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Lactation > Composition Of Human Milk > Flashcards

Composition Of Human Milk Flashcards

1
Q

Immunological component of milk

A
  • lymphocytes
  • macrophages
  • T cells +B cells
  • hematopoietic stem cells
  • immunoglobulins
  • lactoferrin
  • lysosomes
  • oligosaccarides
  • probiotic
  • cytokines
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2
Q

Factors that impact milk composition

A
  • gestation
  • stage of lactation
  • stage of feeding
  • frequency of infant demand for milk
  • degree of breast fullness
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3
Q

Colostrum

A
  • higher in protein and minerals
  • lower in carbs, lipids, vitamins
  • higher concentration of epidermal growth factor, TGF-B and colony stimulating factor
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4
Q

Gastric emptying time human milk vs. formula

A

Human milk = 48 minutes

Formula = 78 minutes

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5
Q

Caloric density?

Higher for males or females?

A

65-70kcal/dL, but wide variation, especially for pretermers
- changes over time to meet infants needs

25% higher for males

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6
Q

Average human milk yield

  1. First 24 hour
  2. by day 5
  3. By 6 months
  4. For multiparous women
A
  1. 37mL
  2. 500mL
  3. 800 mL
  4. Additional 140mL per day at one week
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7
Q

Normal infant weight gain

  1. up to 4 weeks post birth
  2. By end of first year
A
  1. 10g/kg/day (5-7 oz/week)

2. 1 g/kg/day (3oz/week)

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8
Q

Growth - formula vs. breastmilk

A
  1. No difference in length or head circumference
  2. Weight gain greater in breast milk for the first 3-4 months, especially SGA
  3. After 4 months, formula fed babies weigh more - likely overfed
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9
Q

Foods and medications that can change color of breast milk

A
  1. Food - carrots, sweet potatoes, beets, leafy greens
  2. Red/pink - Clofazimine, rifamycins, serratia marcerscens
  3. Green- procardia, propofol, blue green algae, iron supplements,
  4. Black - minocyline
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10
Q

Lactose

A

7/g/dL
Enahnces calcium absorption
Provides glucose to rapidly growing brain

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11
Q

Human Milk Oligosaccharides

A
  • Not digestible
  • Prebiotic- promote bacteria L. bifidus, B. Infantis
  • attach to epithelial cells of pathogens and help them be eliminated through stool rather than causing disease (norovius, e.coli, rotavirus, c. Jejeuni)
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12
Q

Lactoferrin

A
  1. A glycoprotein important in immune health
    2.higher levels in pre-term and early term milk
  2. Antibacterial, viral, and fungal action- prevents attachment to intestinal wall and takes aware iron from pathogens
  3. Reduces inflammatory response
  4. May help prevent iron deficiency
  5. Growth factor for B and T cells
    6.
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13
Q

Lysozyme

A
  1. Part of whey
  2. Destroys e.coli and salmonella with help of peroxide and ascorbate
  3. More abundant in human milk
  4. Increases progressively starting at 6 months after delivery
  5. Works with lactoferrin to kill gram positive bacteria, selectively kills bacteria (bidifus can tolerate lysozymes)
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14
Q

Immunoglobulin SIgA

A
  1. Produced by mother’s breast in respond to messages from gut and lungs
  2. Higher in mothers with babies with infections and in low income women
  3. Provides passive protection of entire GI tract
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15
Q

Lactoperoxidase

A
  1. Antimicrobial
  2. Anti-viral for herpes
  3. Kills streptococci
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16
Q

Cytokines

A
  1. Protein signals secreted by immune cells
  2. Responsible for swelling, tenderness, fever
  3. Chemokines signal to bring more phagocytes
  4. Growth and differentiation of mammary gland
17
Q

Epidermal growth factor

A
  1. Growth promoting cytokine

2. strengthens mucosal barrier to antigens

18
Q

Human milk growth factors (HMGF)

A
  1. 3 kinds

2. Influence growth of target tissues

19
Q

Thyroxine

A

May stimulate growth of infant intestine

Present in small amounts of breast milk
May mask symptoms of congenital hypothyroidism

20
Q

Leptin

A
  • regulates apetite, food intake, and energy metabolism

- may impact BMI

21
Q

Cholecystokinin

A
  • enhances digestion and sedation and well being

- peaks twice after suckling - immediately after feeding and the 30-60 minutes later

22
Q

Prostaglandins

A
  • group of lipids that affect every system

- PGE2 and PGF2a - protects body from inflammation and necrosis through accumulating phospholipids in the stomach

23
Q

Taurine

A

Brain maturation

24
Q

Vitamin D

A

May be insufficient in breast milk
Dependent on maternal levels
Breast fed infants recommended to have vitamin D supplementation

25
Q

Diseases prevented with breastmilk

A
  1. Celiac’s disease
  2. Diabetes
  3. MS
  4. SIDS
  5. Cancer
26
Q

Calcium

A
  • breast fed infants absorb twice as well as formula fed
  • hypocalcemia and tetany more common in formula fed infants
  • formula has high phosphorus which decreases absoprtion and increases excretion of calcium
27
Q

Iron

A
  • relatively low in breastmilk
  • iron stores laid down in utero prevent deficiency
  • high levels of lactose and vitamin c in human milk facilitate absorption
28
Q

Whey vs casein

A
  1. Whey is softer and easier to digest
  2. Whey is higher in early lactatiom
  3. Formula is high in casein, difficult to digest- requires extra energy to digest
29
Q

Pre-term milk

A

Nitrogen higher
Higher protein and fat
Lower levels lactose

30
Q

Fat

A
  • Provides half of milk’s calories
  • varies from one mother to another
  • ranges 22-62g/dL
  • Independent of breastfeeding frequency
  • higher during day and lower at night

Lactation (7 decks)

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