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Breastfeeding Give em ’ the breast breakfast!

Breastfeeding Give em ’ the breast breakfast! . Mara Caris Courtney Klebe. Objectives. Discuss nutritional components and benefits in breast milk Discuss barriers and how to overcome barriers of breastfeeding Discuss recommended diet while breastfeeding

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Breastfeeding Give em ’ the breast breakfast!

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  1. BreastfeedingGive em’ the breast breakfast! Mara Caris Courtney Klebe

  2. Objectives Discuss nutritional components and benefits in breast milk Discuss barriers and how to overcome barriers of breastfeeding Discuss recommended diet while breastfeeding Bring awareness to breastfeeding in public Provide programs supporting breastfeeding

  3. History of breastfeeding[1] Wet nurses were used to breastfeed children of the royal families Wet nursing began as early as 2000 BC and extended into the 20th century By 1900 wet nursing was extinct

  4. Breast Milk[2] • Colostrum “First Milk”: • Thick yellow fluid • Low in fat, and high in Carbohydrates, proteins, and antibodies • Laxative effect • 20 kcal/oz • Mature milk around day 3 or 4 • Defends baby against harmful infections

  5. Infant Stomach Capacity[2]

  6. Components of breast milk:Fats [3,4,5] “Hind milk” higher in fat Amount and type related to maternal diet Essential fatty acids, saturated fatty acids, triglycerides • LCFA(long chain fatty acids): • -DHA- 1.3 g/day AI • -Arachidonicacid- 13 g/day AI • Contains 10-20 mg/dL of cholesterol, and is not reflected in maternal diet

  7. Components of breast milk:Protein:[3,4,5] • Low levels in breast milk • Mostly alpha-lactalbumin Whey(60%) and Casein (40%): • Ratio makes breast milk more digestible • Great infection-protection properties Other proteins: 1. Lactoferrin 2. Secretory IgA 3. Lyzsozymes 4. Bifidus Factor DRI: 25g/day during lactation

  8. Components of breast milk:Carbohydrates [3,4,5] • Lactose: • Primary CHO in breast milk • Enhances Ca, P, and Mg absorption • Monosaccharide's: • galactose • fructose • Oligosaccharides: • Third most abundant component; 130 types • Protective properties against respiratory and enteric diseases • Promotes growth of bifidobacterium and Bacteroides

  9. Components to breast milk: Vitamins- Fat Soluble[5,6] Vitamin A: gives colostrum yellow color (beta-carotene) Vitamin E: Muscle integrity and resistance to RBC breakdown

  10. Components to breast milk: Vitamins- Fat Soluble Cont.[5,6] • Vitamin D: content of milk is related to sun exposure and maternal vitamin D intake • Recommended to take supplementation- 400 IU/day Vitamin K: very little content until normal gut bacteria start making it Vitamin K shot at birth

  11. Components of Breast MilkVitamins- Water Soluble Vitamin C Riboflavin Niacin B6 B12

  12. Components of breast milk:Minerals[6] Largely protein bound and balanced to enhance bioavailability Sodium: low content Calcium: content in breast milk not related to maternal intake

  13. Components of breast milk: Minerals Cont. [6,7] Magnesium: adequate amount for growth and development Zinc: requirements during lactation are more than during pregnancy

  14. Benefits of Breast Feeding:

  15. Benefits to the Baby[6]

  16. Benefits to the Baby: A report by the Agency for Healthcare Research and Quality (AHRQ) [6] 23% reduction in the risk of otitis media in infants if ever breastfed; 50% if breastfed exclusively for 3 months 72% reduction hospitalization for a lower respiratory tract infection during first year of life 15-19% reduction in leukemia if breastfed for first 6 months 27 % reduction of asthma if breastfed for first 3 months without a family history of asthma, 40% reduction with family history

  17. Benefits to the Baby Cont. [4,6] • Easier Digestion • Lactose, whey & casein proteins, and fat are easily digested • Antibodies in breast milk helps build the baby’s immune system

  18. Benefits to the Baby Cont. [4,6] • Brain and growth development • Promotes rapid formation of myelin • Possible role in prevention of obesity • 4% reduction in adulthood obesity each month of being breastfed

  19. Benefits to the mother[6]

  20. Benefits to the Mother Cont.[6] • Weight loss • Pre-pregnancy weight + total pregnancy weight change + parity = greatly impact postpartum weight loss • Increase levels of oxytocin • stimulates uterine contractions, minimizes postpartum blood loss, and returns uterus to nonpregnant size • Lowers blood pressure before, during, and after sessions

  21. Benefits to the Mother Cont. [6] • Fertility is delayed in most women when breast feeding • ovulation is delayed • Increased Bone Health • Reduced risk of hip fractures in postmenopausal women • Improved bone mineral density during you adulthood in adolescent mothers

  22. Benefits to the Mother Cont. [6] • Lowers risk of type II diabetes, breast cancer, ovarian cancer, BP, and rheumatoid arthritis • 4.3 % reduction in risk of breast cancer development each year woman breastfeeds • Partial inhibition of ovulation results in decreased risk of ovarian cancer • >12 months decreased rheumatoid arthritis

  23. Benefits [5,6] Economy Family Less prescriptions Less illness Improves communication • Saves money • reduces health care cost • time off work • Less Bottles = less waste • No manufacturing • Environmentally friendly

