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Bailey’s Golden Start Breastfeeding Curriculum for Nursing Students Objective 6: Social , institutional, and community

Bailey’s Golden Start Breastfeeding Curriculum for Nursing Students Objective 6: Social , institutional, and community benefits Objective 7: Anatomy and physiology. Objective 6 . Examine the social, institutional, and community benefits of breastfeeding. .

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Bailey’s Golden Start Breastfeeding Curriculum for Nursing Students Objective 6: Social , institutional, and community

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  1. Bailey’s Golden Start Breastfeeding Curriculum for Nursing Students • Objective 6: Social, institutional, and community benefits • Objective 7: Anatomy and physiology Property of MN Department of Health/DeJong

  2. Objective 6 Examine the social, institutional, and community benefits of breastfeeding. Property of MN Department of Health/DeJong

  3. Social, Institutional, and Community Benefits (Mesosystem) • Increased cost savings for mothers and families. • Decreased costs for hospitals and public health programs • Decreased absenteeism and loss of income for employers • Decreased environmental burden Property of MN Department of Health/DeJong

  4. Increased Cost Savings for Families • Breastfeeding women and their infants have lower healthcare costs compared with those who formula feed (Pugh et al., 2002). According to Ball and Wright (1999), infants who are not breastfed incur up to $471 more health costs in the first year compared with infants who are exclusively breastfed for three months ($671 in 2008 dollars) (U.S. Bureau of Labor Statistics. Inflation calculator, 2009). Property of MN Department of Health/DeJong

  5. Pre-Class Team Work An exclusively formula fed infant uses 150 cans of formula powder in the first 6 months of life (Riordan, 2005). What does that mean to a caregiver’s pocketbook? Property of MN Department of Health/DeJong

  6. Decreased Costs for Hospitals and Public Health Programs • Tuttle and Dewey (1996) compared breastfeeding to formula feeding from the perspective of the U.S. WIC program among low-income Hmong women in California (n = 838); they projected increased cost savings of approximately $3 million to $5 million for WIC programs in just one California county if women were to breastfeed their children at least six months. Property of MN Department of Health/DeJong

  7. For Every Infant Not Breastfed… • Likewise, in medical insurance organizations (Medicaid) and health maintenance organizations (HMOs), Ball and Wright (1999) concluded that for every 1000 infants never breastfed, there were 2033 surplus office visits, 212 additional hospitalization days, and 609 excess prescriptions written that were ascribed to lower respiratory tract illness, diarrhea, and otitis media among never-breastfed infants when contrasted to breastfed infants. Property of MN Department of Health/DeJong

  8. Billions of Dollars in Savings • It has been speculated that in the near future, endorsement of breastfeeding may arise from entire HMOs, the U.S. government, and insurance companies, who are likely to increasingly distinguish the costs of women not breastfeeding to their institutions (Wright, 2001). According to the AAP (2005), increasing the percentage of children breastfed in the early postpartum period from 64% in 2000 to the HP2010 goal of 75% would save an estimated $3.6 billion in health-care costs annually. Property of MN Department of Health/DeJong

  9. The Joint Commission • This economic point is further emphasized by Bartick, Stuebe, Shealy, Walker, and Grummer-Strawn (2009) when they discussed the leverage accrediting organizations have in modifying hospital practice. For example, the Joint Commission, which accredits most U.S. hospitals, has set quality measures in many areas over the last decade. • These measures are publicly reported and the subject of considerable attention by hospital staff and administrators across the U.S. • Until recently, the Joint Commission did not have quality metrics relating to lactation. However, on July 20, 2009, the Commission made the announcement that it was adding “Exclusive breast milk feeding” as a new hospital Core Measure for prenatal care, effective April 2010 (The Joint Commission, 2009). Property of MN Department of Health/DeJong

  10. Decreased Absenteeism and Loss of Income for Employers (Mesosystem and Exosystem) • Lactating workers have lower rates of absenteeism as a result of an ill child (AAP, 2005; Association of Women’s Health, Obstetric, and Neonatal Nurses, 2008; Brown, Poag, & Kasprzycki, 2001; Dunn et al., 2004; Libbus & Bullock, 2002; USDHHS, 2008; Witters-Green, 2003). Property of MN Department of Health/DeJong

