Ch. 22 Study Guide
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| What care can help the mother who has flat or inverted nipples? | Rolling flat nipples stimulates them to erect. Pumping breasts few mins before nursing or using breast shield draws inverted nipples out.
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| Describe difference in breast fullness | Soft- feel like a cheek, Filling- slightly firmer than cheek, Engorged- Hard, shiny, taut tissue
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| Breast inflammation | Mastitis
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| Mother cups her breast in palm with her thumb on top & fingers underneath and behind areola | Palmar/U position for Breastfeeding
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| Mother places her index & middle finger above & beneath the areola to guide her nipple to the infant | Sissor or V postion for Breastfeeding
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| List methods to prevent engorgement | Early & frequent nursing for adequate lengths of time day & night, Avoid formula/water supplements.
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| List methods to treat engorgement | Feed every 1.5-2h, cold application between feedings, massage to speed milk release, softening areola by using pump/expressing milk to begin flow, meds for discomfort, wear well-fitting bra 24h/day.
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| a. Determine the number of calories per day needed by a 3-day-old infant weighing 3.6 kg (81b). b. Calculate the number of ounces of breast milk or formula (each having 20 calories per ounce) the infant needs daily. c. What are the infant’s daily fluid | See p. 526-527 to help calculate
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| Describe changes in composition and appearance of colostrum, transitional milk, and mature milk. | Colostrum is produced first 7 to 10 days; thick, yellow substance that is rich in immunoglobulins, esp IgA. has laxative effects & high in protein, fat-soluble vitamins, & minerals. lower in carbs, fat, lactose, and some vitamins than mature milk
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| Determine what advantages the breastfed infant receives that the formula-fed infant does not receive regarding the following components. Component Quant4y and Advantages Proteins Carbohydrates Fats Vitamins Minerals Enzymes | See p.527-528
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| List factors and describe the purpose of factors in breast milk that help prevent infant infections. | Bifidus factor promotes growth of Lactobacillus bfidus(increases acidity in GI tract) Leukocytes secrete lysozyme, which acts against gram-positive and enteric bacteria. Lactoferrin inhibits growth of iron-dependent bacteria. Immunoglobulins, particularly
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| Describe the purpose of oxytocin in breastfeeding. What can enhance or interfere with secretion? | Oxytocin stimulates the milk-ejection reflex. It is enhanced by comfort, thinking about the infant, and the stimulation of suckling. It is inhibited by discomfort or inadequate suclding.
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| Describe useful techniques to teach the mother if the infant seems to have trouble breathing while nursing. | mother can bring the infant into a more horizontal position and nearer her body. She should not indent the breast tissue, because this may interfere with milk flow or change the position of the nipple in the infant’s mouth and may lead to sore nipples.
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| Describe differences between nutritive and nonnutritive suckling. How does infant swallowing sound? | Nutritive suckling- smooth, continuous movements with occasional pauses to rest. Swallowing may follow each suck or after 2 or 3 sucks. Nonnutritive suckling- fluttery or choppy motions without the sound of swallowing. Infant swallowing has a soft “ka” or
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| What should the mother be taught about burping the infant? | breastfeeding, burp when nonnutritive suckling begins and change to the other breast. For formula feeding, burp after approximately one-half ounce of formula in the early days, and then to midway in the feeding when the infant’s intake increases.
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| How can you tell whether the infant needs more of the areola in the mouth? How much areola should be inside? | The infant’s cheeks will show dimpling, and he or she will make smacking or clicking sounds. The infant’s lips should be ito 11/2 inches from the base of the nipple if there is enough of the areola in the mouth.
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| How does frequent breastfeeding help resolve jaundice? | Frequent breastfeeding enhances milk production and stimulates peristalsis, which increases the number of stools and thus helps the body excrete bilirubin.
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| In what maternal conditions is breastfeeding not advised? | Serious infections such as untreated tuberculosis, HIV infection, galactosemia, and maternal chemotherapy. Maternal substance abuse is usually also a contraindication to breastfeeding.
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| What should the mother be taught about breast milk storage containers? | Glass, polyethylene, or polypropylene plastic containers.
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| What should the mother be taught about breast milk storage temp? | Milk can be stored in the refrigerator for 72 hours or in the freezer of a refrigerator for 1 month; it can be kept in a deep freeze at —20° C (—4° F) for 3 to 4 months
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| What should the mother be taught about thawing breast milk? | Do not microwave. Thaw in the refrigerator or by holding under running water.
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| How long should a mother breastfeed? | American Academy of Peds and American Dietetics Association recommend breast milk only the first 6 months. Although solid foods are added, suggestion is breastfeeding continue for at least 1 year. However, the decision of how long is up to the mother.
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| Describe use and precautions associated with Ready-to-use formula. | Open & add cap for single-serving containers. For multi-serving cans, wash top of the can & can opener before opening & shake can. Pour into washed bottles and cap. Do not dilute. Refrigerate an open can and discard any remaining milk after 48 hours
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| Describe use and precautions associated with Concentrated liquid formula. | Dilute the concentrated liquid with an equal part of water. Do not over- or under-dilute. Fill clean bottles with diluted formula as in ready-to-feed.
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| Describe use and precautions associated with powdered formula. | Dilute formula in a clean bottle exactly as directed, usually one scoop for each 2 oz of water. As in concentrated liquid formula, do not over- or under-dilute. 20.
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| Explain what a new mother should be taught about frequency. | Feed the infant every 3 to 4 hours, following the infant’s hunger cues instead of a rigid schedule.
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| Explain what a new mother should be taught about propping the bottle. | Do not prop the bottle. Propping can cause aspiration of formula and increases the incidence of ear infections and dental caries (when the primary teeth erupt).
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| Explain what a new mother should be taught about microwaving formula. | Do not microwave formula, because it may have “hot spots” that would burn the infant.
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| Explain what a new mother should be taught about feeding leftover formula. | Discard all remaining formula after 1 hour of use.
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| What should the mother be taught about removing the infant from breast? | Break suction before removing the infant from the breast by inserting a finger between the infant’s gums or indenting the breast tissue near the infant’s mouth.
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| Describe the purpose of prolactin in breastfeeding. What can enhance or interfere with secretion? | Prolactin stimulates the breasts to produce milk. It is enhanced by suckling and removal of milk from the breasts. It is inhibited by estrogen, progesterone, and placental lactogen during pregnancy and by inadequate removal of milic after nursing begins
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| Describe changes in composition and appearance of transtional milk | Transitional milk is lower in immunoglobulins and proteins but higher in lactose, fat, and calories than colostrum.
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| Describe changes in composition and appearance of mature milk | Mature milk begins after 2 weeks of lactation; it is bluish and provides 20 calories/oz. Immunoglobulins are provided in mature milk throughout lactation.
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Created by:
L.moore
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