Breastfeeding and Human Lactation

, by Riordan, Jan; Auerbach, Kathleen G.

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ISBN: 9780763705459 | 0763705454
Cover: Hardcover
Copyright: 7/1/1998

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Wichita State Univ., KS. Text for maternity nurses lactation consultants, and students. Discusses clinical techniques, research, and cultural and social aspects of breastfeeding. Halftone and color illustrations.

Preface

xix

(3)

Chapter Authors

xxii

SECTION 1 THE HISTORICAL AND SOCIOCULTURAL CONTEXT OF INFANT FEEDING

(90)

CHAPTER 1 Tides in Breastfeeding Practice

(26)

Evidence About Breastfeeding Practices

(1)

Large-Scale Surveys

(1)

Small Surveys

(1)

Other Evidence

(1)

The Biological Norm in Infant Feeding

(1)

Early Human Evolution

(1)

Early Breastfeeding Practices

(1)

The Replacement of Maternal Breastfeeding

(3)

Wet-Nursing

(1)

Hand-Fed Foods

(1)

Timing of the Introduction of Hand Feeding

(1)

Technological Innovations in Infant Feeding

(4)

The Social Context

(1)

The Technological Context

(1)

The Role of the Medical Community

(2)

The Prevalence of Breastfeeding

(2)

United States, England, and Europe

(1)

Developing Regions

(2)

The Cost of Not Breastfeeding

(2)

Health Risks of Using Manufactured Infant Milks

(1)

Economic Costs of Using Manufactured Infant Milks

(1)

The Promotion of Breastfeeding

(6)

Characteristics of Breastfeeding Women

(1)

Promotion Efforts

(4)

Summary

(1)

References

(6)

CHAPTER 2 The Cultural Context of Breastfeeding

(24)

Definitions and Characteristics

(1)

The Dominant Culture

(2)

Ethnocentrism Versus Relativism

(1)

Assessing Culture

(2)

Language Barriers

(1)

The Effects of Culture on Breastfeeding

(3)

Rituals and Meaning

(1)

Colostrum

(1)

Resuming Sexual Relations

(1)

Wet-Nursing

(1)

Childbirth Practices

(1)

Infant Care

(2)

Maternal Foods

(4)

Foods That Increase Breastmilk

(2)

Food Restrictions

(1)

"Hot" and "Cold" Foods

(1)

Vegetarians

(1)

Religious Influences

(1)

The Doula

(1)

Weaning

(3)

Implications for Practice

(2)

Summary

(1)

References

(3)

CHAPTER 3 Families

(40)

Family Forms and Functions

(3)

The Effect of a Baby on a Family

(1)

Family Theory

(1)

Fathers

(3)

Attachment to the Baby

(1)

Breastfeeding

(2)

Levels of Family Functioning

(12)

The Teenage Mother

(2)

The Low-Income Family

(1)

Obstacles to Breastfeeling Among Low-Income Families

(4)

The Down Side of Family Experiences

(3)

The Importance of Peer Counselors

(1)

Social Support

(1)

Breastfeeding Promotion

(10)

Advocacy and Counseling

(8)

Breastfeeding Programs That Work

(2)

Summary

(1)

References

(9)

SECTION 2 ANATOMICAL AND BIOLOGICAL IMPERATIVES

(148)

CHAPTER 4 Anatomy and Physiology

(28)

The Mother

(11)

Mammogenesis

(1)

Structure

(3)

Variations

(1)

Pregnancy

(1)

Lactogenesis

(1)

Hormonal Influences

(4)

Milk Production

102

(1)

Galactopoiesis

102

(1)

Oxytocin

103

(1)

Galactorrhea

104

(1)

Clinical Implications: Mother

104

(3)

Breast Assessment

104

(2)

Classification of Nipple Function

106

(1)

Early Frequent feedings

106

(1)

The Infant

107

(6)

Newborn Oral Development

107

(1)

Suckling

108

(5)

Breathing and Suckling

113

(1)

Clinical Implications: Infant

113

(2)

Breastfeeding Assessment

113

(1)

Suckling Assessment

113

(2)

