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B5 > Breast Feeding > Flashcards

Breast Feeding Flashcards

1
Q

What’s Mamogenesis? What triggers it?

A

Growth of mammary gland

Begins when mammary gland is exposed to oestrogen at puberty -> completed at third trimester of pregnancy

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2
Q

What changes occur during mamogenesis?

A

Ductal, alveolar and myoepithelial cells all undergo hyperplasia for lactation

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3
Q

Why isn’t milk produced during pregnancy?

A

High plasma concentrations of oestrogen and progesterone present before delivery inhibit active secretory of prolactin on mammary alveolar epithelium

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4
Q

When does Colostrum appear?

A

In second trimester in acinar glands

By third trimester alveoli contain significant amounts

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5
Q

When is prolactin able to cause colostrum secretion?

A

Post delivery

Inhibitory influence of oestrogen and progesterone removed = prolactin able to stimulate alveolar epithelial cells to being active secretion of colostrum

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6
Q

What does colostrum contain/look like?

A

Yellow viscous fluid - the first milk

Carbohydrates
Protein
Antibodies
Interferon
Immunologically active lymphocytes and monocytes

Low in fat

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7
Q

What does interferon in colostrum facilitate?

A

Facilitates removal of intestinal meconium
Factor for stimulation of lactobacillus bifidus in intestinal tract

= basically prepares GI tract

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8
Q

When is secretory acinar epithelium completely matured?

A

By 4-5 days postpartum = lactogenesis

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9
Q

What hormone stimulates sensory receptors in the nipple to active nerve impulse? How does this work?

A

Prolactin

Nerve impulses to endocrine neurones -> decrease in prolactin inhibiting factor -> lactotrophs released to permit synthesis and release of prolactin

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10
Q

Outline the let down reflex

A

Oxytocin released after sucking on nipple stimulates sensory fibres

Oxytocin becomes conditioned response requiring only visual stimulation or conscious thought

Myoepithelial cells contract to release milk into lactiferous ducts and sinuses

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11
Q

What does the volume of transitional milk change to by the end of the second post partum week?

A

100 - 500ml

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12
Q

What’s beneficial for a breast feeding diet?

A

Increases in protein, carbohydrate, lipid, minerals and calories must be maintained

Low casein content - easily digested by baby stomach

Recommend first stage milk -> second stage milks sit in stomach for longer (these are formula milks)

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13
Q

What’s galactopoiesis and its most important factor?

A

Maintenance of milk production - regular and frequent milk removal from the mammary gland

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14
Q

What are the 3 important mechanisms to enable breast feeding?

A

Regular sucking - promotes synthesis and release of both prolactin and oxytocin

Regular emptying

Demand feeding - amount of milk produced daily is related to the demand of the baby

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15
Q

Why does the breast need to be emptied regularly?

A

Breast has a capacity to store milk for a maximum of 48 hours before there’s a substantial decrease in milk production (if milk left in there)

Left unemptied glandular epithelium is less stimulated by prolactin

Vascular stasis caused by increased intramammary pressure

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16
Q

What’s the nipple to nose position?

A

Nose level to nipple - latching position

Baby should open mouth really wide with tongue down and tilt head back -> to breast with chin first

17
Q

What’s ankyloglossia?

A

Tongue tie - seen in neonatal examination, decrease mobility of tongue by short thick frenulum

Can affect feeding

18
Q

What are the advantages for the baby with breast feeding?

A 
Lower risk of GI, Resp, Ear and UTIs
Lower risk of allergic disease (eczema, asthma etc)
Lower risk of insulin dependent DM
Obesity
Sudden infant death syndrome
Childhood leukaemia
Improved neurological development
19
Q

What’re the advantages for mother with breastfeeding?

A 
Increased skin to skin contact with baby
Promotion of bonding
Involution of uterus
Lower risk of breast and ovarian cancer
Lower risk of hip fractures
Prevention of rheumatoid arthritis
20
Q

What’s uterine involution?

A

The return of the gravid uterus to its original size and shape (but never its nulliparous state)

21
Q

When do you monitor uterine involution?

A

Only in high risk pregnancies (maybe lochia discharge is indicating part of placenta still inside)

22
Q

What suppresses lactation?

A

Stop in sucking
Fall in prolactin
Breast binding (wear a supportive bra)
Pharmacological methods (eg in stillbirth)

23
Q

What’s breast involution?

A

Decrease in size of alveolar lobular ductal units
Stimulated by reduced frequency of sucking = increases amount of milk retained in breast = vascular stasis = alveolar atrophy

24
Q

What’s the difference between breast involution and the decrease in size during the menopause?

A

Involution decrease in size of alveolar-lobular-ductal units

Menopause is reduction in quantitative loss

25
Q

How many months after cessation of lactation have the breasts fully regressed?

A

By 3 months

Breasts retain some of increased fatty tissue, so will remain slightly larger than pre-pregnancy size

26
Q

Who shouldn’t breast feed?

A

Women misusing alcohol
Drugs: Methotrexate, Lithium
Active TB
Infants with galactosemia/phenylketonuria

27
Q

When do you start weaning foods?

A

6 months

28
Q

How long does a baby’s iron store last for?

A

6 months (if full term baby)

Premature baby’s may not have much iron store as in the last month of pregnancy is when iron is stored in fat

29
Q

How many toddlers are anaemic?

A

35% among minority ethnic children and white children

30
Q

When would you pick up coeliac disease in an infant?

A

When you’re introducing weaning foods - fatty stools present in nappy

31
Q

What are some common food allergies?

A

Egg, milk, soy, tree nuts, wheat

32
Q

Which food allergy are children most likely to grow out of?

A

Tree nuts

33
Q

What’s the prevalence of vitamin D deficiency in young children?

A

12%

40% below optimal threshold

34
Q

What % of toddlers consume sugar-sweetened beverages? What’s the major problem?

A

70% - dental caries

35
Q

Which guideline aims to prevent obesity and promoting physical activity - how many minutes/day

A

UK Physical activity guideline 2011

Early years (children under 5) physically active for 180 minutes spread throughout the day

36
Q

What’s the mechanism of breastfeeding as a contraceptive?

A

Regular feeding stimulates production and release of Prolactin from anterior pituitary
Prolactin has negative feedback (inhibitory) effect on the release of GnRH and FSH from the pituitary to suppress ovulation
(Only reliable for first 6 months and regularly, exclusively breastfeeding)

B5 (20 decks)

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