Breastfeeding and Bonding Quiz

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Questions and Answers

How long does it typically take for breast milk to appear after childbirth?

  • 2 to 3 days
  • 1 to 2 days
  • 4 to 5 days (correct)
  • 6 to 7 days

What physiological change allows prolactin to stimulate milk production after childbirth?

  • Withdrawal of estrogen and progesterone (correct)
  • Increase in progesterone levels
  • Increase in estrogen levels
  • Release of oxytocin

What does the term 'breast crawl' refer to?

  • The hormone release from the pituitary gland
  • The increase in breast engorgement
  • The process of milk let-down during feeding
  • The instinctive movement of a newborn towards the breast (correct)

What happens to prolactin levels in a woman who is not breast-feeding after 2 weeks?

<p>They decline (D)</p> Signup and view all the answers

What is a common treatment for breast engorgement?

<p>Cold applications (C)</p> Signup and view all the answers

When does breast engorgement typically peak postpartum?

<p>3 to 5 days (D)</p> Signup and view all the answers

What sensation may a woman experience before or during breastfeeding due to the let-down reflex?

<p>Tingling sensation in the breasts (A)</p> Signup and view all the answers

Which hormone is responsible for promoting milk let-down?

<p>Oxytocin (C)</p> Signup and view all the answers

What characterizes bonding between parents and a newborn?

<p>It occurs within the first 30 to 60 minutes after birth. (A)</p> Signup and view all the answers

Which factor does not significantly affect the bonding process?

<p>Parental age at the time of birth (A)</p> Signup and view all the answers

What is the essence of attachment in the context of parent-infant relationships?

<p>It involves reciprocal behaviors from both the infant and the caregiver. (D)</p> Signup and view all the answers

Which of the following behaviors is considered part of attachment?

<p>Providing emotional attentiveness to the infant's needs (A)</p> Signup and view all the answers

What is a potential complication in the attachment process for parents of high-risk newborns?

<p>Lack of time to develop a relationship due to premature birth (C)</p> Signup and view all the answers

What emotional change might a partner experience after the birth of a child?

<p>An enhanced sense of self-esteem (D)</p> Signup and view all the answers

Which of the following statements is true regarding attachment behaviors?

<p>Attachment behaviors include staying close and emotional caregiving. (D)</p> Signup and view all the answers

During what state is the infant most receptive to bonding behaviors from parents?

<p>In a quiet, alert state (D)</p> Signup and view all the answers

What is a significant risk factor for urine retention in postpartum women?

<p>Decreased bladder tone (A)</p> Signup and view all the answers

Why might tachycardia in a postpartum woman require further investigation?

<p>It may suggest dehydration or hypovolemia (B)</p> Signup and view all the answers

At what time does blood pressure typically return to prepregnancy levels after childbirth?

<p>By 6 weeks postpartum (C)</p> Signup and view all the answers

What typically happens to hemoglobin and hematocrit levels in the first 24 hours postpartum?

<p>They decrease slightly (C)</p> Signup and view all the answers

Which factor contributes to postpartum diuresis?

<p>Retention of excess fluids during labor (C)</p> Signup and view all the answers

What is a common gastrointestinal issue postpartum women may face?

<p>Constipation (B), Sluggish bowels (C)</p> Signup and view all the answers

How long can coagulation factors remain elevated postpartum?

<p>2 to 3 weeks (A)</p> Signup and view all the answers

What might frequent voiding of small amounts of urine indicate in a postpartum woman?

<p>Urinary retention with overflow (B)</p> Signup and view all the answers

What characterizes the taking-in phase of maternal psychological adaptation?

<p>Dependent behavior and a need for sleep (D)</p> Signup and view all the answers

During which phase do mothers typically start to demonstrate increased autonomy?

<p>Taking-hold phase (C)</p> Signup and view all the answers

What physical process begins the puerperium period after delivery?

<p>Delivery of the placenta (B)</p> Signup and view all the answers

What change occurs first during uterine involution?

<p>Contraption of muscle fibers (D)</p> Signup and view all the answers

By the end of 10 days postpartum, what typically happens to the fundus of the uterus?

<p>It cannot be palpated because it has descended (A)</p> Signup and view all the answers

How much does the uterus typically weigh immediately after birth?

<p>1,000 grams (B)</p> Signup and view all the answers

What is a major focus during the letting-go phase of maternal adaptation?

<p>Assuming parental responsibilities with confidence (B)</p> Signup and view all the answers

What is typically true about the taking-hold phase of maternal adaptation?

<p>Concerns increase regarding health and infant care (C)</p> Signup and view all the answers

Which of the following is a risk factor for postpartum infection?

<p>Prolonged labor exceeding 24 hours (B)</p> Signup and view all the answers

What is considered a postpartum danger sign indicating potential complications?

<p>Shortness of breath without exertion (C)</p> Signup and view all the answers

What is the recommended frequency for assessing vital signs during the first hour postpartum?

<p>Every 15 minutes (D)</p> Signup and view all the answers

Which condition is a risk factor for postpartum hemorrhage?

