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114 Cards in this Set
- Front
- Back
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What years were there an influx of heavy formula advertising worldwide trending toward modernization?
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1930s-1950s
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What were health professionals beginning to see during the 1940s-1950s in regards to formula feeding.
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Baby Bottle disease
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What are the Ds of formula feeing in developing nations?
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Diarrhea
Dehydration Diarrhea Dehydration Death |
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What was the tactic of the formula companies to win over patient trust?
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Link the formula to "Doctors or Nurses" to make the patients think that they can trust them
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What occurred in 1979 with the WHO and UNICEF?
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They convened
-Mounting concerns about improper infant feeding and increased mortality -Recommendation: develop an international standar to control inappropriate marketing practices |
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Who developed the CODE?
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WHO/Unicef
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What are the rules of the Code?
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Baby foods "shound not be marketed in ways that may interefere with the proctection and promotion of breastfeeding.
-No direct advertising to mtohers -No pictures of healthy babies -No free stuff -No discounts, promotions or contact with patients -No hospital or health facility promotion or advertising |
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What was the outcout of the WHO/Unicef vote on the CODE?
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118-1: USA said NO!
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Why did the USA vote against the Code?
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Heavy lobbying by US-based formula companies
-infringed on free speech and restrained trade |
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__% of the world's infant deaths occur in developing countries.
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90
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What is the WHO recommendation about breastfeeding?
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EXCLUSIVE breastfeeding for 6 months and weaning after 1 year is the MOST effective intervention
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Breastfeeding has the potential to prevent ___ infant deaths per year, equal to preventing 13% of the world's childhood mortality.
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1 million
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ToF: the epidemics of developing countries are diarrhea and malnutrition
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TRUE
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What are the epidemics of the US?
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Obesity, diabetes and asthma
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ToF: formula feeding significantly increases all of these health risks for all children.
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TRUE
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Which organizations recommend breastfeeding for 6 months: exclusive?
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AAP, AAFP, ACOG and WHO/Unicef
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How long should breastfeeding be continued after the 6 months of exclusivity?
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1 year or beyond as mutually desired: 2 years or beyond
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What are the Healthy people 2020 breastfeeding goals?
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80% Initiation (Ever breastfed)
60% at 6month 34% at 1 year 46% Exclusive breastfeeding for 3 months 25% exclusive breastfeeding for 6 months |
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What were the US breast feeding rates in 1998?
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64% initation
20% at 6months 16% at 1 year |
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Which company collected the breastfeeding data prior to 2000?
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Ross!!! Formula company!
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Which organization collects breastfeeding statistics now?
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CDC
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What were the breast feeding stats of 2000?
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68.4% initiation
31.4% at 6 months no data for 1 year |
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In which year were the breastfeeding stats as follows: 75% initiation, 43% at 6 months and 22% at 1 year with 33% and 13% exclusivity at 3months and 6months?
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2007
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What were the breastfeeding stats of 2009
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77% initation
47% at 6 months 25% at 1 year exclusive: 3 months: 36% and 16% for 6 months |
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According to the map put out by the CDC, which states have the least amount of breastfeeding?
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The southern ones
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Which group has the highest rate of breastfeeding as of 2009?
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Hispanic/Latino women
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What % of non-hispanic black women breastfeed (initation rates?)
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58%
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Which group has the lowest initation rates for breastfeeding?
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low income non-hispanic black 37%
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ToF: Women who are WIC ineligable are more likely to use formula?
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False: they have higher initiation rates for breastfeeding
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Which age group has the highest initation rates for breastfeeding? Which group has the least?
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Most is > 30 years old: 79%
those <20 years only have 59% |
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What is the initiation rate of breastfeeding in Non-hispanic Black mothers under age 20 y?
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30%
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What are the 5 arenas in which elements of breatfeeding-friendly communities are measured?
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1. Support from birth facilities
2. health professionals (IBCLCs) 3. state legislation 4. pulic infrastructure 5. Support in child care settings |
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For healthly people 2020, the goal is to increase the proportion of employers that have worksite lactation support programs to __%? What was it in 2006?
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38%; 25% in 2006
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What does healthy people want to reduce by 202?
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the proportion of breastfed newborns who receive formula supplementation within the first 2 days of life to 14%. (24% in 2006)
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In terms of delivering babies, what does healthy people 2020 want?
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to increase the proportion of live births that occur in baby-friendly hospitals that provide care for lactating mothers to 8%. Only 2.9% in 2009)
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In terms of breastfeeding statistics, the "norms" that are talked about are usually in terms of ___ fed babies?
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Formula
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In research, how are the statistics of breastfeeding usually expressed?
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in terms of reduced risk
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ToF: breastfeeding is an evolutionary biological norm.
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TRUE
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ToF: in terms of statistics, formula feeding carries significant health risks for mom and baby.
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TRUE
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What is the composition of one drop of colostrum?
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Live fat globulues and live WBCs
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When a "breastfeeding Benefit" is presented, it is being compared against a __ of exclusive formula feeding
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norm
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What is meant of a benefit have a dose response relationship?
