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HUEC 2112-Lifecycle > Human milk and decisions to breast feed- FINAL EXAM! > Flashcards

Human milk and decisions to breast feed- FINAL EXAM! Flashcards

1
Q 
Human Milk:
Basic content highly \_\_\_\_. 
Volume depends on \_\_\_\_. 
\_\_\_\_ first affects quantity
Composition affected by \_\_\_\_ \_\_\_\_. 
Type and amount of milk depends on \_\_\_ since \_\_\_. 
Mean volume \_\_\_ mls/d (Range 3-1000 ml)
A 
variable
demand
Malnutrition
severe malnutrition
time, birth
750
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2
Q 
Human Milk potential hazards:
\_\_\_\_\_reduces milk volume
Alcohol reduces infant’s \_\_\_ and \_\_\_\_ development
Only \_\_\_\_ approved drugs
\_\_\_ can be transmitted by milk
A

Smoking
intake, psychomotor
physician
HIV

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3
Q

Composition of Human Milk:
Solution of ___, ____ and ____ with suspended ___.
More than ___ recognized constituents

Composition varies, depending on:
Period of _____
___ of the day
___ __ of the infant

A 
protein, sugar and salts, fat
100
lactation
time
Gestational age
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4
Q 
Types on mammary secretions:
\_\_\_\_\_- Opaque fluid secreted for a few days after birth
\_\_\_\_\_ milk – day _-_
\_\_ \_\_\_ milk
\_\_\_ or \_\_\_\_ milk
A

Colostrum
Transitional 3-6
Pre term
Term or mature

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5
Q

Volume and Composition of Colostrum:

__-__ mls per feeding depending on ____ (the number of times a female has given birth)

A

2-10

parity

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6
Q 
Colostrum:
Compared to mature milk, it has:
More \_\_\_ – \_\_\_\_
Less \_\_\_\_
Less \_\_\_
Less \_\_\_\_ (kcals)
More \_\_, \_\_, \_\_\_
A 
protein, immunoglobulins
sugar
fat
energy
Na, K, Cl
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7
Q

Colostrum has more secretory ___ and ____.

A

IgA and lactoferrin

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8
Q

Composition of Transitional Milk:

____ levels fall
____ and ____ increase
Major changes completed by day ___

At one month:
____ firmly established
No significant changes in _____

A 
protein
lactose and fat
10
lactation
compostition
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9
Q

Composition of Pre-Term Milk: compared to term milk
Higher in __ and __ ___ _
Higher in __, ___, ___, ___, ___, and ____.
Higher in ____
Higher in ___, ___ and long chain ____
Lower in ____

A 
protein and non protein N
Ca, Na, K, Cl, P, Mg
 IgA
 fat, MCT and long chain PUFA
lactose
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10
Q

What happens if the baby is premature?

A

The breast milk composition changes

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11
Q

Premature and LBW infants should be on:

A

Pre term milk + a special supplement and Pre term commercial formula

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12
Q

Premature = < __ weeks

A

37

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13
Q

Low Birth Weight (LBW)=<____ g

A

2500

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14
Q

Very Low Birth Weight (VLBW)=<____ g

A

1500

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15
Q

Extremely Low Birth Weight (ELBW)=<____ g (cut off is 400 g which is less than 1 pound!)

A

1000

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16
Q

Micropremies = <___-___g

A

750-800

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17
Q

Premature:
Caloric needs based on kcal/kg are ___ in premature.
May not be able to breast feed but can be fed ___ ____.
May require __ or ____ (fewer kcals needed) feeding

A

higher
expressed milk
enteral or parenteral

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18
Q

Enteral is ___ because it supports ___ _____ maturation

A

better

gi tract

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19
Q

_____- delivering nutrients directly into the circulatory system: IV feeding

A

Parenteral

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20
Q

____- delivering food via tube: tube-feeding. “nil by mouth”: naso enteral

A

Enteral

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21
Q

Protein Composition of Mature Human Milk:
Approximately ___ %(cow’s milk >4%)
___ ____ synthesizes
(Casein, Lactalbumen, Lactoferrin)

The following are obtained from ___ ____:
Albumen, Immunoglobulins, Peptide hormones

About ___% Nitrogen is non protein N
_____ are present

A 
1%
Mammary gland
maternal blood
25
enzymes
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22
Q

Maternal diet has little influence on __ ____of milk.

A

protein content

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23
Q

Low maternal protein intake has ___ ___.
Chronic protein deficit will have an ___

__ __ ___ of breast milk is ideal for human infant

A

little effect
effect
Amino acid content

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24
Q 
Lipid Composition of Mature Human  Milk:
\_\_\_% triglycerides
Compared to cow’s milk, higher levels of:
\_\_\_\_
\_\_\_\_\_\_
\_\_\_\_\_
A

90%
Cholesterol
N-6 PUFA
N-3 PUFA

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25
Q

Maternal diet affects type of ___.

