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Nutrition During Lactation-2


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Unformatted text preview: ) until zero level in milk is reached for women at different body weights Other Drugs and Lactation • Caffeine – Level in breast milk is only 1% of that in mother’s plasma – May accumulate in infants younger than 3 to 4 months – May interfere with sleep or cause hyperactivity & fussiness of infant Environmental Exposures “The advantages of breastfeeding far outweigh the potential risks from environmental pollutants. Taking into account breastfeeding’s short­ and long­term health benefits for infants and mothers, the WHO recommends breastfeeding in all but extreme circumstances.” World Health Organization Infant Allergies • Exclusive breastfeeding for ≥4 months protects against allergies, ectopic dermatitis & wheezing • Development of food allergies influenced by numerous factors: – genetics, duration of breastfeeding, time of introduction of other foods, maternal smoking, air pollution, etc. • Consumption of omega­3 fatty acids by lactating mother may protect against allergies Peanut Allergies • Genetics plays a big part – Family history of allergies may necessitate need to alter maternal diet – Avoid peanuts and tree nuts if there is a family history of allergies Food Intolerance • No scientific evidence shows gassy foods in mother’s diet produce gas in infant • Low­allergen maternal diet associated with reduction in distressed behavior (colic) – Allergenic foods eliminated were cow’s milk, eggs, peanuts, tree nuts, wheat, soy, & fish Neonatal Jaundice and Kernicterus •Jaundice—a yellow color of the skin seen in about 60% of full­term & 80% of preterm infants • AKA hyperbilirubinemia •If not resolved, the elevated bilirubin can cause permanent neurological damage •It is the most frequent cause for hospital readmission for newborns Bilirubin Metabolism •Bilirubin—a pigment produced as heme from red blood cells (RBC) break down •Usually processed by the liver and excreted in the baby’s stool •Newborn’s liver not fully mature so jaundice is common during first few days of life •Color appears first in the face & upper body then progresses downward toward the toes Bilirubin Metabolism • In the fetal state, high levels of hemoglobin were needed to carry oxygen delivered by the placenta • At birth, infants have very high levels of hemoglobin and hematocrits of 50% to 60% • As infant breathes on his own, high hemoglobin is not needed, so RBC begin to break down Physiologic versus Pathologic Newborn Jaundice Physiological • Begins after 1st day after birth rising steadily with peak ~ day 6­7 • Bilirubin <12 mg/dL • Condition resolves within a few days • Cause: normal heme breakdown Pathological • Begins within 1st day after birth rises rapidly & lasts longer • Bilirubin >8 mg/dL in 1st day • Medical intervention with phototherapy • Cause: various pathological conditions Bilirubin Encepahlopathy or Kernicterus • Bilirubin is toxic to cells & may cause brain damage • Mortality rate is 50% for pathologic jaundice • May cause: cerebral palsy, hearing loss, paralysis of upward gaze, etc. Breast­Milk Jaundice Syndrome • Onset later than physiological jaund...
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