Lactation

Question 1

What is the physiology of lactation?

Answer 1

1. Rapid decline of oestrogen and progesterone after birth removes -ve feedback to anterior pituitary and causes a release of prolactin.
2. Oxytocin from posterior pituitary stimulates ejection in response to nipple suckling.

Question 2

What is passed for the first three days before milk in lactation?

Answer 2

Colostrum - yellow fluid containing fat, proteins (IgA) and minerals

Question 3

What can cracked nipples cause?

Answer 3

Mastitis

Question 4

Which organism is responsible for mastitis and how is it treated?

Answer 4

1. Staphylococcus aureus

2. Maintain feeding, flucloxacillin

Question 5

What causes a breast abscess and how is it treated?

Answer 5

1. Sequelae of untreated mastitis

2. Maintain feeding, flucloxacillin, incision, drainage

Question 6

What are the pros of breastfeeding?

Answer 6

1. Easy, free, and convenient for child
2. Promotes bonding
3. Reduces atopy, GI infections, obesity, diabetes
4. Passive immunity
5. Maternal weight loss
6. Reduces risk of breast/ovarian/endometrial cancer

Question 7

What are the cons of breastfeeding?

Answer 7

1. Not easy/convenient for mother
2. Painful, sore nipples
3. Drugs pass through
4. HIV with high viral load can transmit