breast feeding Flashcards
describe the kind of protein in breast milk
whey based
alpha lactalbumin is main protein
what benefit does alpha lactalbumin have
associated with destruction of over 40 kinds of cancer
what is the most common carbohydrate in breast milk
lactose is primary carbohydrate
provides 40% total calories
what is the role of fats in the breast milk
essential for brain development and fat soluble vitamin absorption
long chain polyunsaturated fatty acids support development of entire nervous system
what is the role of vitamins and minerals in breast milk
essential for wound healing, bone growth, strengthening immune system
what is the role of growth factors in breast milk
epidermal, insulin and transforming factors promote gut growth
what is the role of transfer factors in breast milk
enable effective absorption of nutrients in the milk
help with absorption of fats and vitamins
what is the role of lactoferrin
assists in absorption of iron
bacteriocidal
what is the role of stem cells in breast milk
help with growth and repair
what immunoglobulins are in breast milk
IgA
IgG
IgM
IgD
what is the role of IgA
provides protective coating on gut to protect from pathogens and enteroviruses
what is the role of leukocytes
destroy harmful bacteria
macrophages produce lysozyme which can destroy bacteria cell walls
what is the role of milk lipids
damage outer surface of some viruses
what is the role of IL-7
involved in immune system
stimulates antibody producing cells
linked to size of thymus
what is the role of cytokines
boost immune system
what is colostrum
the first milk produced by the mother
is more concentrated
what does colostrum contain
nutrients and protective factors
how does colostrum minimise jaundice
has laxative effect to help with passage of meconium
why does colostrum have less water in it
because the baby has immature kidneys and is already trying to process lots of ISF so excess water would be difficult to process
how does colostrum reduce the risk of necrotising enterocolitis
it has anti-inflammatory factors in it
helps cells and villi in the gut proliferate and reach gut maturity
what is the role of oligosaccharides in relation to the microbiome
oligosaccharides feed healthy gut bacteria and encourage cells in gut to produce an adhesive protein to seal the gaps between the cells in the gut wall
what happens to the number of lactobacilli bacteria in the mothers vagina during pregnancy and why
number increases in preparation for baby to pass through during birth
this exposes the baby to the mothers microbiome
what are the three things that help build up a good microbiome
vaginal delivery
skin to skin contact
breast feeding
what is epigenetics
additional information to DNA that can attach to, change and modify the gene
breast feeding can change the epigenome
what is the GALT/BALT mechanism
gut/bronchus activated lymphatic tissue
when the mother passes on antibodies to current infections to the baby through breast milk
what is formula
formula is modified cows milk with additional nutrients added
it does not have the live constituents of breast milk and is not as beneficial
how should formula be used
first stage milks for the first year
can use cows milk after that - no need for follow ons
what happens in lactogenesis 1
alveolar epithelial cells differentiate into lactocytes that secrete colostrum from 3-4 months of pregnancy
what happens in lactogenesis 2
rise in prolactin and decrease in pregnancy hormones
onset of copius milk secretion
32-96hrs after birth
Milk comes regardless of whether women wants to breastfeed or not.
what happens in lactogenesis 3
maintenence of milk production
what hormones influence breast development in pregnancy
oestrogen
progesterone
what hormones increase after birth
prolactin and oxytocin
what causes an increase in prolactin levels
the baby touching/suckling the nipples
circadian rhythm - higher at night
what does prolactin act on
receptors on lactocytes to activate them to produce milk
what does oxytocin do in breast feeding
acts on muscle cells to release milk from lactocytes
what causes an increase in oxytocin
if the baby is nearby levels will rise
how does stress effect milk production
cortisol levels rise and compete with oxytocin
the cortisol tightens the muscle so the milk can’t be released
what psychological effect does oxytocin have
‘love hormone’
oxytocin helps from the bond between mother and baby
what is the role of FIL
feedback inhibitor of lactation
whey protein in the milk slows down synthesis of milk when the breasts are full/ineffective milk removal or long spacing between feeds
what else reduces milk production
the pressure of the milk in the breast stretches the cells and means that it is harder for prolactin to attach
when should a newborn baby wear a hat
only if there are problems thermo regulating
the head should be exposed - the mother smells it, skin to skin contact supporting early bonding
what are the benefits of skin to skin contact
triggers lactation regulates temperature, HR and breathing helps form microbiome stimulates feeding reduces stress
What are the risks to mother and baby of NOT breast feeding?
Babies:
- gastroenteritis
- respiratory infections
- allergies
- obesity
- type 1 and 2 diabetes
- Sudden infant death syndrome
- Necrotising enterocolitis
Mother:
- breast cancer
- ovarian cancer
- hip fractures
- heart disease
When using formula, when should the baby switch to cows milk?
After 1 year
What hormone does lactogenesis 3 rely on?
Less reliant on prolactin like lactogenesis 2.
Feedback inhibitor of lactation (FIL).
When the breasts are full = high FIL, slows milk production.
Opposite when breasts are empty.
Which hormones cause development of the ductal and alveolar system in pregnancy?
- oestrogen
- progesterone
- human placental lactogen
What is prolactin responsible for?
milk production
What are the main features of prolactin?
- higher levels at night
- respond to touch and stimulation
When do prolactin levels return to normal if mother is not breast feeding?
7 days post partum
What is oxytocin responsible for?
milk delivery - acts on the muscle cells in a pulsatile action.
Which hormone can delay the delivery of milk by competing with oxytocin?
Cortisol
In stressful situations, it takes longer for the milk to be delivered.
(Adrenaline also causes tightening of the muscles so they’re not relaxed)
What does cortisol do?
Affects milk delivery BUT DOES NOT affect milk production.
What are the ‘mothering hormones’?
oxytocin and prolactin - allows the mother to fall in love and want to protect her baby.
what is feedback inhibitor of lactation?
A whey protein found in the mothers milk.
Where are oxytocin receptors found?
lots in:
- mammary gland
- uterus
Also in:
- stomach
- brain
- kidneys
- blood vessels
- heart
Which hormone does oxytocin help to reduce?
Cortisol
this lowers blood pressure and boosts the immune system.
Why does colostrum not have much water?
Babies are born with increased interstitial fluid that the kidneys needs to remove, if there was excess water the kidneys couldn’t keep up.
Why does the colostrum act as a laxative?
To clear the meconium (First stool)
