Lactation

Question 1

Describe the changes to the breasts in preparation for infant feeding during pregnancy

Answer 1

Hormonal changes
Growth of the ductal system
Swelling and tenderness
Increase and darkening of the areolas
Rapid growth of all tissues (glandular, connective tissue, fat, blood, lymphatic vessels, nerves)

Question 2

Describe the action of prolactin and oxytocin in relation to milk production

Answer 2

Prolactin – stimulates milk production
Oxytocin – promotes breast and uterine muscle cell contraction
In the breast tissue to allow the milk to flow out of the ducts for the baby to drink (sometimes called the ‘letdown’)
In the uterus tissue causing it to contract, seal blood vessels, and shrink its size

Question 3

List stimuli that can promote milk flow

Answer 3

suckling
hearing a baby cry
sexual arousal
thinking about nursing

Question 4

Exclusive breastfeeding is promoted for how long?

Answer 4

first 6 months

Question 5

How long should breastfeeding continue?

Answer 5

At least 12 months

Question 6

List the benefits of breastfeeding for the mother

Answer 6

1. Oxytocin plays a role in uterine muscle contraction and blood vessel changes
2. Prolactin delays the return of regular ovulation and menstruation, which is a form of (unreliable) contraception - good for disadvantaged countries who do not have access to other forms.
3. May help women return to pre-pregnancy weight
4. Not breastfeeding is associated with post-partum depression
5. Psychological benefits of self-confidence and infant bonding
6. May protect against breast and ovarian cancer and reduce the risk of T2DM
7. Cost savings

Question 7

What is the composition of breast milk?

Answer 7

6% protein
55% fat
39% carbohydrate

Question 8

What is the thick yellowish fluid secreted in first few days after delivery?

Answer 8

Colostrum

Question 9

List the benefits of breastfeeding for the infant

Answer 9

1. Immuno-protection - extends beyond the period of breastfeeding.
2. Provides hormones that promote physiological development
3. Improved cognitive performance, reduced risk of SIDS and infant mortality, as well as obesity.
4. Compared with formula-fed infants, breastfed infants have lower blood pressure and lower blood cholesterol as adults.
5. Optimal nutritional value of breast milk, tailored to meet nutritional needs of the infant

Question 10

What are the consistently positive factors of breastfeeding?

Answer 10

Higher maternal education
Support of midwives
Father’s preference for breastfeeding
Doctor’s support 
Pleasant birth experience
Greater breastfeeding knowledge
Rural environment

Question 11

What are the consistently negative factors of breastfeeding?

Answer 11

Low socioeconomic background
Formula supplement in maternity ward
Mother’s intention to use supplements
Previous short-term experience
Not rooming in
Higher number of work hours/return to work
Perceived insufficient milk supply 
Smoking and alcohol use

Question 12

Approximately what volume of milk is produced daily?

Answer 12

750ml

Question 13

What are the additional energy requirements per day for the first 6 months of breastfeeding?

Answer 13

+2000kJ/day

Question 14

Which nutrients in breast milk most likely to decline in response to prolonged inadequate intakes?

Answer 14

A, D, B6 and B12

Question 15

What are some common concerns regarding breastfeeding?

Answer 15

1. Sore nipples - causes can be poor positioning, poor attachment or incorrect sucking
2. Breast fullness and engorgement - over full breasts are difficult for babies to attach to, express some milk to resolve
3. Mastitis