Summary

115

(1)

References

115

(6)

CHAPTER 5 The Biological Specificity of Breastmilk

121

(42)

Maturational Changes

121

(2)

Energy, Volume, and Growth

123

(3)

Caloric Density

123

(1)

Milk Volume and Storage Capacity

123

(3)

Infant Growth

126

(1)

Nutritional Values

126

(7)

Fat

127

(1)

Lactose

128

(1)

Protein

129

(1)

Vitamins and Micronutrients

130

(1)

Minerals

131

(2)

Renal Solute Load

133

(1)

Antiinfective Properties

133

(4)

Respiratory Illness

135

(1)

Otitis Media

135

(2)

The Immune System

137

(5)

Cells

138

(1)

Antibodies and Other Immunoglobulins

138

(3)

Nonantibody Antibacterial Protection

141

(1)

Fecal Flora

142

(1)

Antiinflammatory Components

142

(1)

Bioactive Components

142

(5)

Enzymes

143

(2)

Growth factors

145

(1)

Hormones

146

(1)

Taurine

147

(1)

Antiallergenic Properties

147

(2)

Implications for Clinical Practice

149

(2)

Summary

151

(1)

References

151

(12)

CHAPTER 6 Drugs and Breastfeeding

163

(58)

The Passage of Maternal Drugs into Breastfeeding Infants

164

(3)

Drug Factors

164

(1)

Maternal Factors

165

(1)

Infant Factors

165

(1)

Breast and Milk Factors

166

(1)

Routes of Transport

166

(1)

Drugs That Affect Milk Volume

167

(1)

Drug Safety

167

(13)

Nonsteroidal Antiinflammatory Drugs

170

(1)

Analgesics and Narcotics

170

(1)

Anesthetics

170

(1)

Anticoagulants

170

(1)

Anticonvulsants

170

(2)

Antidepressants

172

(1)

Antihistamines

173

(1)

Antimicrobials

173

(1)

Antifungals

174

(1)

Bronchodilators

174

(1)

Beta-Blockers and Antihypertensives

174

(1)

Calcium Channel Blockers

174

(1)

Contraceptives

175

(1)

Diuretics

175

(1)

Laxatives

175

(1)

Herbs

175

(1)

Scabicides and Pediculicides

176

(1)

Steroids

176

(1)

Clinical Implications

176

(4)

Maternal Substance Abuse and Addiction

180

(2)

Marijuana

180

(1)

Cocaine

180

(1)

Amphetamines

181

(1)

Alcohol

181

(1)

Clinical Implications

181

(1)

Environmental Contaminants

182

(2)

Summary

184

(1)

References

185

(5)

Appendix 6-A: The Transfer of Drugs and Other Chemicals into Human Milk

190

(31)

CHAPTER 7 Viruses in Human Milk

221

(20)

Human Immunodeficiency Virus

221

(6)

Laboratory Tests

222

(1)

What We Know in the Late 1990s

222

(1)

Clinical Implications

223

(3)

U.S. Public Health Service Recommendations

226

(1)

Counseling

227

(1)

Herpes Simplex

227

(2)

Chickenpox

229

(1)

Cytomegalovirus

229

(2)

Rubella

231

(1)

Hepatitis B

231

(1)

Hepatitis C

232

(1)

Human T-Lymphotropic Virus

233

(1)

Implications for Practice

234

(1)

Summary

234

(1)

References

235

(6)

SECTION 3 PRENATAL, PERINATAL, AND POSTNATAL PERIODS

241

(274)

CHAPTER 8 Breastfeeding Education

241

(38)

Learning Principles

242

(1)

Adult Education

242

(2)

Curriculum Development

244

(1)

The Change Process

244

(2)

Parent Education

246

(7)

Prenatal Education

248

(1)

Early Breastfeeding Education

249

(1)

Continuing Support for Breastfeeding Families

249

(4)

How Effective Is Breastfeeding Education?

