Introduction to Breastfeeding Flashcards
What are the breasts made up of?
Nipple areola, mammary tissue and supporting connective tissue
Fate, lymphatic vessels and nerves
Describe the anatomy of the breast
Made up of approx. 20 lobed which contain alveoli
Within alveoli are the milk producing cells lactocytes
Alveoli are surrounded by myoepithelial cells
Nipple has average of 9 opening surrounding the areola
What does oxytocin stimulate the myoepithelial cells to do?
Contract, pushing the milk into lactiferous ducts and towards the nipple
What are montgomery tubercles?
Glands which secrete a sebaceous fluid that lubricates the nipple and protects the skin
Fluid has aroma which attracts infant to the mother
Describe breast development during puberty
Hormones such as oestrogen prompt mammogenesis through development of ductal system within breast as they increase to adult size
Describe breast development during pregnancy
Progesterone and human placental lactogen enhance structures that produce milk
Blood supply to breasts increase to provide nutrients
What does the event of sucking acting as a stimulus lead to?
Stimulus via higher sensors in hypothalamus to posterior pituitary which secretes oxytocin
Also acts on anterior pituitary to produce prolactin
What does prolactin stimulate?
Secretes milk for the next feed
Describe the feedback inhibitor of lactation
As lactocytes secrete milk, it accumulates and inhibits new milk production
When breast is full then milk production is ceased
What psychological effects does prolactin and oxytocin have on the mother and the infant?
Produces feelings of calmness in both
They help the mother fall in love with her infant and want to hold, stroke and protect them
What is the difference of water in human milk and infant formula?
Human - water is filtered at source
Formula - water must be boiled for reconstruction
What is the difference in protein between human milk and infant formula?
Human - predominantly whey based and easy to digest, main protein is alpha lactalbumin
Cow’s milk protein has been linked to increased risk of juvenile onset of diabetes
What is the difference in carbohydrates between human milk and infant formula?
Human - lactose is primary carbohydrate and provides 40% of total calories, improves absorption of calcium and promotes healthy bacteria production
Formula -lactose is also predominant
Describe fats in human milk
Long chain fatty acids are present and contain transfer factors
Essential for brain development and absorption of fat soluble vitamins
Major calorie source
Describe fats in infant formula
Mainly vegetable based but some contain egg
Some have docosahexaenoic acid
Describe vitamins and minerals in human milk and infant formula
Human - small quantities, absorption dependant on transfer factors
Formula - extra vitamins and minerals
What are some constituents of human milk that are not present in infant formula?
Growth factors, stem cells, immunoglobulins, leukocytes, lactoferrin, oligosaccharides, human milk lipids and IL-7
What is the function of growth factors in human milk?
Epidermal, insulin and transforming factors promote gut growth
What is the function of stem cells in human milk?
These constitute an internal repair system and cells have ability to develop into many different cell types
What is the function of immunoglobulins in human milk?
IgA, IgG, IgM and IgD - IgA is most important as it covers the mucosal gut surface to prevent entry of pathogenic bacteria
What is the function of leukocytes in human milk?
Destroys harmful bacteria
What is the function of lactoferrin in human milk?
Protein which binds to iron, making it unavailable for bacteria which helps prevent gastroenteritis
Also kills bacteria
What is the function of oligosaccharides in human milk?
Supports healthy gut microbiota
Also support growth of friendly bacteria and destroy bacteria like group B strep
What is the function of human milk lipids in human milk?
Damages the outer surface of certain virus types
What is the function of IL-7 in human milk?
Linked to size of thymus
Breastfed infants have a larger thymus - which plays a role in stimulating antibody producing cells
Describe the microbiome in breastmilk
Mother transfers her microbial heritage to her infant via vaginal birth, skin to skin contact and breastfeeding
Contains bacterial strains, fungi, parasites and viruses
What are the functions of the microbiome?
Producing vitamin K, biotin and folate
Development of immune system
Converts oligosaccharides to short chain fatty acids which provide energy sources for enterocytes
Provides a barrier that may prevent absorption of toxins
Helps immature gut of premature baby to seal
What is the first milk produced from the breasts called?
Colostrum - produces from 16 weeks of pregnancy and consists of thick, yellow fluid which increases in days 3-4
What are the main components of colostrum?
Rich in vitamin A, creates acidic environment, immunoglobulins, antibodies and anti-infective proteins, high viral fragments, mild purgative and epidermal growth factors
Describe immune protection by breastfeeding
Breastfeeding activates broncho-entero-mammary pathway
Mother can share her immunity with her infant - lungs and small intestine LNs manufacture specially sensitive lymphocytes
Describe brain development and breastfeeding
Contain docosahexaenoic acid (long chain polyunsaturated fatty acid) which supports brain development and higher performance of intelligence
Describe maturation of gut and breastfeeding
Epidermal growth factors promote healing whilst neuronal growth factors promote development of peristalsis - help reduce chance of necrotising enterocolitis
Describe protection of mother’s health during breastfeeding
Protects against post partum haemorrhage, postpartum depression, ovarian and breast cancers, heart disease and type 2 diabetes
Why is skin to skin contact important?
Trigger lactation and mothering hormones
Triggers calming hormones in baby and counter adrenaline
Stimulates digestion
Stimulates instinctive feeding behaviours
Enables baby’s skin to be colonised by protective bacteria
Describe the positioning of breastfeeding
Keep baby close
Baby will tilt head back to allow chin to lead
Baby’s head and body should be in line
Nose to nipple positioning