  24. Barriers to Breastfeeding Embarrassment Lack of support Lack of confidence Concerns about diet/health practices Fear of pain Infections Insufficient breastfeeding education Disruptive hospital policies Promotion of infant formula Time

  25. Barriers to Breastfeeding: Solutions Do what makes you feel comfortable Don’t judge others who choose to breastfeed Educate yourself on breastfeeding Use a breast pump Wear clothes compatible with breastfeeding Practice at home Find support

  26. Breastfeeding Conditions[5] Sore Nipples Flat or Inverted Nipples Let Down Failure Hyperactive Letdown Hyperlactation Engorgement Plugged Duct Mastitis

  27. Breastfeeding Conditions[5] Hyperlactation Sore Nipples • Causes: • Incorrect positing • Suction trauma • Poor latch • Improper release • Treatment: • Nurse on least sore breast • Find comfortable position • Pump to express milk • Causes: • milk volume of the mother exceeds the intake of the baby • Treatment: • Nurse on one breast while mother expresses on other • Cabbage leaves or cold compresses to decrease production

  28. Breastfeeding Conditions[5] Hyperactive Letdown Letdown Failure • Causes: • Oxytocin is suppressed and milk can’t be expressed • Treatment: • Oxytocin nasal spray • Decrease stress • Causes: • Milk streams from the breast as feeding begins Treatment: • Express milk till flow stops • Remove infant from breast until flow stops

  29. Breastfeeding Conditions[5,8] Flat or Inverted Nipples • Causes: • naturally occurs • Treatment: • Correct latch positioning • Use breast pump prior to feeding to draw out nipple

  30. Breastfeeding Conditions[5,9] Engorgement • Causes: • Milk building up in the breasts • Treatment: • Continue to nurse baby • Nurse frequently • Pump prior to nursing or hand express

  31. Breastfeeding Conditions[5,10] Plugged Duct • Causes: • Milk duct does not properly drain and becomes inflamed • Treatment: • Correct position of baby on the breast • Wear lose nursing garments • Proper time span between nursing

  32. Breastfeeding Conditions[5,11] Mastitis • Causes: • Inflammation, cracked sore nipples, engorgement, restriction from tight bra or clothing • Treatment: • Continue nursing • Switch to unaffected side • Apply wet or dry heat to breast • Adequate rest/ fluid

  33. Tips to ease pain[12] Correct latching Over the counter breast lotion Massage breast before and after feeding Wet or dry heat on breast before feeding Herbs to promote/reduce milk flow Positioning (demo/ pictures)

  34. Position demonstration

  35. Medications and Breastfeeding[5] 90-99% of women who breastfeed take some type of medication during their first week postpartum Most medications are excreted in breast milk Medications contradicted during breastfeeding include antineoplastic agents, drugs of abuse and drugs that suppress lactation

  36. Herbs and breastfeeding[5] Approved with breastfeeding: Not recommended: Echinacea Ginseng Root St. John’s Wort Fenugreek Goat’s-Rue

  37. Alcohol and Breastfeeding[5] Alcohol consumed is concentrated in breast milk and can inhibit milk production Odor and volume of breast milk changes Takes a 120 pound woman about 2-3 hours to clear one serving of beer or wine from her body Sleep patterns and psychomotor development of infants change

  38. Smoking and Breastfeeding[5] • Cigarettes • Asthma, respiratory infections, colic, and acid reflux • Results in lower milk output, lower fat content, and slower growth of infant • Marijuana • Possible decrease in infants motor development

  39. Maternal Diet[13] The U.S Department of Agriculture’s MyPyramid Food Guide has set guidelines Healthy-weight women expend around 500 kcal/day in the first 6 months due to breastfeeding - 400 kcal after 6 months

  40. Maternal Diet Cont.[13] Well-nourished breastfeeding mothers do not need to take routine vitamin or mineral supplementation Fluid needs and demands increase Like pregnancy, should avoid fish high in mercury,

  41. Maternal Diet cont.[5,13] • Caffeine • Does not pose as much as a problem; around 5 oz. a day is okay • Some symptoms do occur like infants being wakeful and fussy • No long-term effects have been documented

  42. Maternal sample diet[14] Breastfeeding: Yes Age: 26 Height: 5 ft. 7 in. Weight: 140 lbs. Baby birth date: Aug 28th, 2013 Physical activity: 30-60 minutes of moderate activity per day

  43. My SuperTracker Plan [14]

  44. Breast milk vs. formula[4,5,6] Cow’s milk-based formula Breast milk 7 % of calories from protein 38% of calories from carbohydrates 55% of calories from fats 9-12% of calories from protein 41-43% of calories from carbohydrates 48-50% of calories from fats

  45. Formula[4,5,6] Made under sterile conditions Babies who are formula-fed aren’t as hungry as babies who are breastfed Some reasons as to why women choose to formula feed: 1.Convience 2.Flexibility 3.Time and frequency of feedings 4. Diet

  46. Healthy People 2020 on breastfeeding[15] 42 focus areas, one of which is Maternal, infant, and Child Health “New objectives will take on some of the most challenging barriers to breastfeeding success faced by U.S. mothers.” [4]

  47. Healthy People 2020 Objectives[15] • Increase the proportion of infants who are ever breastfed. • Increase the proportion of infants who are breastfed at six months and one year • Increase the proportion of infants who are exclusively breastfed through three and six months

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