A

fat

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26
Q

Type of fat in maternal diet milk affects ___ ___.

A

lipid composition

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27
Q

Maternal ___ ____ affects milk lipid content

A

energy restriction

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28
Q

____ levels higher than cow’s milk

A

Carnitine

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29
Q

Lipases in breast milk aid ___ ____.

A

fat digestion

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30
Q

Carbohydrate in Mature Human Milk:
Lactose stimulates beneficial microorganisms in ___ ____

Lactose improves ___ ___
e.g. Calcium

Other ____ present in small amounts

A

infant gut
mineral absorption
sugars

31
Q

Maternal diet and carbohydrate:
Doesn’t influence _____
Lactose intolerant mothers have lactose in their ___.
Infants born to lactose intolerant mother’s are not ___ ____.

A

lactose
milk
lactose intolerant

32
Q

Minerals in Mature Human Milk:

It’s all about ______. This is why formula has to have higher ____ content.

A

bioavailability

mineral

33
Q

Cow’s milk higher in some ____.

A

macrominerals (Na, Ca, and P)

34
Q

Breast milk contains _____.
Zinc and iron and others
(aka: trace elements)
Micromineral content ____, but bioavailability is ____.

A

microminerals
low
high

35
Q

Iron:
___ bioavailable in breast milk than from cow’s milk
Breast fed infants require supplement at ___ months (AND)

A

more

5

36
Q

Calcium:
___ compared to cow’s milk
Level ____ by maternal diet
__ ___in mother if mother’s diet is inadequate
Her bone will be ____ after weaning
____ aid to maintain bone health in lactation

A 
low
unaffected
Bone loss 
renewed
Hormones
37
Q

Fat Soluble Vitamins are affected by ___ ___ and ____.

A

maternal intake and stores

38
Q 
Vitamin D:
Levels in breast milk \_\_\_
Milk content affected by:
\_\_\_\_\_ diet
Maternal \_\_\_ \_\_\_
A

low
maternal
sun exposure

39
Q 
Vitamin A:
Levels affected by \_\_\_ \_\_\_. 
Good sources for mother
\_\_\_\_
Fruits and vegetables high in \_\_\_ \_\_\_.
A

maternal diet
milk
beta carotene

40
Q

Vitamin E:
Breast milk Levels ____ than in cow’s milk
Vitamin E in formula now ____ breast milk

A

higher

matches

41
Q

Vitamin K:
Levels ___ compared to cow’s milk
Infant gut ____ so no synthesis by microbes
Most get an intramuscular ___ at birth

A

low
sterile
dose

42
Q

Water Soluble Vitamins:

Values increase with ___ ___ and ___.

A

maternal intake and plateau

43
Q

Water soluble Vitamins:
Vitamin B6
Levels in breast milk may be __ ___ to meet the AI for infants

A

too low

44
Q

Water soluble Vitamins:
Vitamin B12
Not significantly affected by __ ___.
Milk of strict ___ (___) )may be deficient

A

maternal diet

vegetarians (vegans

45
Q

Resistance Factors in breast milk:
Favor the growth of beneficial ____.
Antiviral activity Immune factors reduced with ___ ___.

_____transferred to infant

A

bacteria
maternal malnutrition
Antibodies

46
Q

Anti infectious Factors in Human Milk:
__ ___ – antagonist to pathogenic bacteria. Lactose and calcium are involved.

Secretory IgA, IgM, IgE, IgD, and IgG – ____.
____ ___ – specific for staph infection

A

Bifidus factor
same
Antistaphylococcus factor

47
Q

Anti infectious Factors in Human Milk:
____– a protein that binds iron and therefore inhibits bacterial growth (some bacteria need iron)

_____ – this enzyme kills streptococci and enteric bacteria.
_____– promotes phagocytosis of bacteria

A

Lactoferrin
Lactoperoxidase
Complement

48
Q

Anti infectious Factors in Human Milk:
_____ – inhibits viral replication
_____ – lyses bacteria
__ ___ ____ - B12 not available to bacteria

A

Interferon
Lysozyme
B12 binding protein

49
Q

Anti infectious Factors in Human Milk:

_____ - synthesize IgA
_____ – synthesize complement, lactoferrin, lysozyme, carry out phagocytosis and probably other things

A

Lymphocytes

Macrophages

50
Q

Human Milk:

It also contains “___” ____ to protect functional proteins from digestion

A

“anti” proteases

51
Q

___ ___ ___ (___) and ___ ___ protects the infant against a wide range of infectious and other diseases.

A

Human Breast Milk (HBM)

beast feeding

52
Q

Advantages of Breast Feeding:

___ ___ designed for ____ ___
____ normal for mammals
Breast feeding has advantages for ____ and ___.

A

Human milk
human infants
lactation
mother and infant

53
Q 
Advantages for the Infant:
Designed exclusively for \_\_\_\_. 
\_\_\_\_\_\_ superior 
\_\_\_\_\_ safe 
Provides \_\_\_\_
Stimulates \_\_\_\_ \_\_\_\_\_ system
Decreases risk of \_\_\_\_ \_\_\_\_
Prevents or reduces \_\_\_\_ of \_\_\_\_
Promotes proper \_\_\_ \_\_\_
Decreases risk of \_\_\_\_ \_\_\_\_
Promotes \_\_\_-\_\_\_attachment
A 
humans
nutritionally
bacteriologically
immunity
infant immune 
infectious diseases
risk allergy
facial development
childhood obesity
maternal-infant
54
Q

Advantages for the Mother:

Promotes recovery from _____.

