6 - Nutrition during Lactation Flashcards
Process of Mammary gland development
Puberty: Ovaries Maturation - Estrogen and Progesterone Hormone increased - Lobular structure in the mammary gland is starting to develop - Ductal system is matured
Pregnancy: Luteal and Placental hormones is produced - Milk glands starting to develop - Tubules elongation and epithelial cells duplications
Hormones that stimulate Milk glands development ____ and tubules elongation & epithelial cells duplication stimulate by _______
Estrogen ; Progesterone
Characteristic of Ductal system Maturation
Increase of Fibrous and Fatty tissues around the ducts
6 hormones that contributing to breast development and lactation
Estrogen Progesterone Growth Hormone Placental Lactogen Prolactin Oxytocin
Estrogen has a role of ______ during lactation and in which stage of lactation is occur?
Ductal Growth ; Mammary gland differentiation with menstruation
Progesterone has a role of ______ during lactation and in which stage of lactation is occur?
Alveolar development; After onset of menses and during pregnancy
Human Placental Lactogen has a role of ______ during lactation and in which stage of lactation is occur?
Alveolar Development; Pregnancy
Prolactin has a role of ______ during lactation and in which stage of lactation is occur?
Alveolar development and Milk Secretion; Pregnancy and Breastfeeding (trimester of pregnancy to weaning)
Oxytocin has a role of ______ during lactation and in which stage of lactation is occur?
Letdown->Ejection of milk; From the onset of milk secretion to weaning
There are 3 steps of Lactogenesis, define each steps of lactogenesis.
Lactogenesis I: 2nd and 3rd trimester extends through 0-2 days od postpartum - Colostrum production ( High in sigA & vitamin K) - Lactose and protein increase
Lactogenesis II: 2-5 postpartum - Increased blood flow into mammary gland - increase the volume of milk when baby increase suckling
Lactogenesis III: 10 days postpartum - Foremilk ( increase water and lactose) Hindmilk ( increase fat and energy) - Milk composition more stable
Components of Milk
Lactose Milk fat Immunoglobulin Other plasma proteins and componenst water Sodium Potassium Chloride
Lactose is produced in ____ and secreted in ___
Secretory cells; Ducts (exocytosis)
Milk Fat is coming from ____ and secretes in ___
Triglycerides from mothers’ blood and new fatty acid in the breast; ducts
Immunoglobulin is coming from ____ and secretes in ___
Mothers’ blood and taken into alveolar cells; ducts
Water, Sodium. Potassium, and Chloride are using _____ to transport
Passive Diffusion
Pathway for Other plasma components and Leukocytes is ______
Paracellular Pathway (Pass directly between Cells)
Letdown Reflex Mechanism
Stimuli pass through the nerves into the hypothalamus - oxytocin hormone release from posterior pituitary gland
4 types of stimuli that cause letdown reflex
Infant suckling
Hearing a baby cry
Sexual Arousal
Nursing Thinking
Hormones that cause contraction of myoepithelial cells is ______
Oxytocin
Milk secretion is caused by _____ hormones and milk ejection is caused by _____
Oxytocin; Prolactin
During Lactation the mothers need additional ___ kcal for first 6 months and ____ kcal per day afterwards
330;400
Common Nutritional problems during lactation are
Inadequacy of folate, thiamin, vitamin A, calcium, iron, and zinc
Effect of Protein-calorie malnutritions is ________
Decrease Volume of milk
Advantages of Breastmilk rather than Formula milk
Protects infants from infectious and chronic diseases
Changeable over a single feeding, over a day, according age of infant
Contains hundreds of components
Nutrition in Breastmilk are
Colostrum Water Energy Lipids Protein Milk Carbohydrates Water&Fat Soluble vitamins Minerals
Benefits of consuming Colostrum
Have the highest of mononuclear cell that provides immune protection
Breast milk is _____ to plasma
Isotonic
Water allows suspension of several components, include
Milk Sugar Proteins Immunoglobulin A sodium Potassium Citrate Magnesium Calcium Chloride Water-soluble vitamins
Milk Production of first month postpartum is _____ml per day and 4-5 months ___-___ ml per day
600;750-800
Lipid composition in Breast milk
DHA
Trans Fatty acids
Cholesterol
3 effects of maternal diet on fat composition
Does not vary according to maternal diet
Fatty acid profile reflects the variation of dietary fatty acid intake during pregnancy and postpartum
Low fat and low adequate calories from carbohydrate and protein then medium-chain fatty acid is synthesized in breast
3 types of protein in breast milk
Casein
Whey protein
Nonprotein Nitrogen
5 types of Milk Carbohydrates
Lactose Oligosaccharides Monosaccharides (glucose) Polysaccharides Protein-bound carbohydrates
4 fat soluble vitamins in Breastmilk
Vitamin A
Vitamin D
Vitamin E
Vitamin K
Vitamin that response to the content of maternal diet
Thiamin Riboflavin Vit B6 Bit B12 Choline
Folate is bound to ______ in human milk and it’s less influenced by _______
Whey protein; Maternal Intake
The highest amount of Mineral in Breast milk is _____
Calcium
Why minerals are lower in breast milk rather than other mammalian milk?
