Introduction to Lactation and breast-milk Protein Composition Flashcards
Breastfeeding is also known as?
Exterior gestation
What is the magic hour?
hour where skin on skin is important to comfort the baby.
Why should the baby breastfeed as soon as possible?
To stimulate hormones in the mother after the drop of progesterone and estrogen at the end of pregnancy.
Why is a support system necessary to begin breastfeeding?
to learn how to do it, not be afraid, get used to it and to stick with it
The suckling stimulus causes the release of what hormones?
release of Prolactin and oxytocin
Where is prolactin released from?
Anterior pituitary
What does Prolactin do?
stimulate production of milk by alveolar cells in mammary gland
Where is oxytocin released from?
Posterior Pituitary
What does oxytocin do in breastfeeding?
Stimulate the Myoepithelial cells in mammary glands to contract to expel the milk from the breast
What does oxytocin do outside of its involvement in breastfeeding?
induces mothering response by increasing bonding and emotional ties.
thought to act on brain by neurotransmitters
also help uterus return to original size
What effect does breastfeeding have on ovulation and how?
suppresses ovulation by decreased levels of progesterone and estrogen with increased levels of prolactin
Does a women who is breastfeeding need contraceptives?
No, if the baby is exclusively breastfeeding. has to be pretty frequent
What are the advantages of breastfeeding?
proper jaw and tooth development bacteriologically safe and always fresh anti-infectious agents and immune cells nutritionally superior lower risk of food allergy
What are the sources of milk components?
transferred from maternal plasma
synthesized from secretory cells from maternal plasma precursors
Synthesized from other mammary cells in situ
What is colostrum?
Breast-milk first 5-7 days
Compared to mature milk, what nutritional differences does colostrum have?
more protein and mineral content (Na, K, Cl),
less energy, fat and lactose content
high carotenoid content
What is Transitional milk?
milk at 7 days to 3-4 milk
Compared to mature milk, what nutritional differences does Transitional milk have?
less protein more lactose and fat
What is mature milk? What is it separated into?
After the first month
Fore-milk and Hind-milk
Is the mature milk nutritional content constant?
No, changes according to needs (time of day or age)
When comparing to average mature milk, early morning milk is characterized by?
more water and lactose to hydrate
called fore-milk
What is Hind-milk and what is it characterized by nutritionally?
Higher in fat
Why is hind-milk so crucial for young children?
higher in fat which is good for brain development
In what way does breast-milk provide immunological properties?
direct action against pathogens
modulation of immune response
promotion of growth and maturation of GI tract
What is milk banking?
freezing extra milk in the freezer for later
Whey proteins are resistant to what? Why?
proteolysis and acid denaturation
They come with anti-proteases that protect by preserving S-S bonds
Which antibodies are present in breast-milk and which immunity do they provide?
IgA, IgM, IgE, IgG
passive immunity
Where are the antibodies produced?
locally in mammary gland
except IgG which is adsorbed from plasma
What does IgA do and where do they come from?
protect against many pathogens
from B cells from maternal sites exposed to a lot of pathogens
Which is the most common antibody?
IgA
What do the antibodies do in general?
bacterial and viral neutralizing capacities to inhibit colonization of the gut
What is the Bifidus factor?
A carbohydrate with nitrogen that promotes the growth of lactobacilli
Why is the bacillus factor good?
promotes lactobacillus which can antagonize the growth of enterobacteria which are bad
How do lactobacillus prevent the growth of pathogenic bacteria?
they secrete organic acids which lower the pH and make the environment less friendly
What is necrotizing enterocolitis?
destruction of intestinal tissue due to health problem, disruption of oxygen or bacteria
True or False. breastfeeding can reduce the risk of necrotizing enterocolitis?
true
How can breast-milk reduce staph infections?
anti-staphylococcus factor
Breast-milk contains lysozymes, Why is this useful?
Break down successible bacteria by breaking down proteoglycans from cell walls of those bacteria
What is Lactoferrin produced by?
Milk lymphocytes
What does lactoferrin do?
inhibits siderophilic bacteria by binding to iron and prevent access to it
most of it is in apo form which wants bind to iron to make holo form
What does lactoperoxidases do?
kill streptococci and enteric bacteria
What are lactoperoxidases and lipases?
bactericidal proteins
How do lipases have anti-viral properties?
fat break down in gut of free fatty acid and monoacyl glycerol can have antiviral properties
List 5 anti-infectious agents in breast milk
whey protein antibodies bifidus factor anti-staphylococcus factor lysozymes lactoferrin lactoperoxidases lipases interferon B12-binding protien macrophages neutrophils lymphocytes fibronectin complement
What does B12 binding protein do?
binds to B12 to make it unavailable for bacterial growth
What are the 3 major white blood cells in breast milk?
