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Breastfeeding

Breastfeeding. Anatomy. Montgomery’s tubercules lactiferous sinuses lactiferous ducts. Anatomy. Nipple-contains  25 nipple pores Areola-houses Montgomery’s glands Montgomery’s glands-secrete a protective lubricant Lobe-one of divisions of glandular tissue

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Breastfeeding

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  1. Breastfeeding

  2. Anatomy • Montgomery’s tubercules • lactiferous sinuses • lactiferous ducts

  3. Anatomy • Nipple-contains 25 nipple pores • Areola-houses Montgomery’s glands • Montgomery’s glands-secrete a protective lubricant • Lobe-one of divisions of glandular tissue • Lactiferous sinuses-milk collecting sinuses • Alveoli-milk production glands • Nerves-strong sucking elicits a response

  4. Suclking Let Down Reflex • Stimulates anterior pituitaryprolactin • Prolactin Stimulates alveoli • Alveoli milk • Stimulates posterior pituitary oxytocin • oxytocin alveoli contract • Alveolar contraction milk ejection

  5. Hormones of Lactation • Estrogen-growth of ducts, inhibits milk production • Progesterone-growth of lobules • Prolactin-milk production,mothering behavior • Oxytocin-milk ejection reflex

  6. Natural food +bonding no sanitation or refrig. Fewer illnesses less constipation colostrumantibodies develops dig. Enzymes saves $ No mixing/mistakes stools/reg. no bad smell no weight problems speeds involution less br. Cancer later easier to travel allergies  longer birth control Mothers don’t make much methane Advantages of Breastfeeding

  7. Keys to successful breastfeeding • Graspable Nipples • Positions • C hold • Latch on • Support • Signs of Effective Suckling

  8. Graspable Nipples • Compression test • flat inverted, and retracting nipples • breast shells

  9. Positions • Cradle • Football • side-lying • other

  10. Latch on • C-hold • baby’s mouth open wide • center nipple and areola in mouth • baby’s chin and nose touch breast • baby’s body facing mother • baby’s lips flanged out

  11. Support • Use lots of pillows for baby and mom • Mother should always bring baby to her • sitting upright requires foot support

  12. Signs of effective suckling • Baby’s lips flanged out • baby’s cheeks puffed out • ears wiggle • baby’s tongue down and over gumline • no pain • audible swallow

  13. Signs of Letdown Reflex • Uterine cramping • sleepiness • thirst • tingling, filling or tightening sensation • leaking from opposite breast • audible swallowing at regular intervals • by 7 days, minimum 6 wet diapers/day • by 7 days, minimum 4 BM’s q 24 hrs

  14. Supply and Demand • Do not time feedings • nurse on one breast til baby asleep or comes off • burp and diaper, offer second breast. Baby may or may not feed on second breast • Sucking produces demand, body will respond with adequate supply

  15. Baby is eating enough if: • He nurses often • seems relaxed after feeding • adequate number of wet/messy diapers • baby seems happy, alert and growing

  16. Hunger cues • Hands in mouth/clenched fists • sucking motions • rooting • crying

  17. Temperament • Sleepy baby-unwrap, change diaper, situps, undress, talking • Excited baby-swaddling, talking, rocking, bouncing, dim lighting • sleeping patterns • eating patterns

  18. Days 1-7 • Nurse within 1 hr birth • nurse on demand • room-in • wet messy diapers will increase from one of each on day 1 to 6wet and 4bm by day 7 • Milk comes in on day 3-7 • avoid supplemental bottles • initial nipple soreness common • wear supportive nursing bra after week 1, growth spurts, relief bottles

  19. Nutrition during lactation • 500-1000 additional calories • 2500-3000 cc/day fluid • protein 62-65 gms/day (4 servings) • calcium, 1200 mg/day • phosphorus-400mg additional/day • niacin 20mg/day • riboflavin 1.8mg/day • increased vit A,C,E

  20. Lactation diet • 2-3 qts fluid • 4 servings protein • 4+ servings grains • 5 servings dairy • 6 servings fruits and veggies • prenatal vitamins with iron

  21. Common problems FLAT AND INVERTED NIPPLES • Compression test • Milk cups prenatally • Milk pump to pull out nipple • avoid nipple shields • football hold allows more control

  22. Common problems SORE NIPPLES • occurs in almost everyone--first 3-4 minutes • lasts 1-2 wks • allow nipples to air dry • aim nipple straight into mouth • support breast with C hold • football hold • Always break suction before removing nipple from mouth

  23. Common problems ENGORGEMENT • nurse frequently • before feeding warm shower • feed baby on both breasts • gentle massage while nursing • avoid pumping--unless baby refuses 2nd breast

  24. Breast assessment •  for lumps •  for cysts •  size and shape •  symmetry •  for engorgement •  for inverted, everted, or flat nipples

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