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FN 123 > FN 124 - Lactation > Flashcards

FN 124 - Lactation Flashcards

1
Q

makes the milk-secreting cells contract

A

oxytocin

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2
Q

“Bonding” hormone – strengthens the mother-child bond
from early on

A

oxytocin

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3
Q

makes them secrete milk

A

Prolactin

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4
Q

surrounded by fat tissue

A

Alveolar tissue

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4
Q

(Interplay of hormones) Diabetogenic or causes increase of
blood glucose levels in mother

A

Prolactin and hPL

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5
Q

Mark on which infants are signaled to latch

A

Areola

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5
Q

Fat is stored because of ______

A

estrogen

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6
Q

Releases a sort of oil/lubricant to improve flow of milk in baby

A

Montgomery’s glands

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7
Q

A physiologic process done by females

A

lactation

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8
Q

What happens during the 1st trimester?

A

Small ducts from the mammary ducts proliferate to create maximum number of surface cells for alveolar cell formation

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8
Q

Human lactation determined by:

A

o The anatomic structure of the mammary tissues and development of milk

o Initiation and maintenance of milk secretion

o Ejection of milk from the alveoli to the nipple

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9
Q

Lobules gradually appear becoming distinct ____________

A

12-18 months after 1st menstrual period

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9
Q

As the ovulation pattern becomes usual, the regular development of ____________________ in the ovaries promotes further development

A

progesterone-producing corpora lutea

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10
Q

What happens during the 3rd trimester?

A

Milk-producing cells dilate as final preparation step for lactation

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11
Q

What happens during the 2nd trimester?

A

Reduplicated small ductules group together to form large lobules

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12
Q

Additional proliferation of the lining cells takes place shortly ______________

A

before delivery or parturition

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13
Q

produced by the anterior pituitary gland that stimulates and maintains lactation in postpartum mammals

A

prolactin

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13
Q

The proliferation is in response to the increasing levels of the hormone __________

A

prolactin

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14
Q

2-3 days postpartum, secretion of small amount of
__________

A

colostrum

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15
Q

first 2-3 weeks is the period of _____________

A

lactation initiation

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15
Q

two stages of lactation

A

o Milk Secretion; and
o Milk ejection whereby the milk passes along the duct
system

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16
Q

Secretion involves the ____________ and _____________

A

milk production and passage of the
formed milk into the ducts

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17
Q

Recite the process of milk secretion

A

Flowchart A

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17
Q

Recite the process of let-down reflex

A

Flowchart B.1

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18
Q

The secretory process activated by the _______________

A

sucking stimulus of the
infant

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19
Q

Recite the process of let-down reflex

A

Flowchart B.2

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20
Q

Suckling infant -> ___________________

A

Stimulus to increase in milk production

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21
Q

FACTORS THAT AFFECT “LET-DOWN” REFLEX

A

Psychologic influences such as embarrassment or stress but easily set-off by the thought of the baby or sound of his/her cry

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22
Q

The composition varies from ?

A

human to human, period of lactation, during the day, stage of lactation, timing of withdrawal, individual differences (diet, age, parity, health, and social class)

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23
Q

Composition of Human Milk

A

o High CHON, Sodium, Vitamin A
o Low CHO, fat
o Calcium and phosphorus necessary in milk secretion

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23
Q

Signs of Successful “let-down” reflex

A

o Milk dripping from the breast even before baby starts
nursing
o Milk dripping from the breast opposite the one being
nursed
o Contractions of the uterus during breastfeeding which may
cause pain or discomfort
o Tingling sensation in the breast

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23
Q

Human milk consists of a solution of ?

A

protein, sugar, and salts in which a variety of fatty compounds are suspended

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24
Q

Nutrient content of mature milk that varies from mother to mother

A

fats, Vit A, D, E, K, B1, B2, B3, C

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25
Q

Mean milk volume

A

between 600-900 ml/day

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26
Q

Opaque, yellow fluid secreted in the 1st few days after delivery

A

Colostrum

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26
Q

Volume varies depending on the parity, usual amount 2-10ml for
the 1st 10 days

A

Colostrum

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27
Q

Nutrient content of colostrum

A

o Higher carotene, protein, ash, sodium, potassium, and chloride

o Less sugar, fat, and kcal that future milk produced

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28
Q

Content of colostrum only found in human milk

A

Considerable high levels of antibodies (IgA)

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29
Q

Type of milk between the 3rd and 6th day, at which the CHON content is still rather high

A
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30
Q

when does the CHON content falls but lactose and fat rise progressively

A

end of 1st month

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30
Q

when transitional milk —> mature milk

A

End of the 1st month

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31
Q

Why do we not boil milk?