<p>Multiparity, with more than three births closely spaced (A)</p> Signup and view all the answers

What is considered a normal pulse rate for a postpartum woman during the first week after birth?

<p>60 to 80 beats per minute (bpm) (C)</p> Signup and view all the answers

Which symptom might indicate infection in a postpartum patient?

<p>Foul-smelling lochia (D)</p> Signup and view all the answers

In the assessment of vital signs, how often should observations be made after the first 24 hours postpartum?

<p>Every 8 hours (D)</p> Signup and view all the answers

What is a common respiratory rate range for a postpartum woman at rest?

<p>12 to 20 breaths per minute (C)</p> Signup and view all the answers

What is a positive behavior that indicates healthy parental attachment with a newborn?

<p>Talking to or admiring the newborn (D)</p> Signup and view all the answers

Which of the following is a recommended approach for helping siblings adjust to a new baby?

<p>Giving the older sibling the title 'mommy's helper' (A)</p> Signup and view all the answers

What should be assessed to evaluate a family's readiness for parenting?

<p>The family's strengths, weaknesses, and readiness for parenting (D)</p> Signup and view all the answers

Which of the following factors may impact the family dynamics when a newborn arrives?

<p>The cultural beliefs surrounding family interactions (D)</p> Signup and view all the answers

What is a challenge faced by families after discharge from the hospital?

<p>Lack of role models for breastfeeding and infant care (A)</p> Signup and view all the answers

What should be encouraged to help siblings feel involved with the new baby?

<p>Involving the sibling in decisions like choosing the baby's name (A)</p> Signup and view all the answers

Which behavior is a common sign of negative parental attachment towards the newborn?

<p>Showing a lack of interest in caring for the newborn (A)</p> Signup and view all the answers

How should childbirth be explained to an older sibling?

<p>In a way that is appropriate for the child's age (C)</p> Signup and view all the answers

Flashcards

Taking-In Phase

The first stage of maternal adaptation following childbirth, characterized by dependency on others for care and reliving the birth experience. This phase typically lasts 1-2 days.

Taking-Hold Phase

The second phase of maternal adaptation where the mother begins to take charge of her care and that of her infant.

Letting-Go Phase

The final phase of maternal adaptation, where the mother focuses on re-establishing relationships with others and adapting to her new role as a parent.

Puerperium Period

The period following childbirth, lasting approximately 6 weeks, during which the mother's body returns to its pre-pregnancy state.

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Uterine Involution

The process of the uterus returning to its normal size after childbirth.

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Contraction of Muscle Fibers

The first stage of uterine involution, where muscle fibers contract to reduce the size of the uterus.

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Catabolism of Myometrial Cells

The second stage of uterine involution, where enlarged cells in the uterus shrink in size.

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Regeneration of Uterine Epithelium

The third and final stage of uterine involution, where the uterine lining regenerates.

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Postpartum Bradycardia

A decrease in cardiac output after childbirth that lasts up to 2 weeks. It can cause a slower heart rate (bradycardia) between 40-60 bpm.

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Postpartum Tachycardia

An increase in heart rate above 100 bpm after childbirth, potentially indicating low blood volume, dehydration, or bleeding.

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Postpartum Diuresis

A normal and expected process of the body getting rid of excess fluids accumulated during pregnancy, starting within 12 hours after birth.

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Postpartum Coagulation

The ability to clot blood remains heightened for 2 to 3 weeks after childbirth. This is a natural protection against potential bleeding.

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Postpartum Blood Pressure

Blood pressure usually drops for the first 2 days, then increases between 3 and 7 days after birth. It returns to pre-pregnancy levels by 6 weeks.

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Postpartum Urinary Retention

A decrease in the bladder's ability to empty properly after childbirth, often caused by factors like anesthesia, blood clots, oxytocin, or weakened bladder muscles. It can lead to infections and bleeding issues.

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Postpartum Constipation

The digestive system may be sluggish after birth, leading to constipation. This is due to decreased bowel tone and can often be helped with stool softeners.

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Postpartum Preeclampsia

A serious condition that can occur after childbirth, marked by high blood pressure and potential organ damage. It's crucial for healthcare professionals to monitor blood pressure during the postpartum period.

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Bonding

A strong emotional connection between a parent and their newborn that develops quickly after birth, within the first 30 to 60 minutes.

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Attachment

A reciprocal, long-term bond between an infant and a significant person in their life. It develops gradually over time.

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Extreme elation

The partner's feeling of immense happiness and joy after the birth of their child.

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Increased sense of self-esteem

A significant increase in self-esteem experienced by the partner after the birth of their child.

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Awareness of distinct features

The ability to recognize and distinguish one's newborn from other infants in the nursery.

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Postpartum assessment

A comprehensive evaluation of a new mother's physical and emotional well-being.

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Lactation

The process of breast milk production, triggered by hormonal shifts after childbirth.

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Prolactin

The hormone that stimulates milk production in the breasts, increasing during pregnancy and peaking after delivery.

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Oxytocin

The hormone responsible for the let-down reflex, which helps release milk from the breasts during breastfeeding.

