Lactation Consultant QUESTIONS AND ANSWERS

what does the AAP recommend? -that infants be breastfed exclusively for the first 6 months of life but should continue for at least 12 months. -if infants are weaned before 12 months, they should receive iron-fortified infant formula women most likely to breastfeed women over 30, caucasian and well educated benefits of breast-feeding -contains growth factors that promote development of the brain and GI system -bacteriologically safe -has nutrients that are more easily absorbed than in formula contraindications of breastfeeding -galactosemia in infant -active TB -HIV -T-cell lymphotropic virus I or II -maternal chemotherapy or therapeutic radioactive isotopes -maternal use of "street drugs" Galactosemia not able to digest galactose- baby will die. people who have immigrated from poorer countries think that: formula is better US-born hispanic women: are less likely to initiate breast-feeding muslim and jewish cultures: value breastfeeding anatomy of breast -composed of 15 to 20 segments (lobes) embedded in fat and connective tissues -well supplied with blood what are in each lobe of the breast? alveoli, the milk-producing cells, surrounded by myoepithelial cells How many pores does each nipple have? 15 to 20 what is it that triggers the release of prolactin decrease in estrogen and progesterone after delivery of placenta When are prolactin levels the highest? during the first 10 days after birth and gradually decline but remain above baseline levels for duration of lactation oxytocin -other hormone essential to lactation -also responsible for contracting uterus after birth what produces oxytocin? the posterior pituitary prompted by the hypothalamus what reflexes is oxytocin responsible for -milk-ejection reflex -let-down reflex synthetic oxytocin pitocin what does human milk contain -digestive enzymes -the proteins Whey and Casein When does stage 1 of lactogenesis happen begins at 16 to 18 weeks of pregnancy what is produced in stage 1 of lactogenesis -colostrum -rich in immune globulins -high concentration of proteins and minerals -less fat than mature milk When does stage 2 of lactogenesis occur by day 3 to 5 when copious amounts of milk comes in to breast At the beginning of nursing what is released? -foremilk -60% skim milk -35% whole milk -provides lactose, protein, and water-soluble vitamins Hindmilk -(cream) -5% -increases after initial "let-down" rooting reflex head will turn towards finger if brushed against side of cheek *Frequency of feedings at least q 3h **how many times should a woman breastfeed in 24 hours? 8 to 12 times skin to skin -helps regulate baby's blood glucose -regulates baby's breathing how do you know a full-term infant is getting enough milk -feeds 8 to 12 times in 24 hours -has burst of sucking and swallowing -enough wet and soiled diapers -regains birth weight in 10 to 14 days what does prolactin cause for mom? vaginal dryness when is it best to breast-feed? within one hour of birth when does breast milk change in composition? -with each stage of lactation -during each feeding -as the infant grows breast milk production is based on a _______ principle -"supply meets demand" -more the infant needs the more abundant the milk supply when should solid food be started? after age 4 to 6 months