A

Because casein complexes with pyridoxine, making it less bioavailable for the body

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32
Q

types of protein found in milk

A

casein and whey

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32
Q

phosphorus-containing proteins that occur only in
milk

A

casein

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33
Q

thin liquid milk remaining after the curd (casein) and cream have been removed

A

Whey protein

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34
Q

contains lactoferrin and lactalbumin

A

Whey protein

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35
Q

Amount of protein in milk

A

0.8 to 0.9g CHON per 100 ml of milk

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36
Q

excess protein -> excess glucose then cause:

A

o Increased adipocytes (adipocity)

o Increased glycogen stores (after conversion of
amino acids)

o Eventually, may increase probability towards
kidney and liver problems

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36
Q

amino acid that humans cannot synthesize

A

taurine

37
Q

Excess protein leads to excess __________

A

glucose

38
Q

What amino acids are low in human milk?

A

Met, Phe, Tyrosine

39
Q

_____ of the fat is triglycerides with small amounts of phospholipids, cholesterol, mono- and diglycerides, glycolipids, sterol esters, and free fatty acids

A

~90%

39
Q

What amino acids are high in human milk?

A

Cystine and taurine

40
Q

Needed for bile acid conjugation and may also be a
neurotransmitter or neuromodulator in the retina

A

taurine

41
Q

composition of human milk that Vary according to individual, parity, sampling method, season of the year, health status of the mother, and maternal diet composition

A

lipids

42
Q

main CHO in human milk;

A

lactose

42
Q

Recite the omega-6 and omega-3 FAs

A

table

43
Q

Benefits of higher cholesterol level compared to milk

A

o Cholesterol – structural development (phospholipid bilayer)

o Myelin synthesis and development of enzymes needed for
cholesterol degradation

44
Q

stimulates the growth of microorganisms producing organic acids and synthesizing vitamin B complex

A

lactose

45
Q

exerts 60-70% of the total osmotic pressure of milk;

A

lactose

46
Q

not influenced by the maternal diet

A

lactose (CHO)

47
Q

The _______ created by lactose helps in the absorption of Ca, P, Mg, and other minerals

A

acidic milieu

48
Q

_______ promote the growth of lactobacilli, the dominant acid-producing bacteria in the gut

A

N2-containing sugars

48
Q

Enters human milk and can cause _____ poisoning
of the breastfed infant

A

Nicotine

49
Q

________ also present, an alternative pathway for digestion of glucose polymers when pancreatic amylase is low

A

Amylase

50
Q

trace amounts in human milk

A

Fe, Cu, and Mn

50
Q

major minerals in human milk

A

K, Ca, P, Cl, and Na

50
Q

their packaging that makes them more bioavailable

A

Mg, Ca, Fe, Zn

51
Q

Iron in human milk is ___ available compared to ___
available from cow’s milk

A

49% ; 10%

51
Q

________ more responsive to maternal dietary changes
than fat-soluble

A

Water-soluble

52
Q

Level of the vitamin ___ is substantially greater and
absorbed faster than that of cow’s milk

A

Vit E

53
Q

Recite the anti-infectious factors in human milk

A

Table (8)

53
Q

Only vitamin that cannot be found in sufficient amounts in human milk

A

Vit K

54
Q

Necessary that protein is adequate to ensure proper
absorption of vitamins

A

Proteolytic enzymes

55
Q

Too much ___ = increases bacterial growth that may cause
diseases

A

Fe

56
Q

Lactoferrin – ___ is a food source for bacteria

A

Fe

57
Q

Passes from the maternal blood to the breastmilk

A

Caffeine

58
Q

____ of caffeine passed on to the human milk may
accumulate over time

A

~1%

59
Q

______ of caffeine-containing beverage intake of a
mother may give an infant “coffee nerves”

A

6-8 cups

60
Q

may exhibit a __________ if human milk contains ethanol or delayed psychomotor development at 1 year old (Alcohol)

A

pseudo-Cushing’s syndrome

61
Q
  • Similar symptoms to PCOS, hence often misdiagnosed
  • Distinguishing factor
A

Pseudo-Cushing’s Syndrome

62
Q
  • ____ is transmitted through bodily fluids
  • Hence, although not confirmed by study,
    there’s a high chance of passing the virus onto the infant
A

HIV

63
Q

Energy during Prenatal Stage

During pregnancy, most women store _____ of body fat, which may be used for additional energy during lactation

A

~2-4kg

64
Q

Stored fat will provide ______ during lactation for 3 months but added energy must come from the diet

A

200-300 kcal/day

65
Q
  • Studies conclude that the energy needed for daily
    milk production is _____
  • The production efficiency of human milk is ______
A