  11. Decreased Absenteeism and Loss of Income for Employers (Mesosystem and Exosystem) • Mothers who continue to breastfeed while working report fewer lost work days due to infant illness, even if the infant is in daycare (Visness, Kenendy, & Labbok, 1995). Property of MN Department of Health/DeJong

  12. Supported Mothers have Increased Productivity • Supported mothers have improved morale, decreased stress, and increased productivity which increases the financial benefits to employers (Brown et al., Dunn et al., Lippus & Bullock; Ortiz, McGilligan, & Kelly, 2004). Property of MN Department of Health/DeJong

  13. Decreased Environmental Burden • What do you think is required to manufacture artificial feeding products? • Human milk is a RENEWABLE resource! Property of MN Department of Health/DeJong

  14. Breastfeeding Protects the Environment • Breastfeeding, by its very nature, protects society and the environment from pollution and disposal problems, eliminating the need for discarding tin, paper, and plastic cans and bottles, as well as diminishing the energy demands and expenditures for preparing, packaging, and transporting artificial feeding products (Baby Friendly U.S.A, 2009). Property of MN Department of Health/DeJong

  15. Objective 7 Develop a thorough understanding of the anatomy and physiology of lactation. Property of MN Department of Health/DeJong

  16. “In the Beginning” - Lactogenesis I • Starts mid pregnancy and occurs to day 2 postpartum • Alveolar cells differentiate to secretory cells • Mammary secretory cells are stimulated to produce milk by prolactin. Property of MN Department of Health/DeJong

  17. Prolactin = Production • When progesterone levels fall (after delivery), prolactin secretion increases 10-fold! • Its major responsibility is MILK PRODUCTION! • Think P for Prolactin and P for Production. Property of MN Department of Health/DeJong

  18. Did you Know? • Breast size is not an indicator of milk production. • In a healthy, normally lactating woman, breast milk production reflects the infant’s appetite and not the mother’s ability to produce milk. Property of MN Department of Health/DeJong

  19. Oxytocin • Produced in the _____________________________. • Ejection of oxytocin is stimulated by the infant sucking at breast. • Oxytocin is released in _______ and sent through the blood stream to the breast tissue. • Major responsibility is to get the milk _____ of the breast • Oxytocin also aids in uterine ________________ Property of MN Department of Health/DeJong

  20. Strong Surges When Baby Touches the Breast Property of MN Department of Health/DeJong

  21. Oxytocin Leads to Contentment • Results in the opposite of “fight or flight” • BP drops • Brain activity becomes calm and introverted • Mom and Baby go to their “happy place” (DeJong, 2012) Property of MN Department of Health/DeJong

  22. Mnemonic Device • Hormones • Prolactin = Production • Oxytocin = Out of the breast Property of MN Department of Health/DeJong

  23. Lactogenesis II: Secretory Activation • Occurs from Day 3 to Day 8 postpartum • Onset of copious milk production • Breasts become full and firm Property of MN Department of Health/DeJong

  24. Breast milk Characteristics Property of MN Department of Health/DeJong

  25. If Milk is Not Removed… • The secretory cells become flattened • The prolactin can not enter the flattened cells • Cells are signaled to stop producing milk, and milk is eventually reabsorbed • INVOLUTION occurs – “apoptosis” – which is planned cell death Property of MN Department of Health/DeJong

  26. How Much Intake Should I Expect in a Breastfed Infant? • Day 1: • Day 2: • Day 3: • Day 4: • Day 5: Property of MN Department of Health/DeJong

  27. How to Measure Intake and Output in a Breastfed Infant • Intake (Once milk supply is established) • Breastfed infants feed on average 8 – 12 times per day. • Audible swallowing, and quantity of stools and wet diapers, are the best indicators of adequate intake at breast. Pre- and Post-feeding weights (in grams) may also be necessary. Property of MN Department of Health/DeJong

  28. How Much Output Should I Expect in a Breastfed Infant? • Day 1: • Day 2: • Day 3: • Day 4: • Day 5: • Day 6: Property of MN Department of Health/DeJong

  29. End of: • Objective 6: Social, institutional, and community benefits • Objective 7: Anatomy and physiology Next: • Objective 8: Nurses’ role • Objective 9: Positions • Objective10: History and trends Property of MN Department of Health/DeJong

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