Nutrition During Lactation: Conditions and Interventions PDF

Chapter 7 Nutrition during Lactation: Conditions and Interventions  Common Breastfeeding Conditions Sore nipples Letdown failure Hyperactive letdown Engorgement Plugged duct Infection  Condition: Sore nipples May be prevented by proper positioning of b...

Chapter 7 Nutrition during Lactation: Conditions and Interventions  Common Breastfeeding Conditions Sore nipples Letdown failure Hyperactive letdown Engorgement Plugged duct Infection  Condition: Sore nipples May be prevented by proper positioning of baby on breast The areola should be Areola in the baby’s mouth with tongue extended against lower lip  Condition: Letdown Failure When milk does not eject from the breast Very uncommon Oxytocin nasal spray may be prescribed Relaxation techniques may help reduce problem Condition: Hyperactive Letdown Streams of milk come from breast If too active, may cause infant to choke while nursing Mother should express milk until the flow slows then allow infant to nurse  Condition: Engorgement Breasts are overfilled with milk Results when supply-and-demand process is not yet established and milk is abundant Best prevention: nurse frequently—newborns may nurse every 1 to 2 hours  Condition: Plugged Duct Caused by milk staying in the ducts Painful knot may form in breast Treated by massage and warm compress Prevented by complete emptying of breasts and changing position of infant while feeding  Condition: Infection Mastitis is a bacterial infection of the breast Incidence is 1 to 5% of breastfeeding women Most common at 2-3 weeks postpartum May result from: – Sore and cracked nipples – Blood borne source of bacterial infection – Missing a feeding resulting in engorgement, then plugged duct may precipitate engorgement  Maternal Medications Most medications are excreted in breast milk Variables to consider related to medications during lactation: – Pharmacokinetic properties of the drug – Time-averaged breast milk/plasma drug concentration ratio – Drug exposure index – Infant’s ability to absorb, detoxify & excrete drug – Infant’s age, feeding pattern, total diet, & health  Alcohol and Other Drugs Alcohol Nicotine (smoking cigarettes) Marijuana Caffeine Other drugs of abuse Environmental exposures  Alcohol Alcohol consumed quickly passes to breast milk Level of alcohol in breast milk is same as in maternal plasma Peak plasma levels occur at 30-60 min. after consumption if consumed w/o food and 60-90 min. if consumed with food Contrary to popular belief, alcohol decreases oxytocin and let-down Impact of Alcohol on Lactation Contrary to popular belief, alcohol decreases oxytocin & let-down Affects odor of milk Decreases volume consumed by infant Interferes with sleep pattern of infant  Other Drugs and Lactation Nicotine (smoking cigarettes) – Levels are 1.5 to 3 times higher in breast milk than mother’s blood – Half-life of nicotine is 95 minutes, so best to delay feeding as long as possible after smoking Marijuana – May change DNA/RNA & the proteins needed for growth  Other Drugs and Lactation Caffeine – Level in breast milk is only 1% of that in mother’s plasma – May accumulate in infants younger than 3 to 4 months—varies from infant to infant – May interfere with sleep or cause hyperactivity & fussiness of infant