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A risk of a condition is reduced by duration of exclusive breastfeeding
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What does breastfeeding do for the mouth of babies?
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Fewer cavities, less dental malocclusion
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Babies who are breastfed have _-% (more/fewer_ ear infections in the first year of life.
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50%; fewer
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ToF: only exclusive breastfeeding reduces the overall risk of OMG by 23% and BF for > 3 months exclusively reduces by 50% for OM?
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FALSE!: Any breastfeeding drops the risk by 23% and exclusive BF for 3 months drops risk by 50%
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Exclusive BF > or equal to 6 months reduces risk of recurrent OM by ___%
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77
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What is the established benefit of breastfeeding in terms of baby's bowel movements?
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deceases the incidence and/or severity of diarrhea
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There is a __% reduction in the incidence of gastroenteritis with ___ breastfeeding.
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64, ANY!!!!
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ToF: when a mother stops breastfeeding, the baby has an increased risk of developing gastroenteritis.
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FALSE: the benefits of breastfeeding last for 2 months after cessation
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What is the reduced risk for IBD with any breastfeeding? What falls under IBD?
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31% reduced risk with ANY!
Includes irritable bowel syndrom, crohn's, ulcerative colitis |
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What is the new and upcoming GI issue that his been found to have a reduced risk of developing in breastfed infants?
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Celiac disease
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ToF: a woman who is sick should not breastfeed until the illness passes.
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FALSE! Breastfeed through it! The baby gets the antibodies with her!
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ToF: there is a 63% reduction of risk for URI with any breastfeeding.
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FALSE: exclusvie for > or equal to 6 months
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For mothers who have exclusively breastfed for > or equal to 4 months, they have reduced the baby's risk of hospitalization for LR by ___%
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72%
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The severity of RSV bronchiolitis is reduced by 74% with ___ months of __ breastfeeding.
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> or equal to 4 of exlusive
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ToF: children who receive ANY breast mil have significantly reduced odds of being diagnosed with asthma before age 24 months.
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TRUE
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ToF: the protective affects of breastfeeding in developing asthma and allergy are even greater if there is a positive family hisotry of atopy.
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TRUE
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For children who are exclusively breastfed for > or equal to 3 months, what is the reduced risk of atopy with a family history and without?
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With family history: 42% reduced risk
without: 27% reduced risk |
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In the large meta-analysis: what were the reduced risks for asthma for babies exclusively BF for > or = 3 months with and without fam hx?
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With fam hx: 40% reduction
without fam hx: 26% reduced risk of asthma |
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Describe the obesity statistics for children fed any Breast milk.
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1. Lower BMI score and lower odds of being overweight at age 1 and 35% less obesity entering kindergarten
2. 15-30% reduction in adolescent and adult obesity rates if any BF occurred. |
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ToF: children who receive cow's milk formulas before age of 6 months are twice as likely to develop IDDM.
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False: 2 months
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Why do they think that cows milk can increase the risk of IDDM?
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A protein in it triggers a gene that attacks pancreatic Beta cells
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IF a baby is exclusively BF for >= 3 months they have a __% reduced risk of Type 1 DM.
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30
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ToF: Exclusive breastfeeeding reduces the risk of type 2 DM more so than type 1.
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True!! Reduces type 2 by 40%
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Does BF help protect against UTIs?
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YES, less risk in breast fed babies
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What is the reduced risk for leukemia in breastfed babies?
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21%
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There is a ___% lower risk of SIDS with BF, even lower than with the use of __
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36; pacifiers
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ToF: the reduction rates of epilepsy was studied and found to have a ___ relationship
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CAUSAL!
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What are the reduction risk %'s for epilepsy with any BF at 3-5 months; 6-8; 9-12; and > 13 of breastfeeding?
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3-5 months: 26% reduced risk
6-8 months: 39% 9-12 months: 50% > 13 months: 59% |
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What are the breastfeeding benefits for the mother?
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1. Decreased risk of postpartum bleeding
2. Earlier return to pre-pregnancy weight (500 calories a day) 3. Increased birth spacing 4. Decreased risk of osteoporosis later in life |
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The relative risk of breast cancer in women decreases by ___% for every __ months of breastfeeding.
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4.3%; 12 months
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Breast feeding for at least 2 months per child reduces risk of __ __ by 25%
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ovarian cancer
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What are the breastfeeding benefits for the family?
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1. Lower costs related to infant feeding
2. Fewer doctors visits for ill infants and days of missed work for mom |
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What are the key factors to keeping breastfeeding simple?
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1. Any breastfeeding is better than none
2. More breastfeeding is better 3. Exclusive breastfeeding is best |
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When does the WHO recommend to start breastfeeding the baby?
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Initation within the First HOUR of life!!
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ToF: the WHO says that the infant should receive only breastmilk without any additional food or drink for 6 months, but water is ok.
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FALSE: No water too!
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When/ how often should a baby be breastfed?
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ON demand!
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What should babies not be given other than formula during infancy, according to the WHO?
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bottles, teats or pacifiers
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What are the AAP standards for breastfeeding?