Neutrophile, macriphage and lymphocytes
What do neutrophiles do?
phagocytosis
What do macrophages do?
synthesize complement, lactoferrin, lysozymes and do phagocytosis
What do macrophages do?
synthesize complement, lactoferrin, lysozymes and do phagocytosis
What do Lymphocytes do?
synthesize secretory IgA and other Igs
What does the complement do?
promotes opsonization
What does fibronectin do?
increase phagocytosis
Name 3 growth factors in breast milk.
Cortisol/thyroxine/insulin Prostaglandins polyamines insulin-like growth factor vitamin E
What does cortisol/thyroxine/insulin do as a growth factor?
stimulate synthesis of intestinal enzymes and maturation of gut mucosa
What does prostaglandins do as a growth factor?
stimulate mucus secretion and cell division
What does Polyamines do as a growth factor?
increase cell replication (maturation of GI)
What does insulin-like growth factors do as a growth factor?
increase rate of gut maturation
What does vitamin E do as a growth factor?
stimulate immune system
What are 2 examples of Polyamines?
Spermine and spermidine
Why does human breast milk have one of the lowest protein contents compared to other species?
The protein content in breast milk is proportional to the growth rate of the species and humans grow really slowly
What are caseins?
Phosphoproteins only found in milk. come in a micelle of sodium caseinate and Phosphates, Ca and Mg
Why is the micelle structure good for caseins?
just by being in that form the milk can carry more Ca, Mg and phosphates
What is Whey?
what remains after the removal of the curd after adding acid
major supplier of minerals
What are the differences between human milk and cow’s milk?
Whey/casein ratio is much higher in human milk
more nucleotides
better aa balance
less allergenic reactions
Why is the whey casein ratio different in human’s milk?
makes a softer curd in the stomach that’s easier to break down cine the baby stomach isn’t that strong
What does the whey protein lactalbumin do?
a metalloenzyme that binds Ca and Zn
also part of lactose synthetase
What does the whey protein Xanthine Oxidase do?
supplies Fe and Mo
What does the whey protein glutathione peroxidase do?
supplies Se
What does the whey protein alkaline phosphatase do?
supplies Zn and Mg
What does the whey protein lactoferrin do?
supplies Fe
What are the major proteins in human milk?
alpha-lactalbumin and IgA
What are the major proteins in cow milk?
IgG and beta-lactoglobulin
Which protein in cow’s milk is mostly responsible for the adverse reactions some have to milk? Why does this explain the low reactions of human milk?
Beta-lactoglobulin
there isn’t any in human milk
How are bovine serum albumin and diabetes related?
some people have an anti-body for BSA. BSA have similar binding sites to pancreas so it can lead to destruction of pancreatic cells and may cause type 1 diabetes
What whey protein has been associated with colic?
IgG
How is having more (than cow’s milk) nonprotein nitrogen compounds advantageous?
aids in digestibility
some of them play a role in growth factors (polyamines, nucleotides…)
What is Taurine?
(aa) A principal component of the nonprotein nitrogen compartment of breast milk
True or false. There is much more taurine in human milk than cow milk.
True, 30x more
What does Taurine do?
membrane stabiliser
bile acid conjugation (1 step to make bile salts)
inhibitor neurotransmitter
What are the significant aspects of amino acid composition in human milk?
more cysteine, less methionine
Why is a high cysteine and low methionine ratio good?
allows to utilize cysteine without needing to metabolize methionine since this system is not good yet and methionine is the most toxic aa at high levels
system not ready because of developmental delay of cystathionase (for break down of methionine into cysteine)
Why is lower phenylalanine and tyrosine levels a good thing?
excessive phenylalanine and tyrosine can be neurotoxic (mostly for premature)
the enzymes that metabolize these 2 amino acids are late to develop
tyrosine aminotransferase and para-hydroxyphenyl pyruvate oxidase
What are the clinical signs that the baby has a cow’s milk allergy?
vomiting, nausea, sneezing, wheezing, chronic cough, dermatitis, headaches,
best sign: blood in poo
What do you do when a cow’s milk allergy has been identified?
special formula
not soy because the allergy may extend to soy based
How can IgA in breast milk protect against milk allergy?
aids in blockage of whole food proteins from absorption by binding to them. the complex then promotes mucus release and proteolysis at mucosal surface (before proteins reaches systemic circulation)
How does blood IgA protect against milk allergy?
blood IgA binds to food proteins and takes them out via reticuloendothelial system
Besides through IgA, how can breast feeding protect against milk allergy?
Colostrum makes leaky tight junctions close faster so antigens can’t pass through
What is Heiner’s syndrome?
hypersensitivity to cow’s milk protein
presents itself as a pulmonary disease
GI blood and iron deficiency anemia
failure to thrive