~560 kcal; ~90%

66
Q

Along with a recommended energy increase, ______ increment in daily CHON intake is advised

A

15-20g

67
Q

Other foods advised

A
  • Citrus fruits
  • Vegetable oils
  • leafy green vegetables
67
Q

Foods allowed to meet increased kcal and CHON

A
  • 3-4 cups of milk//day
  • 2-3 cups of rice
68
Q

The extra CHON is believed to cover the requirement
for milk production with an allowance of ______ of CHON utilization

A

70% efficiency

68
Q

Nutrient profile of breastmilk changes as the months go by - _______

A

decreases

69
Q

Decreases after 6th month due to development
of teeth in infants, which means they can begin
complementary feeding

A

Milk volume

70
Q

Process of feeding baby human milk either directly
from the breast or in the expressed form

A

breastfeeding

70
Q

Exclusive breastfeeding should only be limited to ______ because breastmilk can no longer fully support infant’s health on its own

A

first 6 months

71
Q

Infant has been breastfed on at least one occasion

A

Ever breastfed

71
Q

Infant has only ever been fed with breast milk. No other liquids or solids have been introduced, with the exception of vitamin and mineral supplements

A

Exclusive breastfeeding

72
Q

Infant has mainly been breastfed but may have
consumed water, fruit juices, teas, or oral
rehydration fluids

A

Predominant breastfeeding

73
Q

Includes both exclusive and predominant breastfeeding behavior

A

Full breastfeeding

74
Q

Process of feeding baby liquid or semi-solid foods via
a bottle with a teat. Generally, this refers to feeding a
cow’s milk-derived substitute to human milk

A

Bottle-feeding

74
Q

Process through which an infant is nourished through a combination of breastfeeding and solid or semi- solid food

A

Mixed feeding

75
Q

The infant is nourished through a combination of
breastfeeding and solid or semi-solid foods

A

Complementary feeding

76
Q

Steps for proper latch on

A

Recite

77
Q

Steps for latching positions

A

Recite

78
Q
  • Diagnosed by pressing the areola between the thumb and forefinger
  • A flat or normal nipple will protrude, an inverted nipple will retract
A

Inverted Nipples

79
Q

RELIABLE SIGNS THAT A BABY IS NOT GETTING ENOUGH MILK

A
  • Poor weight gain - less than 500g
  • Small amount of concentrated urine - less than 6 times/day
80
Q
  • Accompanied by tenderness and redness of the areola
  • More common in women with fair skin
  • Treated immediately because it may lead to cracks and fissures
    and then infections may occur
A

Nipple Soreness

81
Q
  • Engorged breasts are hot, heavy, hard with milk
A

Breast engorgement

82
Q
  • Experienced during the first few weeks of breastfeeding * Caused by fullness of the breast
  • May occur during nursing on the opposite breast
  • Sometimes caused by psychologic conditioning
A

Milk leaking

83
Q

Manual expression of milk

A

Marmet technique

84
Q

Electrically-wired and battery operated, mimicks suckling action of child

A

Breast pump

85
Q

Freshly expressed milk is bacteriologically safe for __ hours under room temperature

A

6

86
Q

Freezing stores up to _ month, refrigeration is not enough

A

1

87
Q

The genetic disease _______ is a contraindication to breastfeeding

A

phenylketonuria (PKU)

88
Q

inborn error of metabolism where there is a decreased metabolism of the amino acid phenylalanine

A

PKU

89
Q

_____ can be transmitted through bodily fluids such as breast milk

A

AIDS

90
Q

Successful breastfeeding usually happens after the effect of anesthesia has worn

o Anesthesia → mom feels nothing, so suckling may not
trigger expression of milk

A

Caesarian birth

91
Q

____ and ____ are known separately to decrease milk output since ____ inhibits oxytocin release

A

Anxiety and stress; adrenalin

92
Q

_______ levels also effect let-down function

A

Cortisol

93
Q

The presence of ____________________ such as influenza is usually no reason to discontinue lactation.

A

colds or other milk viral infections

94
Q

Caused by incomplete emptying of one or more milk ducts – unequal drawing on all milk sinuses during feeding, causing stasis

A

Clogged milk ducts

95
Q

________ accumulate within a duct and form a blockage. Milk then builds up behind the plug. Tenderness may develop around the area and a lump may be felt

A

Milk or cast-off cells

96
Q

A mother with ______ may be advised to halt breastfeeding so that immediate treatment may be given to the mother

A

cancer

97
Q

Recite the diagnostic flowchart: Failure to thrive

A

Flowchart

FN 123 (10 decks)

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