253

(2)

Teaching Strategies

255

(1)

Therapeutic Communication

255

(3)

Small-Group Dynamics

258

(1)

Multimedia Presentations

258

(2)

Slides

259

(1)

Transparencies

259

(1)

Videotapes

259

(1)

CD ROMs

260

(1)

Educational Materials

260

(2)

Education for At-Risk Populations

262

(2)

Educational Needs and Early Discharge

264

(1)

Health Care Provider Education

265

(5)

Continuing Education

265

(4)

Objectives and Outcomes

269

(1)

The Team Approach

270

(1)

Lactation Consultants

271

(1)

Summary

272

(1)

References

273

(6)

CHAPTER 9 The Breastfeeding Process: The Perinatal and Intrapartum Period

279

(32)

Breastfeeding Preparation

279

(1)

Breast and Nipple Preparation

280

(1)

The Birth Plan and Feeding Plan

281

(1)

Early Feedings

281

(6)

Cup-Feeding the Neonate

287

(2)

Nipple Shields

287

(1)

Hypoglycemia

288

(3)

Cesarean Births

291

(3)

Breast Fullness Versus Engorgement

294

(1)

Hand Expression

295

(3)

Clinical Implications

298

(6)

Discharge Planning

300

(1)

Feeding Positions

301

(1)

Basic Feeding Techniques

301

(2)

Signs That Intervention Is Needed

303

(1)

Summary

304

(1)

References

305

(6)

CHAPTER 10 The Breastfeeding Process: The Postpartum Period

311

(30)

Adequate Hydration and Nutrition of the Neonate

312

(1)

Insufficient Milk Supply (IMS)

312

(3)

Perceived Insufficient Milk Supply

312

(2)

Actual or Primary Insufficient Milk Supply

314

(1)

Breast Massage

315

(1)

Sore Nipples

315

(6)

Neonatal Physiological Jaundice

321

(1)

Crying and Colic

321

(3)

Stooling Patterns

324

(2)

Changes Over Time

324

(1)

Stooling as an Indication of a Problem

325

(1)

Multiple Infants

326

(2)

Refusing the Breast

328

(1)

Too Much Milk

329

(1)

Leaking and Breast Pads

330

(1)

Clothing

331

(1)

Breastfeeding During Pregnancy

331

(1)

Clinical Implications

332

(3)

Summary

335

(1)

References

336

(5)

CHAPTER 11 Slow Weight Gain and Failure to Thrive

341

(34)

Normal Growth

341

(2)

Growth Charts: How Good Are They?

343

(1)

The Slow-Gaining Infant

344

(3)

Failure to Thrive

347

(2)

Factors Associated with Inadequate Caloric Intake

349

(10)

Red Flags

349

(6)

Infant Factors

355

(3)

Maternal Factors

358

(1)

Clinical Implications

359

(1)

Supplementation

359

(5)

Devices

359

(3)

Other Methods

362

(2)

Summary

364

(1)

References

364

(4)

Appendix 11-A: Maternal-Infant History Form

368

(7)

CHAPTER 12 Jaundice and the Breastfeeding Baby

375

(18)

Early-Onset (Neonatal) Jaundice

375

(2)

Pathological Jaundice

377

(1)

Factors Associated with Early-Onset Jaundice

377

(3)

Infant Characteristics

377

(1)

Hospital Routines

378

(2)

Routine Therapy for Early-Onset Jaundice

380

(1)

Incipient Vulnerable Child Syndrome: One Cost of Overdiagnosis

381

(1)

Late-Onset Jaundice

382

(2)

Clinical Implications

384

(5)

Summary

389

(1)

References

389

(4)

CHAPTER 13 Breast Pumps and Other Technologies

393

(56)

Concerns of Mothers

393

(1)

Stimulating the Milk-Ejection Reflex

394

(2)

Hormonal Considerations

396

(3)

Prolactin

396

(2)

Oxytocin

398

(1)

Pumps

399

(1)

Mechanical Milk Removal

399

(1)

The Evolution of Pumps

399

(1)

Hand Pumps

399

(3)

Battery-Operated Pumps

402

(1)

Electric Pumps

402

(6)

Product Effectiveness and Safety

408

(1)

Miscellaneous Pumps

408

(1)

Juice-Jar Breast Pump

408

(1)

