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Certified Breastfeeding Counselor
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Certified Breastfeeding Counselor Exam
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Different stages of breast development
- Embryogenesis
- Mammogensis
- Lactogenesis 1
- Lactogenesis 2
- Lactogenesis 3
Embryogenesis: mammary gland devo while 5 wk embryo
Mammogenesis: @ puberty, estrogen influences growth of ducts and buds
Lactogenesis 1: completion of mammary development from placenta stimulation; ducts stimulated +
colostrum secretion at 16 wks
Lactogenesis 2: Secretory activation when placenta out --> decr progesterone --> inc prolactin --> inc
milk supply
Lactogenesis 3: Milk removal --> mature milk prod; Infant sucking= ^ oxytocin= let down.
Estrogen
Progesterone
Prolactin
Oxytocin
TSH
Estrogen - ^ during pregnancy; stim growth in ductile system
Progesterone - ^ during pregnancy; stim alveoli and lobes
Prolactin - frm ant pituitary gland; lands on prolactin receptor sites to start milk prod
Oxytocin - from post pituitary gland; cause LETDOWN
TSH - ^ responsiveness of mammary cells
Tail of spence: What is it, symptoms
Mammary gland tissue that extends to axillary area, connected to milk ducts --> can cause swollen
armpits & mastitis
Accessory tissue: Where are they found? Can they lactate?
Diagonal line from axilla to groin area
- can lactate & undergo malignant change
Flat nipples
Pseudo inverted nipple
Retracted nipple
Inverted nipple
- possible issues, short shank, solutions
Flat - remains flat after stimulation or retract with compression (short shank) --> diff w/ latch
Pseudo - seems inverted but erect upon stimulation
Retracted - retracts upon stimulation
Inverted - retracted at rest &s stimulation
Nipple shield may help.
Hypoplasia, what is it?
Underdevelopment, insufficient glandular tissue --> can lead to insufficient milk
, Active let down
- How is milk ejected into ducts from alveoli? aka let down
- signs of let down
- postions that are helpful for let down
Myoepitheal cells encase the aveoli, contract in response to oxytocin. In response to sucking oxytocin
increases
What is breast milk composed of?
- Fats: most variable, help brain devo, hi in evenings
-Protein: Casein- allows for iron to be absorbed, mature milk. Whey- hi in colostrum, contains IGA; has
lysozyme that kills bacteria
Carbs: creates acidic environment in gut & has lactose that reg milk vol
Vitamins: A,D,E,K,C, thiamin, riboflavin, b's that influenced by mom.
Minerals: calcium, phosphorus, magnesium, not affected by diet. + 88% water
Impact of breast surgery on lactation
- Implants
- hyaluronic acid injections
- breast reduction
Implants
- compress milk ducts --> impede milk flow --> compromise reaching max milk vol
Hyaluronic acid injections
- no risk of being absorbed in baby's GI tract
Reduction
- BF might not be possible after
- BF early + stim bm early
Signs of milk transfer
Swallowing, air from nose, ca sound, movement seen
Feeding patterns 24-48 hrs & 48 and further
24-48hr --- > Cluster feeding (feed freq over short amt of time) , must stimulate breast
48 and further --> on demand (cue based feeding) ; offer q 3 hrs
How does poop transform?
Normal urine output
Black to green to yellow (by end of first week). Watery and seedy at first
Urine output --> 1 diaper per day of life (e.g: 2 day old infant min of 2 wet diapers)
LATCH tool
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