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General Information- breastfeeding > Core Curriculum - 3rd Edition > Flashcards

Core Curriculum - 3rd Edition Flashcards

1
Q

Describe lactocytes

A

Specialized epithelial cells that absorb nutrients, immunoglobulin and hormones from mother blood stream to compose milk

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2
Q

Where are prolactin receptor sites and what do they to

A

They are in the lactocytes and allow prolactin to be absorbed from the blood Baseline prolactin doubles during a nursing session from infant suck

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3
Q

What is the role of estrogen and progesterone in the pregnant breast.

A

Estrogen stimulates growth of the ducts

progesterone causes glandular tissue to expand

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4
Q

Where does excess lymph fluid drain?

A

To the axillary lymph nodes

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5
Q

Trauma to what nerve might result in some loss of sensation in the breast. Where is it located

A

the 4th intercostal nerve 4 oclock L breast and 8 o’clock R breast

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6
Q

Breast asymmetry is not uncommon. Which breast is often smaller?

A

Right often smaller.

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7
Q

Accessory nipples may be associated with ———–

A

renal or other organ anomalies.

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8
Q

What is Polands Syndrome

A

unilateral hypoplasia with hypoplasia of the thorax and pectoral muscles.

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9
Q

Cranial Nerves for Suck and swallow

A

V trigeminal -mastication
Vll- Facial——expression and taste
1X –Glossopharyngeal——taste, pharynx sensation swallow
X - Vagus– larynx and pharynx-
XII - Hypoglossal - innervates tongue muscle

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10
Q

muscles for swallowing

A

sternohyoid- depresses hyoid and larynx
omohyoid - dpresses the hyoid
sterno thyroid depresses thyroid cartilage
thyrohyoid raises and changes the form of the larynx

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11
Q

What is the function of the soft palate during swallowing

A

It elevates during swallowing contacting the pharyngeal walls and closing off the nasal cavity directing the bolus towards the hypo pharynx

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12
Q

What is the typical lenths of the hard palate

A

Approx 1 inch from the alveolar ridge to where the soft palate folds

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13
Q

What causes a channel palate

A

this is a midline groove from prolonged presence of orotracheal tubes.

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14
Q

Describe Epstien pearls and where are they commonly located.

A

acumulation of epithelial cells (retention cysts) at the juncture of the hard and soft palate

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15
Q

Where is the gag reflex elicited in a newborn

A

At the midtongue area

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16
Q

Prenatal breast changes hormonally affected by

A

Human Placental Lactogen
Prolactin
Human chorionic gonadotropin
all of the above accelerate growth

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17
Q

What is the funtion of Glucocorticoid during pregancy

A

Enhance the formation of the lobules

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18
Q

Purpose of estrogen

A

stimulates ductal sprouting

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19
Q

purpose of prgesteron

A

stimulates the lobuloalveolar growth and supressors secretory activity

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20
Q

What gland secretes prolactin inhibiting factor

A

Hypothalmus - negatively controls controls prolactins effects

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21
Q

When does lactogenesis 1 begin

A

16 weeks prenatally

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22
Q

Colostrum - antepartum shows presence of

A

lactose, casein and alpha lactalbumin

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23
Q

Colostrum after delivery increases

A

SIgA and lactoferrin

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24
Q

lactogenesis 11 - onset of copius milk production occurs

A

30-72 hours post delivery of the placenta when there is a decrease in levels of estrogen , progesterone and HUMAN PLacental Lactogen

