Anatomy
The brown area surrounding the nipple
What is the areola
Per the hypoglycemia policy, which babies need to be supplemented even on day 1 if they have a stable blood glucose but are not breastfeeding effectively?
What are late preterm babies?
How soon after the baby is delivered can a mom start hand expressing?
What is immediately after delivery.
When teaching breastfeeding to a new mother, proper ________ makes latching easier.
What is positioning. When a newborn is held securely against mom he benefits from positional stability. Bringing the baby to breast chin first, nipple to nose, he is more likely to gape widely and latch deeply.
This, most abundant type of immunoglobulin, found in breast milk helps to protect the baby from a variety of illnesses including those caused by bacteria, viruses, fungi, and parasites.
What is Secretory IgA.
A small raised area on the areola that
secrets a lubricant for the nipple and
has antibacterial properties.
What are the Montgomery glands/tubercles?
Per AHS hypoglycemia policy, while a baby is weaning off supplementation, blood glucose needs to be at what level and monitored how many times?
What is greater than or equal to 2.6 mmol/L x 2.
How often should a mom hand express in the first 24 hours?
What is 8-12 times or after each breastfeeding attempt.
The nipple must reach what point in the baby's mouth to avoid pinching/pain and a flattened or ridged nipple?
What is the junction between the hard and soft palate. The nipple should be round upon removal from baby's mouth. (Jan Riordan and Mary Margaret Coates, Breastfeeding and Human Lactation Study Guide 2005)
The American academy of pediatricians recommends this "_______" be performed as long and as frequently as possible during the postpartum period which is typically defined as the first 3 months.
What is skin to skin.
The ‘feel good’ hormone released by
the maternal pituitary gland while
breastfeeding. This hormone causes
the breast to produce milk ejection or
“milk let down.”
What is oxytocin.
The AHS policy for discharging babies <37 weeks gestation is after how many hours of age?
What is 72 hours.
How much milk do we expect moms' to be able to express on day 1 postpartum?
What is little to no milk at first. It can take 4-5 times or longer before moms' express drops of colostrum!
What part of the baby can help the baby landmark or "map" the breast and facilitate latching by making the nipple more prominent?
What are the hands.
What is oxytocin! Oxytocin can also cause after pains and increases lochia.
If mom has had a breast reduction surgery and the 4rth intercostal nerve is severed, what could be the potential negative outcome for breastfeeding?
What is inhibiting the milk let down reflex?
Per AHS policy, how many blood sugars does the healthy term AGA baby need if not feeding effectively in the first 24 hours?
What is none or zero. Continue breastfeeding attempts every 3 hours or sooner if baby cueing. Start mom hand expressing and feed the baby any and all available expressed milk via syringe or on gloved finger. Blood glucose should be checked if baby is symptomatic.
What color is colostrum?
What is yellow! But white, green, and pink/orange are all normal variances and can all be safely fed to baby.
When latching a baby which part of baby's face should touch the breast first?
What is the chin. This helps to create an asymmetric latch.
What is 'yes.' Remember each breast has a different storage capacity. Breasts are more like sisters than twins!
What might we be concerned about if mom has a wide (>4 cm) space between her breasts, breast asymmetry, tubular shaped breasts, overly large and bulbous areolae, and/or absence of breast changes in pregnancy, postnatally, or both?
What is hypoplasia? Please ask a L.C. to see your mom if you suspect breast hypoplasia. Also suspect this could be an issue if your mom had breast implants!
How much volume can we safely cup feed a baby?
What is 20 mL.
When teaching hand expression, what actions should we teach mom to perform in the correct order?
-hold the breast at least one finger width from the areola
-Press straight back in toward the back of the chest wall
- Squeeze the fingers together as if trying to meet the fingers through the breast
- Relax the hand
Repeat
Name 2 signs that a baby is effectively feeding.
What are:
- sustained sucking and swallowing 1:1:1 or 3:1:1
- relaxed hands and arms
- baby coming off the breast/letting go of the nipple
- correct number of wet and dirty diapers
What medication can be prescribed to women with PCOS to increase milk supply?
What is metformin! Remember that feeding, expressing and pumping are the most important first steps for milk production. Medications will not work well if the breasts are not adequately stimulated.