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1. Human milk is uniquely superior
2. Exclusive breastfeeding for "about " 6 months 3. Continue to 1 year or beyond "al long as mutually desired." |
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What are the 3 contraindications to breastfeeding?
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1. Mom using illicit drugs
2. Baby with galactosemia 3. Positive HIV status of mom (in developed nations) |
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ToF; mom's in methodome programs should not and cannot breastfeed because of the risk of the drug on the baby.
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FALSE! They should, the methodome can also help the baby withdraw. Mom must test clean for all other drugs
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Why does exclusive breastfeeding actaully protect the baby from blood transmitted diseases (HIV)?
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the breastmilk coats the gut and does not allow for any breakdow in the epithelium and thus no HIV to enter into the bloodstream. ANY formula feeding can cause micro-tears in the gut and increase the risk for HIV transmission
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What are the 4 situations in which BF should be temporarily interrupted?
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1. Mom with active, untreated TB, brucellosis, HINI
2. Active varicella (1wk postpartum only) 3. Active herpes lesions on the breast! 4. a few Rx drugs (ie chemo) |
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ToF: mother's with CMV should not breastfeed?
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FALSE: healthy babies can handle it
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What are the situations where moms can breastfeed, but think they cannot!?
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1. Moms with Hep B, C or carriers of CMV
2. Moms with fever or infection 3. Moms exposed to low levels of environmental chemical agents 4. Baby with hyperbilirubinemia 5. Mom on methodome |
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What are the 3 reasons that moms are most likely to quit BF in the first 4 weeks of baby's life?
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1. Lack of confidence in ability to BF***
2. Problems with latch or infant suck 3. lack of individualized encouragement from their clinicans |
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How much longer do mother's continue to breastfeed that have been given encouragement from the HCP?
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5 weeks longer than mothers who got none
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what are the 3 ways that PNPs can support BF?
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1. Be enthuasiastic in promoting breastfeeding
2. Ask an expentant mother "Have you though about breastfeeding?" instead of "Breast or bottle?" 3. Tell a breastfeeding mother to "Keep it up! You're doing a great thing for your baby!" |
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ToF: familiy members should be included in breastfeeding because they often dictate how long a mother can continue to BF.
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TRUE
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Where should a HCP seek help for women struggling with breastfeeding?
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International board of certified lactation consultant (IBCLC) or the international lactation consultant association. Www. Ilca.org
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Where should mom's with minor problems with feeding be referred?
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Loca La Leche league. Www. Llli.org
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What can the breastfeeding answer book help with?
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quick-reference answers to hundres of breastfeeding issues
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Where should HCP go to find info about meds with mothers?
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Medication and Mother's Milk by Thomas Hale
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According to the AAP, when should a breast fed baby be evaluated after leaving the hospital
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3-5 days of life!!!! Then at 2-3 weeks of age
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What are the 3 most important tasks to conquer during baby's first days home?
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1. Establishing good positioning and latch
2. Ensuring adequate milk transfer (Drinking and pooping) 3. Teaching parents appropriate feeding frequency and how to monitor intake and output |
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ToF: breastfeeding usually hurts!
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False: effective breastfeeding should NOT HURT
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What are the rules of engagement of breastfeeding?
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1. Sit well supported
2. Good alighnment of baby 3. should not hurt |
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What should a mother be referred to an IBCLC for?
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1. Very sore or cracked/bleeding nipples
2. Mom expresses frustration and may quit breastfeeding 3. baby is "constantly" on the breast |
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ToF: the let-down reflex is something that all mothers should feel.
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FALSE. Not all mom's feel it
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What should the mother be taught in terms of feeding frequency?
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1. know the feeding cues
2. On-demand frequency |
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What is the "recommended" breastfeeding schedule?
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8-12 times in 24 hour period
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ToF: it is uncommon for babies to go long periods of time without eating.
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False: they may cluster feed, especially when they get older
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Why are pacifiers not recommended
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they can extinguish feeding cues
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What is the rules for output in healthy babies?
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1. 1 poop on day 1
2. 2 poops on day 2 3. At LEAST 3 poops in 24 hours on days 3 and beyond! Or 6-8 wet diapers in 24 hours |
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When does transitional stool come out?
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days 2-3
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What does normal breastfed stool look like day 3 and beyond?
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Seedy yellow/mustardy color
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What is an imporatnt milestone at 2 weeks of life?
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baby returns to birthweight
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When does physiologic jaundice occur?
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day 2-3 of life peaks at day 3-5
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What can exacerbate physiologic jaundice?
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ABO incompatiblity or cephalohematomas
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Should mother's continue breastfeeding jaundice babies?
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YES!
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What is breastmilk jaundice?
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1. Peaks at days 10-21, may continue for 2-3 months
2. it is NORMAL, rarely, if ever, does BF need to be discontinued even for a short time |
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When can a child begin solid foods?
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6 months at the earliest
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When do growth spurts occur in infancy?
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1-3 weeks; 6-8; 3 months and 6 months! Increase in feeding!
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What disorder often happens in breast fed babies between 2-6 months?
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Thrush
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