Ora'lac

408

(1)

Venturi Breast Pump

408

(1)

Medela Pedal Pump

408

(1)

Clinical Implications Regarding Breast Pumps

409

(9)

Sample Guidelines for Pump Recommendations and Pumping Techniques

418

(1)

Common Pumping Problems

419

(8)

Nipple Shields

427

(5)

Review of the Literature

428

(1)

Risks

428

(2)

Responsibilities of Health Care Professionals

430

(1)

Weaning from a Shield

431

(1)

Breast Shells

432

(1)

Recommendations on Breast Shells

432

(1)

Feeding-Tube Devices

433

(2)

Description

433

(1)

Situations for Use

434

(1)

Clinical Implications

435

(3)

Summary

438

(1)

References

439

(5)

Appendix 13-A: Manufacturers and Distributors of Breastfeeding Devices

444

(5)

CHAPTER 14 Breastfeeding the Preterm Infant

449

(34)

Preterm Infants

449

(1)

Mothers of Preterm Infants

450

(1)

Rates of Breastfeeding Initiation and Duration

450

(2)

Providing Research-Based Breastfeeding Services

452

(1)

The Decision to Breastfeed

452

(4)

Facilitating an Informed Decision

452

(1)

Alternatives to Exclusive, Long-Term Breastfeeding

452

(4)

Milk Expression and Collection

456

(3)

Principles of Milk Expression

456

(1)

Selecting a Breast Pump

456

(1)

Reimbursement

456

(1)

Milk-Expression Technique

457

(1)

Milk-Expression Schedule

458

(1)

Preventing Low Milk Volume

458

(1)

Skin-to-Skin Care

459

(1)

Nonnutritive Suckling

459

(1)

Management of Low Milk Volume

460

(1)

Gavage Feeding of Mothers' Milk

460

(2)

Fortifying and Modifying EMM

462

(2)

Commercial Additives

462

(1)

Hindmilk Feeding

463

(1)

Maternal Medications and Small Preterm Infants

464

(1)

Standards for Storing and Handling Milk in the NICU

465

(1)

Feeding at Breast in the NICU

465

(7)

The Science of Early Breastfeeding

465

(1)

Initiating Early Breastfeeding

466

(1)

Positions for Early Breastfeeding

466

(1)

Milk Transfer for Preterm Infants

467

(1)

Test Weighing

468

(1)

Facilitating Milk Transfer

469

(1)

Milk Ejection

469

(1)

Infant Suckling

470

(1)

Breastfeeding Devices

471

(1)

Postdischarge Breastfeeding Management

472

(1)

Getting Enough: Milk-Transfer Problems

472

(1)

Practice Implications

472

(1)

Summary

473

(1)

References

474

(9)

CHAPTER 15 Breast-Related Problems

483

(32)

Nipple Variations

483

(1)

Inverted or Flat Nipples

483

(1)

Large or Elongated Nipples

484

(1)

Plugged Ducts

484

(1)

Mastitis

485

(2)

Skin Rashes, Lesions, and Eczema

487

(1)

Candidiasis (Thrush)

488

(4)

Breast Pain

492

(1)

Vasospasm

492

(1)

Milk Blister

493

Mammoplasty

490

Breast Reduction

493

(1)

Mastopexy

494

(1)

Augmentation

494

(2)

Breast Lumps and Surgery

496

(6)

Galactoceles

497

(1)

Fibrocystic Disease

497

(1)

Bleeding from the Breast

498

(1)

Breast Cancer

499

(3)

Clinical Implications

502

(5)

Mastitis

502

(2)

Breast Surgery and Abscess

504

(3)

Summary

507

(1)

References

507

(8)

SECTION 4 BEYOND POSTPARTUM

515

(194)

CHAPTER 16 Maternal Nutrition During Lactation

515

(26)

Maternal Caloric Needs

515

(2)

Maternal Fluid Needs

517

(1)

Weight Loss During Lactation

518

(1)

Exercise

519

(1)

Calcium Needs and Bone Loss

519

(2)

Vegetarian Diets

521

(1)

Dietary Supplements

521

(1)

