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kph - week 2 > Intro To Breastfeeding > Flashcards

Intro To Breastfeeding Flashcards

1
Q

How many lobes make up the breast?

A

Approx 20

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2
Q

What is contained within the lobes of the breast?

A

Alveoli

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3
Q

What is contained within the alveoli of the breast?

A

Milk producing lactocytes

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4
Q

Which hormone stimulates the myoepithelial cells to contract so that milk is pushed into the lactiferous ducts and towards the nipple?

A

Oxytocin

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5
Q

How many openings does the nipple have?

A

An average of 9

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6
Q

What are Montgomery tubercles?

A

Glands which secrete a sebaceous fluid that lubricates the nipple and protects the skin. The fluid has an individual aroma which attract the infant to the mother.

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7
Q

Name a hormone involved in breast development during puberty.

A

Oestrogen

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8
Q

How does oestrogen prompt mammogenesis?

A

Through development of the ductal system.

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9
Q

Name two hormones involved in breast development during pregnancy.

A

Progesterone and human placental lactogen.

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10
Q

Why does blood supply to the breast increase during pregnancy?

A

To provide nutrients from which the milk will be made.

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11
Q

Which action is needed to begin the cycle of lactation?

A

Effective suckling

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12
Q

How does suckling influence lactation?

A

It send a stimulus via the hypothalamus to the posterior pituitary gland. The posterior pituitary gland then secretes oxytocin.

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13
Q

How is oxytocin involved in the lactation cycle?

A

It stimulates the smooth muscle of the breast alveoli to contract so that milk is ejected into the lactiferous ducts.

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14
Q

What is the role of prolactin in the lactation cycle?

A

It is released by the anterior pituitary in order to stimulate the lactocytes to secrete milk for the next feed.

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15
Q

How is the production of milk controlled so that it is not over produced?

A

By feedback inhibitor of lactation (FIL). This is contained within the breast milk so the more breast milk that is present, the less that will be produced. As the infant feeds and milk/FIL are reduced, the cycle of milk production can start again.

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16
Q

What psychological effects do prolactin and oxytocin have on the mother and infant?

A
  • feelings of calmness
  • help mother to fall in love
  • makes mother want to hold/stroke/protect infant
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17
Q

Which constituents do human milk and modified cows milk have in common?

A

Water, protein, carbohydrates, fats, vitamins and minerals.

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18
Q

What is the main protein found in human milk?

A

Alpha lactalbumin (20%)

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19
Q

What is alpha lactalbumin associated with?

A

The destruction of over 40 types of cancer cells.

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20
Q

What protein is found in cows milk and what has it been linked to?

A

Bovine serum albumen, linked to increased risk of juvenile onset diabetes.

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21
Q

What is the primary carbohydrate found in both human and cows milk?

A

Lactose

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22
Q

State two benefits of lactose.

A
  1. Improves the absorption of calcium.

2. Promotes growth of healthy bacteria.

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23
Q

Which carbohydrates may be found in lactose free infant formula?

A

Sucrose, fructose and glucose.

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24
Q

What type of fat is found in human milk?

A

Long chain fatty acids

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25
Q

What do long chain fatty acids contain?

A

Transfer factors which help with absorption

26
Q

State three benefits of long chain fatty acids.

A
  1. Essential for brain development
  2. Essential for absorption of fat soluble vitamins e.g. vitamin A for eyesight
  3. Constitute a major calorie source
27
Q

List the constituents of human milk which are not found in formula. (11)

A
  • growth factors
  • stem cells
  • immunoglobulins
  • leukocytes
  • lactoferrin
  • oligosaccharides
  • human milk lipids
  • IL-7
  • lymphocytes
  • cytokines
  • enzymes
28
Q

What is the function of the growth factors found in human milk?

A

Epidermal, insulin and transforming factors promote gut growth.

29
Q

What is the function of stem cells found in human milk?

A

These constitute an internal repair system as the cells have the ability to differentiate in to many different cell types.

30
Q

Which immunoglobulins are found in human milk?

A

IgA, IgG, IgM, IgD

31
Q

Which immunoglobulin found in human milk is most important and why?

A

IgA because it covers the mucosal gut surface to prevent the entry of pathogenic bacteria e.g. E. coli and enteroviruses e.g. rotavirus into the infant gut.

32
Q

What is the function of leukocytes found in human milk?

A

To destroy harmful bacteria

33
Q

What is the function of lactoferrin found in human milk?

A

It is a protein which binds to iron and so makes it unavailable for bacteria and thus helps to prevent gastroenteritis. It also kills various bacterias e.g. E. coli

34
Q

What is the function of the oligosaccharides found in human milk? (4)

A
  1. They support a healthy gut microbiota.
  2. Defend against pathogens which cause otitis media, respiratory tract, urinary tract and GI infections.
  3. Support the growth of friendly bacteria (Bifidus)
  4. Destroy bacteria such as group B strep
35
Q

How many types of oligosaccharides are unique to human milk?

A

Over 200

36
Q

What is the function of the human milk lipids found in human milk?

A

They damage the surface of certain virus types.

37
Q

What is the function of IL-7 found in breast milk?

A

IL-7 is linked to the size of the thymus which has an important role in stimulating antibody producing cells and so the immune response. Breastfed infants tend to have a larger thymus than formula fed.

38
Q

What is the function of the enzymes found in human milk?

A

Aid digestion and absorption and some destroy bacteria.

39
Q

How does a mother transfer her microbial heritage to an infant?

A

Via vaginal birth, skin to skin contact and breastfeeding.

