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Breast Feeding
10
Quick facts
by Daniel Kozan
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When does a full milk production begin in a mother postpartum?
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3-7 days
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What are signs of inadequate feeding by the infant? (6)
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1. <6 wet diapers/day (after first week)
2. <7 feeds/day
3. sleeping throughout the night
4. weight loss >10% birth weight
5. jaundice
6. sleepy or lethargic
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How many kcal/day are required by a newborn?
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120 kcal/kg/day
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What supplements are required by breast-fed babies? (4)
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1. vitamin K
2. vitamin D
3. fluoride (after 6 mo if not in water)
4. iron (from 4-12 mo)
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What are maternal factors are contraindications to breast feeding? (4)
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1. chemotherapy or radioactive compounds
2. HIV, active untreated TB, herpes in breast region
3. >0.5 g/kg/d alcohol or elicit drugs
4. certain medications (ie. tetracycline, lithium, OTHERS)
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What is the effect of taking the oral contraceptive pill while breast feeding?
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Estrogen may decrease milk production. Not dangerous to baby.
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What are the advantages of breast feeding?
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1. breast milk easily digested
2. baby receives IgA, lysozyme, lactoferrin (inhibits E. coli growth in intestine)
3. lower allergenicity than cow's milk protein
4. lower pH promotes growth of lactobacillus in GI tract
5. parent-baby bonding
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What are maternal complications of breast feeding? (3)
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1. sore/cracked nipples
2. breast engorgement
3. mastitis
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How is mastitis managed? (4)
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1. cold compresses between feeds
2. cloxacillin for mother
3. continue nursing
4. +/- incision & drainage
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What are complications of breast feeding for baby? (4)
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1. breast feeding jaundice
2. breast milk jaundice (rare)
3. poor weight gain
4. oral candidiasis: treat baby with nystatin
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