HNF-150 Week 13 L.O.

Identify the special nutritional needs of a breast-feeding woman. Be able to identify the requirements in terms of energy, fluids, calcium, and overall diet.

-A woman will need about an extra 330 calories of food per day because lactation requires a lot of energy. They will also need to drink about 13 cups (1-2 qts.) of water because breast milk contains a lot of water. -A woman can eat any nutritional foods that she wants as long as it shows no discomfort for the baby. -Moderate weight loss is acceptable. -A woman can produce nourishing milk even if her nutrient needs aren't met, but it can affect the quantity of milk produced. -Calcium intake should be 1000 mg for 19 and up and 1300 mg for 18 and under. -NUTRIENT DENSE DIET: pay attention to protein, calcium, iron, zinc, vitamin B12, especially if vegetarian.

Discuss the differences between breastmilk and formula.

Breast milk is "gold standard" -2-3 months breastfed, grow quicker. Formula is considered an adequate nutritional replacement for breast milk. -Formula = modified cow's milk (or other milks such as soy for babies allergic to cow's milk). -4-9 months. -Most now contain DHA omega-3 fatty acids. -Reduce protein and increase carbs, fortified vitamins and minerals.

Describe the composition of colostrum and mature/transitional milk. Does composition of milk change over time or stay the same?

Colostrum: -First 1-5 days. -2-20 ml (1/2-4 tsp) per feeding. -Protection. -Yellow = beta carotene. Mature milk: -Transition over 1-2 weeks. -More fat, sugar. -45-1200 mls/day (7-16 ounces). -Eventually 25 oz/day.

Explain the difference between breast milk and formula in terms of conferred immune protection, flavor profile and the subsequent introduction of new foods.

Depending on what the mother eats, the breast milk has a wide range of flavors, which allow the baby to try new foods later on. -Formulas have different specific tastes, which don't allow for such a large range of taste for baby early on.

Breastfeeding is a learned process -What resources are available for women who want to breastfeed successfully?

Infant: -Baby's mouth needs to include breast tissue. -Good latch: -->lots of areola in baby's mouth, especially underneath lower gum. -->lips flanged our. -->tongue cupping underneath. -Infant natural reflexes: -->oral search, rooting. -->sucking. -->gag if milk comes too quickly. Mom: -Relax -Listen to baby's hunger & satiety signals. -->Early hunger (rooting, wriggling, fussing) vs. late (crying). -->Squirming and stretching, clenching fists, sucks fist. -->Comfort vs. eating. -Positioning and latch. -->Tummy to tummy. -->Various holds, use of pillows. Resources: -Breast feeding education, La Leche League, hospital policies, doctor, midwife, doula, etc.

List/describe the stages of lactation.

Lactogenesis I: -Last trimester of pregnancy, limited milk production. -Produces colostrum. Lactogenesis II: -2-5 days postpartum, copious milk secretion. -"When milk comes in." Lactogenesis III: -10 days + -Milk composition stabilizes.

Identify good and poor indicators of breastfeeding adequacy.

Good indicators: -Weight gain. -Development. Poor Indicators: -Mothers breasts smaller/less full. -Baby's feeding increases ("greedy"). -Baby doesn't sleep through the night. -Baby is "big."

List the benefits of breastfeeding for both mom and baby, including economic, nutritional and health benefits.

Mom: After birth: -Uterine contraction, decreased bleeding. -Hormonal response-calming, focus on baby. -Suppression of ovulation. Longer term: -Lose pregnancy weight. -Reduced risk of breast & ovarian cancers. -Reduced risk of Type 2 diabetes. Baby: -Milk is species specific. -Human milk matches infant needs for nutrition & fluids. -Composition changes to meet needs of growing infant. -Well tolerated, easily digested (esp. protein). -High in lipids. -Minerals bioavailable. Protects against: -Acute infections --> ear, lower respiratory, GI. -Asthma, dermatitis, eczema. Reduces risk: -SIDS -OBESITY -TYPE I & II Diabetes -CHILDHOOD LEUKEMIA. Benefits: -analgesia -bonding -time (convenience) -environment -work productivity -health care cost saving -formula & bottle cost savings.

What determines how much milk a mother produces?

Supply & Demand: -If baby breastfeeds more, mother will produce more milk. -If baby breastfeeds less, mother will produce less milk. -Mother can respond to growth spurts or growth slow downs with appropriate amount of milk.

What are the breastfeeding recommendations from the US and the WHO (World Health Organization)?

US: -American Academy of Pediatrics, American Dietetic Association, others.. -6 months exclusive, continued to 1 year, longer as mutually desired. WHO: -6 months exclusive, continued to 2 years, longer as mutually desired. 0 to 4-6 months: only breastmilk or infant formula.

Review your notes from the food insecurity lectures on the WIC program (noting what benefits it offers to women and children).

WIC: Nutrition education and food packages to pregnant and nursing women, and kids to five years. -Improved birth outcomes, decreased risk of developmental delays, kids more likely to be food secure, healthy weight and in good health.

Is it possible for women to drink alcohol while breastfeeding? How should they time it?

Yes, but they need to wait 3-4 hours after a drink to feed the baby.