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Colostrum

A yellowish, sticky fluid produced by the breasts during the first few days after childbirth, rich in antibodies, proteins, and vitamins.

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Breast Engorgement

The feeling of fullness and tenderness in the breasts, often experienced in the first few days after birth due to increased blood flow and milk production.

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Breast Crawl

The instinctive movement of a newborn baby towards the mother's breast shortly after birth.

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Let-Down Reflex

The reflex that releases milk from the breasts, often triggered by the baby's sucking or other stimuli, leading to a tingling sensation.

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Breast Engorgement

A temporary condition where the breast feels hard and painful due to increased blood flow and milk production, often occurring between 3 to 5 days after childbirth.

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Positive Attachment Behaviors

Positive behaviors, such as holding the newborn close, talking to them, and showing affection, can help establish secure attachment between parents and baby.

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Negative Attachment Behaviors

Negative behaviors, such as avoiding contact, being dismissive, or showing a lack of interest in the baby, can hinder attachment and potentially lead to problems.

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Monitoring Parental Attachment Behaviors

Observing and assessing how parents handle their child's needs and respond to cues can help identify any potential issues that might require professional support.

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Sibling Regression

Siblings may exhibit temporary regression in behavior, such as thumb-sucking or bedwetting, following the arrival of a new baby.

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Including Siblings in Baby-Related Decisions

Incorporating the sibling in decisions and activities related to the new baby can help them feel involved and less threatened by the change.

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Challenges Facing Families After Discharge

Challenges faced by families after discharge often stem from practical and emotional adjustments, such as navigating breastfeeding, lacking support networks, or dealing with fatigue.

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Limited Family Support

Extended family or friends who live far away may not be able to provide immediate assistance, leading to feelings of isolation and increased stress.

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Overwhelming Information in Short Hospital Stays

Shortened hospital stays can leave parents overwhelmed with information and feeling unprepared for the challenges of caring for a newborn at home.

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Postpartum Infection

A postpartum complication that can occur due to a compromised immune system, prolonged labor, or procedures like cesarean birth. It can manifest as fever, foul-smelling lochia, and pain.

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Postpartum Hemorrhage

A postpartum complication that occurs when the uterus doesn't contract properly after childbirth, leading to excessive bleeding. This can be caused by factors like a large baby, multiple births, or a prolonged labor.

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Puerperal Bradycardia

A period of slower than normal heart rate in the mother, typical during the first week after birth.

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Postpartum Temperature Range

Normal temperature range for the first 24 hours after birth, typically a result of dehydration from delivery. Anything above 100.4°F (38°C) after 24 hours needs medical attention.

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Postpartum Respiration Rate

Normal range of breaths per minute in a resting postpartum mother. If it deviates from this, it could indicate an issue.

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Severe Headache

A potentially dangerous postpartum symptom that requires immediate medical attention. It can be a sign of a blood clot or other complications.

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Swelling or Discomfort at Episiotomy or Incision Sites

This can be a sign of infection or a clot, and may need further medical evaluation. Any discomfort in this area should be monitored closely.

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Postpartum Vital Sign Assessment Frequency

Important assessment parameter of vital signs in the postpartum period. The frequency of assessment depends on the time since delivery - more frequent in initial hours, becoming less so later.

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Study Notes

Maternal Psychological Adaptation

  • Rubin's three phases: taking-in, taking-hold, and letting-go
  • Taking-in phase: client needs sleep, depends on others, relives birth events (1-2 days)
  • Taking-hold phase: dependent & independent behaviors, focused on health of self & infant, increased autonomy (2-3 days to several weeks)
  • Letting-go phase: reestablishes relationships, assumes parental role, separates from symbiotic relationship with infant, accepts reality of infant (continues after)

Postpartum Period

  • Puerperium: 6 weeks after delivery of placenta, called the fourth trimester
  • Body returns to pre-pregnant state by ~6 weeks
  • Reproductive system adaptations: uterine involution (3 stages)

Uterine Involution

  • Muscle fiber contraction
  • Catabolism (shrinking of cells)
  • Regeneration of uterine epithelium

Other Adaptations

  • Cervix: returns to pre-pregnant state by ~week 6, but not same shape initially
  • Vagina: mucosa thickens and rugae return within 3-8 weeks, potentially larger than pre-pregnant state
  • Perineum: edema and bruising common, healing takes 2-6 months, Kegels are beneficial
  • Cardiovascular System: increased cardiac output, then decreases to pre-pregnancy levels (~3 months)
  • Hemoglobin & Hematocrit: slight decrease then gradual increase in next 2 weeks
  • Urinary System: glomerular filtration rates increased during pregnancy, return to normal by ~6 weeks
  • GI System: decreased bowel tone & constipation common, stool softeners may be prescribed
  • Musculoskeletal: fatigue and joint pain, returns to normal ~ 6-8 weeks
  • Integumentary: pigmentation fades, hair loss possible, striae (stretch marks) fade to silvery lines
  • Respiratory & Endocrine: return to pre-pregnancy levels within ~1-3 weeks (tidal volume, minute volume, vital capacity, and functional residual capacity)

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