Chapter 6: Nutrition During Lactation

Question 1

Mammary Gland

Answer 1

The source of milk for offspring, also commonly called the breast. The presence of mammary glands is a characteristic of mammals.

Question 2

Alveoli

Answer 2

A rounded or oblong-shaped cavity present in the breast.

Question 3

Secretory Cells

Answer 3

Cells in the acinus (milk gland) that are responsible for secreting milk components into the duct.

Question 4

Myoepithelial Cells

Answer 4

Specialized cells that line the alveoli and that can contract to cause milk to be secreted into the duct.

Question 5

Oxytocin

Answer 5

A hormone produced during letdown that causes milk to be ejected into the ducts. Increases during infant suckling, baby crying, and thinking about infant.

Question 6

Lobes

Answer 6

Rounded structures of the mammary gland.

Question 7

Lactogenesis

Answer 7

Another term for human milk production.

Question 8

Colostrum

Answer 8

The milk produced in the first 2-3 days after the baby is born. Colostrum is higher in protein and lower in lactose than milk produced after a milk supply is established.

Question 9

Macrophages

Answer 9

A white blood cell that acts mainly through phagocytosis.

Question 10

Neutrophils

Answer 10

Class of white blood cells that are involved in the protection against infection.

Question 11

T-Lymphocyte

Answer 11

A white blood cell that is active in fighting infection. These cells coordinate the immune system by secreting hormones that act on other cells.

Question 12

B-Lymphocyte

Answer 12

White blood cells that are responsible for producing immunoglobulins.

Question 13

Epithelial Cells

Answer 13

Cells that line the surface of the body.

Question 14

Secretory Immunoglobin A

Answer 14

A protein found in secretions that protect the body’s mucosal surfaces from infections. The mode of action may be by reducing the binding of a microorganism with cells lining the digestive tract. It is present in human colostrum but not transferred across the placenta.

Question 15

Morbidity

Answer 15

The rate of illnesses in a population.

Question 16

Mortality

Answer 16

Rate of death.

Question 17

Doula

Answer 17

An individual who surrounds, interacts with, and aids the mother at any time within the period that includes pregnancy, birth, and lactation; may be a relative, friends, or neighbor and is usually but not necessarily female. One who gives psychological encouragement and physical assistance to a new mother.

Question 18

Lactation Consultant

Answer 18

Health care professional whose scope of practice is focused on providing education and management to prevent and solve breastfeeding problems and to encourage a social environment that effectively supports the breastfeeding mother– infant dyad.

Question 19

Letdown Reflex

Answer 19

Stimulates milk release from the breast. The stimuli from the infant suckling are passed through nerves to the hypothalamus, which responds by promoting oxytocin release from the posterior pituitary gland. The oxytocin causes contraction of the myoepithelial cells surrounding the secretory cells. As a result, milk is released through the ducts, making it available to the infant. Other stimuli, such as hearing a baby cry, sexual arousal, and thinking about nursing, can also cause letdown, and milk will leak from the breasts.

Question 20

Sore Nipples

Answer 20

Can be common in first 1-2 weeks of nursing. Women should seek help to rule out improper latch or positioning, infection, and infant suck problem.

Question 21

Treatment for Sore Nipples

Answer 21

Allow breasts to air dry after nursing
Special ointments (Lansinoh)
Warm compresses

Question 22

Hyperactive Letdown

Answer 22

Excessive milk secretion at the beginning of a feeding. Express some HM first, then allow baby to eat.

Question 23

Hyperlactation

Answer 23

Production exceeds infant demand. Cabbage leaves or cold compresses can provide comfort for the mom and reduce supply. Try feeding on one side only.

Question 24

Engorgement

Answer 24

Breasts contain too much milk, which could result in pain/discomfort for the mom and difficulty latching on for the infant.

Question 25

Engorgement Prevention

Answer 25

Feed the baby frequently
Avoid unnecessary mom-infant separation
Warm shower/compresses before feedings
Acceptable pain meds/cold packs/cabbage leaves between feedings
Express HM first as needed

Question 26

Plugged Duct

Answer 26

Area of blocked milk flow in the breast. Main symptom is a lump on the breast. To treat massage the area when the baby nurses, change breastfeeding positions, or lecithin. If left untreated it may lead to mastitis.

Question 27

Mastitis

Answer 27

Breast inflammation with or without infection. Often presents as the flu with a red breast lump.

Question 28

Mastitis Management

Answer 28

Continue feeding the baby frequently
Rest for the mother
See a doctor if symptoms do not resolve in a day
Antibiotics for infection
Can try engorgement relief techniques
Don't wear tight bras/shirts

Question 29

ETOH and Breastfeeding

Answer 29

ETOH crosses quickly into HM so that HM levels match the maternal BAC. It can suppress lactation and reduce an infant’s sleep and psychomotor development. General guideline is to limit drinking to two or less drinks daily or occasionally.

Question 30

Nicotine and Breastfeeding

Answer 30

It is best not to smoke and breastfeed, but it’s better to breastfeed and smoke than to not breastfeed at all.

Question 31

Caffeine and Breastfeeding

Answer 31

<25 oz coffee is often tolerated by the baby. Monitor infant for sensitivity.

Question 32

Hyperbilirubinemia Treatment

Answer 32

Monitor baby for stool output
Breastfeed early and often, no HMS
Phototherapy
Exchange transfusion
Trial withdrawal of breastmilk only in severe or persistent jaundice cases
Careful monitoring of infant while in-house professional evaluation after d/c

Question 33

Breastfeeding with Multiples

Answer 33

Nutritional needs of multiples can be met with breastmilk alone. Barriers to lactation:
These infants are often born premature, SGA, or LBW making initiating breastfeeding a challenge
Time and fatigue
Lack of family support

Question 34

HIV or HTLV

Answer 34

HIV status is a contraindication to breastfeeding. HTLV is the sexually transmitted virus that causes T-cell lymphoma/leukemia in adults.

Question 35

Active TB

Answer 35

No breastfeeding until treatment is provided.

Question 36

Baby with PKU

Answer 36

Ok to breastfeed, but phenylalanine levels must be monitored; supplemental phenylalanine-free formula may be needed.

Question 37

Galactosemia

Answer 37

An absolute breastfeeding contraindication.