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25
What percentage does prolactin levels fall in the first week postpartum
50 %
26
What activity causes the release of prolactin
direct stimulation of the nipple areola in a neurohormonal feedback a pathway
27
Another name for lactogenesis 111 is
galactopoesis occurs later then 9 days after birth to the beginning of involution and is the maintenance phase dependent on local autocrine control
28
Describe prolactin uptake and the full breast.
As milk accumulates in the breast the shape of the lactocyte is distorted and the prolactin cannot bind to its receptor creating an inhibitory effect on level of milk production
29
Fat type and content are influenced by several factors
``` maternal metabolism Maternal weight Maternal diet Gestation age of infant Duration of breastfeeding. ```
30
Complete breast involution varies but typically complete-----
40 days after complete cessation of breastfeeding.
31
where does milk synthese occur? AND | What are the 5 pathways involved in milk syntheses
Milk synthesis occurs in the lactocyte ( secretory epithelial cell) 1. protein secretion (casein,lactoferrin, alpha-lactalbumin and lysozyme 2.Lactose secretion 3 milk fat syntheses 4.Monovlent ion secretion (Na, K, and Cl) 5. Plasma protein secretion (IgA)
32
describe the two phase suck cycle
1. first half of suck cycle----.tongue down in piston like fashion, expanding the nipple, increasing nipple duct diameter, moving nipple to HSPJ an increasing Vacuum 2second half- the tongue raised tip first and milk bolus is cleared from oral cavity under the SP.vacuum reduces and the nipple is compressed
33
true or false lactogenesis may be delayed in a mother with type 1 diabetes
true ( hartman) birth has some effect on insulin since there is no fetus making demands internally
34
what is the 5 of carbs, protein and fats recommended for a lactating woman
carbs 50% Protien 12-15% fats 20-30% ( unsaturated non trans)
35
what is the calorie cost of 1 Liter (33 oz) of breastmilk a day
about 940 calories ( most women produce 750mls (25oz)a day)
36
Micronutrients in breastmilk that are affected by low maternal status
b6, b12, vitamins d and a and selenium, thiamin and riboflavin
37
nutrients in breastmilk NOT affected by mothers status
``` folate (FIZ CC) Iron zinc calcium copper ```
38
true or false a diet mostly of whole grains can be deficient in ca due to calcium binding
true ( important for other countries)
39
calcium supplement recommended for dairy intolerant mom.
calcium citrate ( 600 mg) NOt calcium carbonate - poorly absorbe do NOT take with IRON.
40
Many Babies will tolerate caffeine in their mothers diet if it is less then___________
300 mg per day ( babies usually get 1.55 per hale. | coffee has 2=80-100mg per 8 oz cup.
41
average milk intake for infant 7-12 mos
600 mls plus complimentary foods.
42
after 6 mos children may be low in both IRon and zinc . name some food sources
iron - meant, bread, nuts, legumes, watermelon | zinc-neatm chicken, fortified cereal, oatmeal some legumes an nuts
43
B12 deficiency in breastfed children of vegan moms can develop at 4-8 mos
failure to thrive,developmental delay, weakness, muscle atropy, loss of developemntal milestones. for mom a supplement and fortified cereal, nutritonal yeast and fortified meat substitutes
44
vitamin d deficiency associated with
cancer, autoimmune disease and cardiovascular disease
45
vitamin d found in________and foods_________
sun, flesh of fatty fish and some fish liver oils.
46
what is DHA
a ply unsaturated long chain omega 3 fatty acid that is essetnaila for brain development and visual acuity. Level s in human milk are based on maternal diet. DHA foods - egg yok, chicken and oily fish.
47
at what age can most children eat finger foods that they can feed themselves.
8 mos ( core curriculum)
48
delaying lumpy foods past 10mos can result in________
feeding difficulties
49
what has been found to reduce the risk of celiac disease in children
introducing small amts of gluten food ( wheat , barley, rye) before 7 mos and while the child is still breastfeeding.
50
what is mammogenesis
the development of duct structure from the woman's birth through her first pregnancy
51
what is lactogenesis 2
the onset of copious milk secretion and is triggered with the delivery of the placenta which withdraws progesterone and then polactin is unopposed.
52
what is lactogenesis 3
galactopoesis - the ongoing maintenacne of milk secretion
53
what are the 3 components of fIL
retained peptides ( proteins) , fatty acid accumulation slows fat synthesis, and prolactin in milk downregulates prolacin receptors on the lactocytes
54
describe components of milk express in the second year of lactation.
increased fat and energy serotonin and lysozyme INCREASE over time. zinc decreases over time
55
at what gestation week does colosturm secretion begin
16 weeks
56
what is the ;primary function of colostrum
Protective coats the gut to prevent adherence of pathogens and promotes gut closure
57
at what day does a newborn have a stomach capacity of 57 mls
day 5
58
what is the total protein in mature milk
0.8-1% lowest of all mammal
59
Name whey Proteins available for digestion and perfrom specific function