Foods That Pass Through Milk

522

(1)

Caffeine

521

(1)

Food Flavorings

522

(1)

Goal of the Maternal Diet During Lactation

522

(2)

Nutrition Basics

524

(4)

Energy

524

(1)

Macronutrients

524

(3)

Micronutrients

527

(1)

Clinical Implications

528

(8)

Summary

536

(1)

References

536

(5)

CHAPTER 17 Women's Health and Breastfeeding

541

(36)

Alterations in Endocrine and Metabolic Functioning

541

(9)

Type 1 Diabetes

541

(2)

Thyroid Disease

543

(6)

Pituitary Dysfunction

549

(1)

Cystic Fibrosis

550

(1)

Acute Illness and Infections

550

(1)

Dysfunctional Uterine Bleeding

551

(1)

Surgery

552

(1)

Relactation

553

(2)

Induced Lactation

555

(2)

Autoimmune Diseases

557

(2)

Systemic Lupus Erythematosus

557

(1)

Multiple Sclerosis

558

(1)

Rheumatoid Arthritis

558

(1)

Disabilities and Impairments

559

(3)

Clinical Implications

559

(3)

Seizure Disorders

562

(1)

Headaches

563

(1)

Postpartum Depression

564

(5)

Clinical Implications

565

(4)

Asthma

569

(1)

Smoking

569

(1)

Diagnostic Studies Using Radioisotopes

570

(1)

The Impact of Maternal Illness and Hospitalization

570

(2)

Summary

572

(1)

References

572

(5)

CHAPTER 18 Maternal Employment and Breastfeeding

577

(24)

Why Women Work

577

(1)

Number of Women Who Work

577

(1)

Prenatal Planning and Preparation

578

(1)

The Puerperium

579

(1)

Returning to Work

579

(2)

Hand-Expressing or Breast Pumping?

581

(2)

Storage

583

(2)

Feeding Options

585

(1)

Loss of Sleep

586

(1)

The Triple Breeder-Feeder-Producer

586

(1)

The Continuing "War" Between Work and Home

587

(1)

The Importance of Social Support

588

(2)

Lactation Programs at Work

590

(1)

Health Care Workers: A Special Case?

591

(1)

The Day-Care Dilemma

592

(1)

Clinical Implications

593

(4)

Summary

597

(1)

References

598

(3)

CHAPTER 19 Child Health

601

(36)

Developmental Outcomes and Infant Feeding

601

(1)

Growth and Development

602

(4)

Physical growth

602

(2)

Weight and Length

604

(1)

Senses

604

(2)

Reflexes

606

(1)

Levels of arousal

606

(1)

Theories of Development

606

(2)

Nature Versus Nurture

606

(1)

Erikson's Psychosocial Theory

606

(1)

Piaget's Cognitive Theory

607

(1)

Social Development

608

(12)

Language and Communication

608

(5)

Attachment and Bonding

613

(3)

Temperament

616

(2)

Stranger Distress

618

(1)

Separation Anxiety

619

(1)

Clinical Implications

619

(1)

Immunizations

620

(1)

Dental Health

621

(3)

Solid Foods

624

(4)

Introducing Solid Foods

624

(1)

Choosing the Diet

625

(2)

Choosing Feeding Location

627

(1)

Delaying Solid Foods

628

(1)

Obesity

628

(1)

Weaning

629

(1)

Clinical Implications

630

(1)

Summary

631

(1)

References

631

(6)

CHAPTER 20 The Ill Breastfeeding Child

637

(38)

Infections

637

(5)

Gastrointestinal Infections

638

(2)

Respiratory Infections

640

(1)

Meningitis

641

(1)

Otitis Media

642

(1)

Alteration in Neurological Functioning

642

(2)

Down Syndrome

642

(1)

Neural-Tube Defects

643

(1)

Hydrocephalus

643

(1)

Clinical Implications

644

(1)

Congenital Defects

644

(9)

Congenital Heart Defects

644

(1)

Oral and Gastrointestinal Defects

644

(7)

Clinical Implications

651

(2)

Metabolic Dysfunction

653

(2)

