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Lactation > Anatomy and physiology > Flashcards

Anatomy and physiology Flashcards

1
Q

Effect of Estrogen on Breast during Pregnancy

A

proliferation of ductal system

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2
Q

Effect of Progesterone on Breast during Pregnancy

A

increase in size of alveoli, lobules, and lobes

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3
Q

Effect of prolactin on Breast during pregnancy

A

nipple growth

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4
Q

Effect of placental lactogen on breast during pregnancy

And after birth

A

During pregnancy, promotes areolar growth

After birth, levels drop, allowing prolactin to get to the shared receptor sites

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5
Q

Lactogenesis I/ Secretory Differentiation =

A
  1. Initiation of milk synthesis mid-late pregnancy
  2. Alveolar epithelial cells convert to secretory cells- fat droplets accumulate, increased plasma lactose and a-lactalbumin
  3. Prolactin stimulates these cells to produce milk
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6
Q

Lactogenesis II/Secretory Activation =

A
  1. Occurs 3-8 days postpartum
  2. Triggered by rapid drop in progesterone after delivery of placenta
  3. Closure of desmosomes between epithelial cells - Onset of copious milk production
  4. Fullness and warmth in breasts
  5. Switch from endocrine to autocrine control
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7
Q

Mammogenesis =

A
  • Breast growth, increased size and weight

- proliferation of ducts and glandular system due to estrogen and progesterone

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8
Q

Galactopoiesis =

A
  1. Day 9 through beginning of involution
  2. Maintenance of established secretion
  3. Control by autocrine aka supply and demand
  4. breast size decreases from 6-9 months PP
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9
Q

Involution =

A
  1. 40 days after last breast feed
  2. Addition of supplementation of formula or food
  3. decreased milk secretion due to build up of inhibition peptides
  4. High sodium levels
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10
Q

Causes of delayed lactogenesis II

A
  1. obesity
  2. Maternal-infant separation or lack of holding
  3. PCOS
  4. Ovarian Theca Lutein Cysts (high testosterone)
  5. Smoking
  6. High levels of cortisol
  7. Primiparity
  8. cesarean birth
  9. Prolonged second stage
  10. Excessive IV hydration in labor
  11. Diabetes
  12. Placental retention
  13. Ischemic pituitary necrosis-caused by hemmorhage
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11
Q

Progesterone

A
  1. Maintains pregnancy
  2. Delays lactation
  3. increase in size of alveoli and lobes during pregnancy
  4. Massive drop after placenta delivery stimulates lactation
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12
Q

Action of Prolactin After birth

A
  1. stimulates body to produce milk- released in pulses7-20 times in a 24 hour period
  2. is stimulated by sensation of suckling and milk removal- causes hypothalamus to inhibit release of dopamine
  3. higher at night
  4. decline slowly over course of lactation
  5. Not proportional to milk yield
  6. Delay return of ovulation- inhibits ovarin response to FSH
  7. Drop with cigarette use
  8. Levels are lower in Depressed mothers
  9. Influences intestional fluid in newborn
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13
Q

Role of Dopamine

A
  1. A prolactin inhibiting factor
  2. When nipple is stimulated and milk removed, hypothalamus inhibits release of dopamine
  3. Drop in dopamine stimulates release of prolactin by hypothalamus
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14
Q

Cortisol

A
  1. required by milk cells prior to exposure to prolactin
  2. regulates water transport
  3. high levels associated with delay in lactogenesis
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15
Q

TSH

A
  1. Promotes mammary growth and lactation

2. Significantly increased levels on PP day 3-5

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16
Q

oxytocin

A
  1. Released by Posterior Pituitary in response to suckling

2. Causes Milk Ejection Reflex

17
Q

Milk Ejection Reflex

A
  1. also called the “let-down”
  2. contraction of myoepithelial cells surrounding alveoli
  3. facilitate milk removal
  4. Feels like pressure, warm, tingling feeling
  5. increase in milk duct diameter
18
Q

Benefits of High Oxytocin Levels with breastfeeding

A
  1. contraction of the uterus
  2. calm,
  3. decreased corticosteroids
  4. Diminished response to pain and stress
19
Q

Areolar glands:
Location
Number
Function

A

More on upper lateral segment
Mean of 8, but varies widely
Associated with increased latching, weight gain, active suckling

20
Q

Polythelia

Polymastia

A

Also called accesory nipples- seen along mammary ridge from axila to groin

Accessory mammary tissue

21
Q

Galactorrhea

A

Spontaneous secretion of milk in non-physiological circumstances
- can be accompanied by amenorrhea, infertility, lack of libido

Lactation (7 decks)

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