Discuss the following breastfeeding conditions and the prevention and treatment of each: sore nipples, flat or inverted nipples, letdown failure, hyperactive letdown, hyperlactation, engorgement, clogged ducts, mastitis, and low milk supply.

Sore nipples;

May be prevented by proper positioning of baby or breastmothers nipple approximates to the junction of the hard and soft palate

Flat or inverted nipple;

should not impact breastfeeding if the latch is correctif difficult to latch; roll nipples between fingers or use a breast pump prior to feedinghelps to draw out the nipples

letdown failure;

milk does not eject from the breastoxytocin nasal spray may be prescribedrelaxation technique may help to enhance letdown

Hyperactive letdown;

stream of milk comes from the breastif too active may cause infants to cough, gulp or choke

Hyperlactation;

milk volume produced exceeds intakereduce productioncabbage leaves or cold compress may be used to decrease production

Engorgement;

Breast are overfilled with milkcabbage leaves may be used  to reduce discomfort

plugged ducts;

localized blockage of milk resulting in milk stasiscaused by milk staying in the ductspainful knot may form in breasttreated by massage and warm compressprevented by complete emptying of breast

mastitis;

inflammation of the breastmay be infective or non infectiveoccur in 1 to 33% of breastfeeding mothersmay result from sore or cracked nipples or missing a feeding

Low milk supply;

most common reason for cessation of breastfeedingmay be real or perceivedcauses; ineffective emptying or breast or stress managementgalactogogue may be prescribed.

Carbohydrates,fats and proteins

What happens to the influenza virus every 20-40 years and why?