Phenylketonuria

653

(1)

Galactosemia Hypothyroidism

654

(1)

Congenital Hypothyroidism

654

(1)

Celiac Disease

654

(1)

Cystic Fibrosis

655

(1)

Allergies and Food Tolerance

655

(3)

Allergies While Breastfeeding

656

(2)

Hypoglycemia

658

(1)

Sudden Infant Death Syndrome

659

(2)

Hospitalization

661

(3)

Parental Stresses

662

(1)

Coping with Siblings

663

(1)

Emergency Admission

663

(1)

Home: The Rebound Effect

664

(1)

Chronic Grief and Loss

664

(1)

The Magic-Milk Syndrome

664

(1)

The Empty Cradle

665

(1)

Clinical Implications

665

(2)

Summary

667

(1)

References

668

(7)

CHAPTER 21 Fertility, Sexuality, and Contraception During Lactation

675

(34)

Fertility

675

(10)

The Demographic Impact of Breastfeeding

675

(1)

Mechanisms of Action

676

(1)

Lactational Amenorrhea

677

(1)

The Suckling Stimulus

678

(1)

Breastfeeding Frequency and Duration

679

(1)

Supplemental Feeding

680

(1)

The Repetitive Nature of the Recovery of Fertility

681

(2)

The Bellagio Consensus

683

(2)

Sexuality

685

(6)

Libido

685

(4)

Sexual Behavior During Lactation

689

(2)

Contraception

691

(9)

Contraceptive Methods

692

(6)

Clinical Implications

698

(2)

Summary

700

(1)

References

701

(8)

SECTION 5 CONTEMPORARY ISSUES

709

(92)

CHAPTER 22 Work Strategies and the Lactation Consultant

709

(38)

History

709

(1)

Certification

710

(1)

Educational Offerings

711

(1)

Hospital Lactation Programs

712

(3)

Playing Politics

715

(3)

The Unique Characteristics of Breastfeeding Counseling

718

(1)

Assertiveness

718

(5)

Roles and Responsibilities

723

(1)

Lactation Consultants and Voluntary Counselors

724

(2)

Marketing

726

(1)

Networking

726

(3)

Reporting and Charting

727

(1)

Nursing Diagnosis

728

(1)

Methods for Charting

728

(1)

Clinical Care Plans

729

(1)

Legal Considerations

730

(1)

Reimbursements

731

(1)

The LC in Hospital-Based Practice

731

(1)

The LC in Private Practice

732

(3)

The Business of Doing Business

735

(2)

Collaboration with Other Health Care Workers

737

(1)

Partnerships

738

(1)

Burnout

739

(2)

Do's and Don'ts of Lactation Consulting

741

(2)

Summary

743

(1)

References

744

(3)

CHAPTER 23 Research and Breastfeeding

747

(28)

Approaches to Research Methods

747

(5)

Qualitative Approaches

747

(1)

Types of Qualitative Methods

748

(1)

Quantitative Approaches

749

(1)

Types of Quantitative Methods

749

(2)

Additional Approaches

751

(1)

Multiple Approaches

751

(1)

Elements of Research

752

(6)

Research Problem and Purpose

752

(1)

Variables, Hypotheses, and Operational Definitions

753

(3)

Review of the Literature

756

(1)

Protection of the Rights of Human Subjects

756

(1)

Method

757

(1)

Data Analysis

758

(1)

Results, Discussion, and Conclusions

758

(1)

Application of Methods to Qualitative Approaches

759

(2)

Reliability and Validity

759

(1)

Sampling and Sample Size

760

(1)

Data Collection

760

(1)

Data Analysis

760

(1)

Application of Methods to Quantitative Approaches

761

(7)

Sampling and Sample Size

761

(1)

Data Collection

762

(2)

Reliability and Validity

764

(1)

Data Analysis

765

(3)

The Evaluation of Research Reports and Articles for Use in Practice

768

(2)

Using Research in Clinical Practice

770

(1)

Summary

770

(2)

References

772

(2)

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Breastfeeding and Human Lactation

Summary

Table of Contents

Supplemental Materials