1.alpha lactalbumin- regulates milk syntheses ( mucin is part of this and binds pathogens and kills cancer cells) 2. LACTOFERRIN- iron transport and absorption, competes with bacteria to bind iron 3SIgA - most important as it coats mucosa surfaces 4.enzymes - lipase digest fats, lysozyme attacks pathogen cell walls stimulates neonatal development 5.HOrmones - prostaglandins - antiinflammatory Oytocin thyroid 6. non protein nitrogen compounds- nucleotides, creatinine, glucosamine
60
what carbohydrate supplies 40 5 of babys energy needs
lactose ( galactose and glucose) | colostrum is 4% lactose on day one and then rapidly increases!
61
how does lactose influence milk volume
the rise in lactose secreted in the cell draws water by osmosis .
62
what is the least variable carbohydrate in milk -- the most consistent
Lactose -- also the primary carbohydrate
63
List 3 functions of oligosaccharides
1.stimulate lactobacillus bifidus 2.block pathogens from attaching to gut 3. protect against enterotoxins in the gut as Oligosaccharides bind to bacteria
64
what is the bifidus factor
a combo of several oligosaccharides producing an acid detrimental to bacteral growth. also thought to be responsible for aromatic stool odor.
65
How many calories provided by fats?
50 % - most variable compound in human milk
66
what is the ratio of saturated to unsaturated fats
42%saturated and 57% unsaturated - numbers stable
67
how much sunlight do infant require
2 hours per week fully clothes
68
name fat soluble vitamins
a d e k
69
water soluble vitamins are determined by moms diet
vit b , c thiamin riboflavin niacin folate
70
cells found in milk
``` 1. Macrophages-- contain IgA 2 Leukocytes 3.lymphocytes t and b cells 4.epithelial cells 5.Neutrophil granulocytes 6. multipotent stem cells ```
71
when are sodium levels highest in breastmilk
pregnancy, involution and mastitis
72
what component of breastmilk aids in iron absorbtion
Lactose (higher in breast milk then formula)
73
what is the milk constituent that is protective again NEC
LACTOFERRIN ( also helpful for other inflammatory conditions )
74
the most important immunoglobulin
SIgA- prevents inflammation and viruses
75
how can a newborn infant be protected from HIV
1. Not breastfeed | 2. breastfeed with arv's
76
What is an immature suck pattern
3-5 suck bursts followed by a pause of equal duration - and often detaching from the breast
77
what is a transitional suck patter
6-10 suck bursts, pause of equal duration with occasional detaching and if a longer burst may have apneic espisode
78
Mature suck pattern?
10-30 suck bursts , brief pauses and a 1:1 suck swallow ratio
79
what is disorganized sucking
Lack of rhythm of the total sucking activity
80
what is dysfunctional sucking
the interruption of the feeding process by abnormal movement of the tongue and jaw
81
describe NNS characteristics
1. Observed at 18 weeks gestation 2. 2 sucks per second 3. weak , uncoordinated flutter sucking 4. absence of swallow.
82
How soon should a mother of a premature infant begin milk expression
within 6 hours of birth.
83
Mothers of premature infants should express milk 8-12 x in 24 hours for the first 7-10 days. what should her milk production be at the 7-10 day timeframe
800-1000 mls
84
How much oversupply is considered a "good cushion"
50% more then the infant requires
85
How long can breastmilk be stored in the refrigerator if feeing a premie.
24-48 hours
86
define a late pre term infant by weeks
born at 34 weeks -36 weeks 6/7 days
87
if a mother is nursing and pregnant again, when does her mature milk revert to colostrum
about 4-5 mos of pregnancy
88
Normal intake of a 1 day old
30mls per day ( can be up to 100mls)
89
average intake on day 7
300-450 mls per day (10 -15 oz)
90
average intake at the breast 1 mos and beyone
60-120 mls per feed
91
average in take per feeding in the first 24 hours
2-10 mls
92
average intake in 24-48 hours
5-15mls per feed
93
averate intake 48-72 hours
15-30 mls per feed
94
Average intake at 72 -96 hours ( 4 days)
30-60 mls per feed
95
what nerve is compressed in carpal tunnel syndrome
the median nerve - causing weakness , buring tingeling radiating to forearm and shoulder joint.
96
how to diagnose de quervains tendonitis ( pain and inflamation where two tendons run through a very tight channel on the thumb side of the writst
1. tenderness when pressure applied to thumb side of wrist 2. Positive finkelstein test . bend fingers over thumb in a fist then bend wrist toward little finger. Positive if pain on the thumb side of the writst
97
treatment for carpal tunnel-
ibuprofen, wrist and forearm splint, rest for 2 weeks, . PT exercises and ultrasound.
98
damage to neck vertebrae at ___ to _____ affect all four limbs
c1-c7
99
If a person has high paraplegia and affected trunk control , which vertebrae are likely damamged
T1-T12
100
If a mother has SCI, reduced milk may occur if injury is at
T-4 ( perhpas decreased sensation to nipple)
101
a woman will likely not have low milk production if the sci is below?
T6
102
If a woman has RA and is treatedd with methotrexate, how long should she pump and dump
4 days per hale.
103
average milk output at pospartum day 6/7 is predictive ,of mikl output at _________
6 weeks
104
milk production less then ______mls by PPday 14 is a marker for long term low milk supply
500mls (16 1/2 oz)
105
what percentage of available milk is released during the first milk ejection
45% ( may not be longer then 5 minute period. Mom can pump again in 15 mins to elicit another letdown (ramsey,2006)

General Information- breastfeeding (10 decks)

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