Reduce the workload on kidneys
Benefit of breastfeeding in hormonal level for mothers
Increased level of oxytocin - stimulates uterine contraction
Ovulation Delay - the long interval between pregnancies
Minimize maternal postpartum blood lost
Benefit of breastfeeding in Physical level for mothers
Uterus size return to nonpregnant size
Lower risk of breast and ovarian cancer & rehumatoid arthritis
Benefit of breastfeeding in Psychological level for mothers
Increased self-confidence
Facilitated bonding with infants
5 Sectors of Breastfeeding Advantages for Infants
Nutritional Immunological Health status Growth & deveopment Economic Cost
Benefits in immunological sector for infants are
Creating T and B-Lymphocytes
Secretory immunoglobins (sigA, sigG, sigM, sigE, sigD)
Histocompatibility antigens
T-cell product
Many nonspecific factors (complement, Bifidus factor)
Carrier Proteins ( lactoferrin, transferring, it B12-binding protein and Corticoid-binding protein)
Enzymes (Lysozyme, lipoprotein lipase, leukocyte enzymes)
Benefits in Nutritional sector for infants are
Give appropriate growth and development Meet nutritional requirement Does not cause overloading kidneys Have essential fatty acids Meet minimal mineral demand
Benefits of Breast feeding in Health sector for infants are
Lower infant mortality
Reduce morbidity and mortality due to poor sanitation and water supplies
EBF up to 4 months reduces gastrointestinal illness
Lower the respiratory infection up to 72%
Protect against chronic childhood diseases ( celiac disease, inflammatory bowel disease, diabetes, leukemia, asthma, atopic dermatitis, and eczema)
Challenges of Breastfeeding
Sore nipples & flat or inverted nipples Hyperactive Letdown Hyperlactation Engorgement Plugged duct Mastitis Low supply of milk
How to prevent sore nipples & flat or inverted nipples
Proper positioning of the baby on the breast
Withdraw of Hyperlactation Breastfeeding to the infant
The infant may choke, cough, or gulp
Factors that cause Low Breast Milk supply
Real or perceived insufficient milk supply
Seldomly breastfeeding or pumping
Inefficient emptying of the breast
High stress levels
6 Program for Breastfeeding promotion
Prenatal breastfeeding education and support
Breastfeeding support for individuals
Role of Health care in supporting breastfeeding
Lactation support in hospitals and birthing centers
The workplace
Public health support of breastfeeding
The Baby-Friendly Hospital Initiative Program
Written breastfeeding policy Train all health care staff Inform the benefits and management Help mothers to initiate breastfeeding half one hour birth Show mothers how to breastfeed and show how to maintain lactation Give infants only breast milk Practice rooming in with infants Encourage breastfeeding on demand Give no artificial pacifiers or nipples Establish breastfeeding support groups
How public health support of breastfeeding
Legislate to protect a woman’s right to breastfeed
Legislate Woman’s rights in public and on federal property, express milk at work, and exempt from jury duty.