  • Promotes uterine involution
  • Decreases bleeding
  • Increases period of anovulation (no ovulation…birth control, in a way)
Promotes attachment to the \_\_\_\_
Increases \_\_\_ \_\_\_\_
Allows for daily \_\_\_ \_\_\_\_
Eliminates work involved with \_\_\_ \_\_\_
Decreases risk of \_\_\_\_ and \_\_\_ \_\_\_\_
Promotes \_\_\_\_ \_\_\_\_
More \_\_\_\_
A 
pregnancy
infant
self esteem
rest periods
formula feeding
breast ovarian cancer
weight loss
economical
55
Q

The incidence of breast feeding was at an all time low in ____.

A

1970

56
Q 
Incidence varies by \_\_\_\_\_:
\_\_\_\_
\_\_\_\_ 
\_\_\_\_ level
\_\_\_\_ status
A 
mother
race 
income
educational
marital
57
Q

Incidence of breast feeding:

___ ___ are also a factor

A

Regional differences

58
Q

Incidence increasing due to changes in ___ ___ and ___.

A

medical opinion and attitude

59
Q

AAP (___ ___ of ____) actively recommends breast feeding

A

American Academy of Pediatrics

60
Q 
The decision to breast feed:
Usually made early in \_\_\_\_. 
Complex \_\_\_\_.  involved
Concerns of \_\_\_\_ should be addressed
Techniques that work include
Emphasizing benefits
Prenatal preparation
Education
Choosing a baby friendly hospital
A

pregnancy
factors
mother

61
Q 
Decision to breast feed:
Lactation should be supported by:
\_\_\_ \_\_\_ professionals
\_\_\_\_ \_\_\_, especially the father
\_\_\_\_ influences
A

Health care
Family members
Outside

62
Q 
Deciding to breastfeed:
Techniques that work include
Emphasizing \_\_\_\_
\_\_\_\_\_ preparation
\_\_\_\_
Choosing a \_\_\_ \_\_\_ hospital
A

benefits
Prenatal
education
baby friendly

63
Q 
Breast-Feeding in the Post-Partum Period:
Mother should be \_\_\_\_\_
Mother and infant taught \_\_\_\_
(Position for \_\_\_)
(Importance of \_\_\_ \_\_\_)
A

comfortable
correct
feeding
latching on

64
Q 
Breastfeeding in post partum period:
Breast feeding abandoned due to:
Lack of \_\_\_\_\_\_
\_\_\_ hospital stays
Outdated \_\_\_
Delays between \_\_\_\_ and\_\_\_\_
Time \_\_\_\_
\_\_\_ \_\_\_\_availability
A 
knowledge
Short 
 policies
 birth and initiation 
limitations
Commercial formula
65
Q

____ access to breast important

A

Frequent

66
Q

Frequent Feeding will build up ____ ___.

A

milk supply

67
Q

Feeding on schedule _____.

A

detrimental

68
Q

Newborns need to nurse ___-___times/day for adequate nutrition

A

10-12

69
Q 
Frequent and prolonged feeding will increase:
\_\_\_ output
\_\_\_\_ weight gain
\_\_\_ of breast feeding
\_\_\_ between feeding
A

milk
infant
duration
time

70
Q

Supplementing with formula will ___milk supply

A

decrease

71
Q 
Lactogenesis 1:
During \_\_\_\_\_
\_\_ weeks before delivery
\_\_\_\_ produced but not yet secreted
Progesterone inhibits \_\_\_
For our application we will say it ends when \_\_\_, \_\_\_ and \_\_\_ drops
A 
pregnancy
12
Colostrum
secretion
progesterone, estrogen and hPL
72
Q

Lactogenesis II and III:

Begins when __ ends
Lots of __ in this liquid as well as other important factors
Change in ___ and ___ over these two stages
II is result of rapid drop in ___, ___ and ___.

At the very initiation of II, ___ which contains white blood cells and antibodies, especially Immunoglobulin A (IgA)
Over the first ___ weeks after the birth, colostrum production slowly gives way to mature breast milk.

A 
I
fat
composition and quantity
estrogen, progesterone and hPL
colostrum
two
73
Q

Iron supplements may interfere with the ___ ___-___ ___.

A

lactoferrin anti-infective properties

HUEC 2112-Lifecycle (11 decks)

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