Obstetrics Book

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Breast FeedingAka: Infant Nursing, Lactation

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  1. See Also
    1. Infant Feeding
    2. Infant Nutritional Sources
    3. Infant Nutrition Components
  2. Epidemiology
    1. Incidence
      1. Initial: Under 50% breast feed (HP2000 Goal: 75%)
      2. After 6 months: 20% continue (HP2000 Goal: 50%)
    2. Highest breast feeding rates:
      1. White
      2. Primipara
      3. Over age 30 years
      4. College educated
      5. Employed
      6. Higher socioeconomic status
      7. Western states
    3. Lowest rates among:
      1. Under age 20 years
      2. Unemployed
      3. Unmarried
      4. Lower socioeconomic class
      5. Poor social support
  3. Advantages: Breast feeding
    1. Lower Incidence of Infantile Colic
    2. Most important method of maternal-infant bonding
    3. Easier to digest than formula (related to protein)
      1. Human milk is digested in 1.5 hours
      2. Formula is digested in 4 hours
    4. Does not induce allergic response (contrast to formula)
      1. Diarrhea
      2. Gastrointestinal tract bleeding
      3. Atopic Dermatitis
    5. Lower Incidence of feeding problems
      1. Gastroesophageal Reflux (Regurgitation)
      2. Constipation
    6. Colostrum contains multiple immune factors
      1. Macrophages
        1. Complement
        2. Lysozyme
        3. Lactoferrin
      2. Secretory IgA antibodies
        1. Infant receives 0.5 to 1g Secretory IgA per day
        2. Bacterial, Viral, and protozoal protection
    7. Lower Incidence of infection
      1. Bacteremia
      2. Meningitis
      3. Botulism
      4. Gastrointestinal infection
      5. Lower respiratory infection
      6. Otitis Media
      7. Urinary Tract Infection
    8. Advantages to mother
      1. Faster return to prepregnancy weight
      2. Decreased postpartum bleeding
      3. Increased Bone Mineral Density
      4. Lower Incidence of Ovarian Cancer
      5. Lower Incidence of premenopausal Breast Cancer
  4. Efficacy: Breast Feeding is not guaranteed Contraception
    1. Bottle Feeding
      1. Postpartum 12 weeks: 100% of women ovulating
    2. Breast Feeding
      1. Postpartum 12 weeks: 20% ovulating
      2. Postpartum 20 weeks: 50% ovulating
      3. Postpartum 30 weeks: 75% ovulating
      4. Postpartum 40 weeks: 85% ovulating
      5. Postpartum 50 weeks: 95% ovulating
      6. Postpartum 60 weeks: 100% ovulating
  5. Contraindications: Absolute
    1. Maternal HIV Infection
    2. Chemical Dependency
    3. Important medication use that contraindicates lactation
      1. See Contraindicated Drugs in Lactation
  6. Contraindications: Relative
    1. Tobacco Smoking in lactation
      1. Significant nicotine exposure via breast milk
      2. 10x greater exposure than in bottle fed infants
      3. Mascola (1998) Am J Public Health 88:893
  7. Advantages: Higher risk infants could benefit most from lactation
    1. Respond positively to prenatal education
    2. Physician counseling and support
  8. References
    1. (1997) Pediatrics 100:1035

Breast Feeding (C0006147)

Definition (MSH)The nursing of an infant at the mother's breast.
Definition (CSP)nursing of an infant at the mother's breast.
Definition (NCI)The nursing of an infant at the mother's breast.
ConceptsOrganism Function (T040)
EnglishBreast fed, Breast Feeding, Breastfeeding, Infant breast fed, Infant breastfed, Lactation, Nurse, Nursing
Spanishalimentado a pecho, amamantado, amamantamiento, lactancia, lactancia materna
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Lactation Disorders (C0022927)

Definition (MSH)Disturbances of MILK secretion in either SEX, not necessarily related to PREGNANCY.
ConceptsDisease or Syndrome (T047)
ICD9676.9, 676.90
EnglishDISORDER OF LACTATION, LACTATION DIS, Lactation Disorder, Lactation Disorders, Unspecified disorder of lactation
Spanishtrastorno de la lactancia
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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