CLC Test Module 2
What microbiota framework was found to be doubled in colicky babies? - -
Proteobacteria (
-What 5 things negatively effect milk production? - -1. Long spaces between
feedings
2. Long, slow feedings
3. Excessive pressure in breast
4. Breast surgery/injury
5. Suboptimal breast anatomy
-Describe normal full breasts compared to engorged breasts? - -Normal: soft
to touch, rounder, fuller, firmer, heavier, mother feels well, normal body
temp, breast may be hot to attract baby, baby can grasp nipple.
Engorged: Hard breast, normal temp, mom is uncomfortable, breast is hot
and shiny, nipple is difficult for baby to grasp.
-What is the best solution for engorged breasts? Breast pump or water? - -
Water! can allow myoepithelial cells to contract and let milk spurt out. Breast
pumping can cause capillaries to errupt because there's so much pressure
on the breasts.
-What can cause pressure that leads to engorged breasts? - -Secretory
activation-lactogenesis II, too much milk left in breast, missed feedings,
restrictive bras and clothing, breast implants (less room for milk storage).
-What are the concerns for breast surgery or injury on milk production? - -
damage to nerves and/or ducts
-What should you look for if you suspect breast surgery? - -defined area
where color changes from areola to breast. If areola is completely round
(unusual), if skin tone stands out between areaola to breast (surgery), if it
fades, no breast surgery.
-Describe the nipple graft and how it could negatively impact BF? - -Areaola
and nipple were completely cut off. This cut connections to ducts, circulatory
system, nerves, etc. Nerves may grow back, but we have no way of ensuring.
These ducts have been disconnected at one point-not the best for BF.
-Describe pedicle surgery and how this could effect BF? - -Occurs with
breast reduction, nipple is still intact, but all other areas around breast are
pushed back for reduction, taking out a cup size, then edges are sewn back
together. Women with this surgery had a shorter time of exclusive/any
breastfeeding compared to controls. Women may be able to breastfeed, but
, we have no idea until birth when baby is born and can react to milk transfer.
Tell mom we "don't know" impact until birth.
-Can transgender folk breastfeed? - -It is possible, unsure until baby is born,
similar issues if chest reduction surgery took place, be aware of gender
dysphoria, restarting testosterone was a concern.
-What are breast anatomy concerns? - -Absence of breast changes (in
pregnancy or early days postpartum)
No postpartum breast fullness or signs of abundant milk concern
Hypoplastic breasts
Important to see both breasts in comparison to each other (are they different
sizes). These all require additional follow-up
-What are 5 questions to ask yourself when counseling for mothers with
breast surgery/injury? - -Are the ducts patent?
Are the nipple pores patent?
Are there signs of hormonal connection?
Are there concerns about weight gain of baby?
Is there adequate pediatric supervision?
-What two hormonal issues could be impacted by flat/inverted nipples? - -
Prolactin-nipple stroking
Oxytocin-Nipple stretching
-Can inverted nipples still produce milk? - -Yes, babies have sucked on to
mothers neck, it is possible to get inverted nipples to still expand.
As long as nipple can elongate and form a "teat" and lower breast tissue can
be in babies month, this can occur.
-Describe the tongue positioning of baby for swallowing and milk flow. - -
Tongue in up position: swallow, Tongue in down position: nipple stretches
and milk flow.
-When may flat nipples evert, and therefore may not impact BF? - -During
pregnancy, in postpartum, evert during suckling, other manipulation (sexual
stimulation, finger manipulation, cold)
-Describe the 3 grades of nipple classification? - -Grade 1: easily pulled out
with breastpump/nursing baby
Grade 2: can be pulled out but don't maintain their projection
Grade 3: Difficult/impossible to pull out
-How do we grade inverted nipples - -Grade these by standing over
mother's should and watch when she takes baby off the breast. Classify
based on it's change during feeding, not how they look at rest.