age below 32 weeks

SGA with potentially severa hypoglycemia

Severaly ill mother (e.g., PIH, shock, psychosis)

Inborn errors of metabolism

Acute water loss resulting in fever or other sx of dehydration

Mother taking contraindicated medication (rare)

Term
List four infant indications for supplementation.
Definition

Hypoglycemia

Significant dehydration or fever

weight loss greater than 10% at 24 hours of age - (questionable if no other symptons exist)

Delayed bowel movements or dark stools at day 5

Insufficient intake despite an adequate milk supply

Hyperbilirubinemia related to poor intake, after adequate evaluation and management of breastfeeding

Prematurity, low birth weight if mother is unable to provide sufficient milk for baby's needs

 

Term
List three characteristics of "physiologic sore nipples".
Definition

Normal in first week after birth

Hurts at the start of the feeding

Skin remains intact, but is sore

Pain peaks on the third day after birth and then begins to subside

Term
What are factors in nipple pain that are may require more active management? (name 3)
Definition

Poor position and latch

Engorement

Flat or inverted nipples

Improper tongue position in the baby's mouth

Term
What are some technique to help manage nipple pain? (name 3)
Definition

Carefully assess early feedings for latch and position

Express some milk before latching on

Keep milk flowing and baby sucking throughout the feed.

Teach mother to watch for subtle feeding cues and remove baby carefully when non-nutritive sucking begins

Assess nipples after each feeding for signs of trauma

Avoid engorgement

 

Term
Only about ___% of women will have breasts so engorged that the baby can't latch on?
Definition
2%
Term
List three common causes of engorgement.
Definition

Sleepy baby

Poor milk transfer

Poor attachement/latch

Restricted feeds or scheduled feeds

Breast reduction or augmentation

 

Term
What are the most effective strategies for avoiding or treating engorgement? (name 5)
Definition

Early frequent feedings or breast stimulation

Careful assessment of attachement

Breast massage during early feeds

Keep milk moving through the breast

Oxytocin nasal spray

Apply heat with warm shower, breast bath, heat packs

Ibuprofen

Ice packs after feeding

Term
List 6 of the 10 steps to becoming a Baby Friendly hospital
Definition

Have a comprehensive breastfeeding policy

Train all health care professionals in breastfeeding

Inform all pregnant women about breastfeeding

Initiate breastfeeding within one hour of birth

Show all mothers how to breastfeed

Give infants nothing but breast milk

Practice "rooming in" 24 hours/day

Encourage breastfeeding on demand

Give no pacifiers

Establish breastfeeding support groups

 

Term
In addition to the 10 Steps, Baby Friendly hospitals must adhere to the World Health Organization code of International Marketing of Breast Milk Substitutes.   In practical terms, what does this mean for a baby friendly hospital?
Definition

All breast milk substitutes (formulas) are purchased by the organization and the purchase price reflects fair market value.

No promotion or advertising of formulas can occur in the hospital

Term
List two ways that you can locate the Fairview Breastfeeding policies and algorithms
Definition
Breastfeeding "Best Practice" binder
Online on Intranet under policies tab
Term
How soon after a cesarean birth should a mother and baby be offered the opportunity to breastfeed?
Definition
Within an hour of the time that she is able to respond to her baby, unless medically contraindicated.
Term
How long after a cesarean birth should a mother be offered the chance to hold her baby? (Preferable skin-to-skin)
Definition
Within a half hour of the time that she is able to respond to her baby, unless medically contraindicated.
Term
How often should a baby feed within the first several days after birth?
Definition
Between 8-12 times, as a minimum.
Term
List three cues that baby's use to indicate readiness to feed
Definition
Tongue thrusting
Rooting
Restlessness or squirming
Sucking on the fist or fingers
Crying (late cue)
Lip smacking
Term
List at least two FAIRVIEW resources for post-discharge breastfeeding support.
Definition
Mom and Baby Classes (register through OnCall, 612/672-7272)
UMMC Lactation Consultant (612/273-2220)
Fairview Baby Connection warm line (612/672-4789)
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