40
Q

What does the microbiome of human milk contain?

A

Over 800 bacterial strains, fungi, parasites and viruses

41
Q

What does the microbiome of human milk drive?

A

The development of infant gut physiology.

42
Q

Which component of human milk feeds the bacteria which form the basis of the baby’s microbiome?

A

Oligosaccharides

43
Q

What are the functions of the baby’s microbiome?

A
  1. Producing vitamin K, biotin and folate
  2. Aiding the development of the immune system
  3. Converting oligosaccharides to short chain fatty acids which provide energy sources for enterocytes
  4. Binding to sites on the layer of cells lining the gut and providing a barrier that may prevent the absorption of toxins.
  5. Helping the immature gut of a premature baby to seal, thus preventing colonisation by pathogenic bacteria and reducing the likelihood of them developing necrotising enterocolitis (NEC).
44
Q

What is the first milk produced from the breasts called?

A

Colostrum

45
Q

When is colostrum produced?

A

From 16 weeks of pregnancy

46
Q

Briefly describe colostrum.

A

It is a thick, yellowish fluid which increases in amounts over the first 3/4 days in line with the infants needs

47
Q

List the main components of colostrum.

A
  1. Creates acidic environment
  2. Immunoglobulins, antibodies and anti-infective proteins
  3. High viral fragments and white cells.
  4. Mild purgative
  5. Epidermal growth factors, anti-inflammatory molecules
  6. Rich in vitamin A
48
Q

Breastfeeding activates the broncho-entero-mammary pathway. Briefly describe this pathway.

A

When a mother inhales or ingests pathogens, lymph nodes in the lungs and small intestine manufacture specially sensitised lymphocytes which migrate to the breasts and create unique secretory antibodies against that pathogen, thus enabling the mother to share her immunity with her infant.

49
Q

What component of breast milk helps with development of the brain?

A

Long chain polyunsaturated fatty acids e.g. Docosahexaenoic acid

50
Q

How does human milk help to promote maturation of the infant gut?

A

Epidermal growth factor promotes healing whilst neuronal factors promote development of peristalsis. These factors help reduce the chance of necrotising enterocolitis (NEC).

51
Q

How many times more likely are formula fed infants to develop NEC than a breastfed infant?

A

6-10 times

52
Q

List the ways in which breastfeeding can help with the mother’s health.

A
  1. Protects against post partum haemorrhage
  2. Protects against post partum depression
  3. Protects against breast and ovarian cancer
  4. Protects against heart disease and type 2 diabetes
  5. Supports mother/baby relationship and mental health of mum and baby
53
Q

List some benefits of skin to skin contact between mother and baby.

A
  1. Triggers lactation, mothering hormones and enables mothers to recognise their infants feeding cues.
  2. Triggers calming hormones in the baby and counters adrenaline which in turn regulates heart rate and breathing.
  3. Stimulates digestion.
  4. Stimulates instinctive feeding behaviours e.g. seeking the breast, rooting and suckling
  5. Enables infants skin to become colonised by protective bacteria from mothers skin.
54
Q

Explain the position acronym CHIN.

A

C - keep the baby CLOSE so they can scoop the breast into their mouth
H - the baby will tilt their HEAD back to allow their chin to lead as they come onto the breast
I - the baby’s head and body should be IN LINE (not twisted)
N - NOSE to nipple positioning is the starting point for effective attachment

55
Q

What combination during breast feeding allows the breast milk to be released?

A

The babies jaw dropping down to create negative pressure and the tongue compressing the breast.

56
Q

When babies feel secure they release oxytocin. Why is this important for the baby?

A

It is important for brain development.

57
Q

List some components of responsive breastfeeding. (6)

A
  1. Breastfeeding as a source of food AND comfort
  2. Mother’s learn to recognise infant’s cues
  3. No measurements of quantity needed as baby will stop when full
  4. Breastfed infants cannot be spoilt or overfed
  5. Length of feeds may vary between 5 and 40 minutes
  6. Breastfeeding may be more frequent than mothers led to believe
58
Q

List some of the ‘dos’ for a doctor in relation to breastfeeding.

A
  1. Encourage and discuss important of human milk and breastfeeding with parents.
  2. Encourage and enable skin to skin contact at any time.
  3. Acknowledge that breast feeding is a learned behaviour and that mothers may require support at first.
  4. Do your best to maximise the use of human milk and avoid unnecessary use of supplementary feeds.
59
Q

List some of the ‘donts’ for a doctor in relation to breastfeeding.

A
  1. Advise supplementary feeding just to allay anxiety.

2. Prescribe medication for mother without checking safety for lactation.

60
Q

State some of the societal challenges of breastfeeding.

A
  1. Practical, emotional and cultural barriers.
  2. Little support for breastfeeding in public or longer term breastfeeding.
  3. Infant formula advertisements widely publicised
  4. Media, toys, film etc usually portray bottle rather than breast feeding.
  5. Breastfeeding in public is still frowned upon.
  6. Breasts are seen as items of sexual display and not a food source.
61
Q

In what ways is breastfeeding an economic issue?

A
  1. Large differences in economic divides - 17% in lower socioeconomic to 92% in high socioeconomic groups.
  2. Failing to breastfeed costs global economy approx $302 billion every year
  3. Not breastfeeding is associated with lower intelligence
  4. Increasing breastfeeding to near universal levels could save over 800,000 children’s lives a year and prevent 20,000 breast cancer deaths.
62
Q

What percentage of women in the UK continue to breastfeed after 4 months?

A

34%

kph - week 2 (4 decks)

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