Lactation Flashcards
early writing in the 1900s pointed out __________ related to bottle fed infants.
mortality charts showed a clear difference between breastfed and bottle-feed infants
infectious hazards
in the first half of 20th century, thoughts toward the female breast was that it was ______
in the second half of the 20th century women wanted _______
meant to be a sex object and not for breastfeeding
the right to choose how they fed their infants
percent of infants breastfed at 6 months is highest in the ______
what two states have above 70% ?
north west
hawaii and vermont
fewer ______ infants are ever breastfed compared to asian, white, and Hispanic infants
black
infants eligible for WIC are ____ likely to breastfeed.
less
who is more likely to breastfeed?
younger mothers aged 20-29 or mothers who are 30 years and older
mothers who are 30 yrs or older
what are the functional units of the mammary glands?
alveoli - rounded or oblong shaped cavity in the breast
each alveolus is composed of ________
secretory cells with a duct in the center
secretory cells in the mammary gland is responsible for _________
secreting milk
myoepithelial cells in the mammary gland is responsible for __________
contracting to cause milk ejection into ducts
During puberty, the ovaries mature and release ________________ that stimulates breast development.
usually completed within ____ months after menarche.
estrogen and progesterone
12-18 months
lactogenesis stage 1
- begins during the last trimester through the 1st few days postpartum
- milk formation begins
-lactose and protein content increases
lactogenesis II
starts 2-5 days after birth
onset of copious milk secretion (milk comes in)
lactogenesis III
begins at about 10 days after birth
- milk composition becomes stable
what hormone promotes milk production, stimulated by suckling
where is it made
prolactin
pituitary gland
what is responsible for ejection of milk into the milk gland
tingling of the breast
stimulated by sucking or nipple stimulation
oxytocin release
what happens when the letdown reflex occurs?
stimulates milk release from the breast
- infant suckling stimulates nerves
- oxytocin release from pituitary
- contraction of myoeptithelial cells
- milk is released
lactose is made in the __________
secretory cells
water sodium potassium chloride pass through the alveolar through ________
passive diffusion
milk fat comes from the _____ from the mother’s blood and from new _______
TG
FA produced in the breast
__________ and other plasma proteins are captures from the mothers blood and taken into the alveolar cells and then secreted into the ducts
immunoglobin A
human milk composition changes over ________________.
a single feeding
over a day
based on age of the infant
presence of infection in the breast
with menses
and with maternal nutrition status
the first milk secreted during the first few days postpartum
colostrum
colostrum concentration
higher in protein
lower in CHO and fat
PRIMARY PROTEINS
- secretory IgA
- lactoferrin
high [ ] of mononuclear cells
rlly high vitamin A
colostrum is made in what phase of lactogenesis?
stage II
______ is the major component in human milk
water
energy of breast milk
0.65-0.70 kcal/mL (mature milk)
ranges from 20.9 - 26.2 kcal/oz
breastfed infants consume _____ calories than infanta fed with formula and are usually ______
fewer
thinner
feedings decrease after 1st month. at the very beginning there can be ____ feedings a day
10-12
lipids provide ____ calories in human milk
fat content is higher in the ______
1/2
hindmilk
DHA is essential for _____
retinal development
higher IQ
cholesterol is higher in human milk or formula ?
human milk
protein in breast mil is determined by __________
age of infant
two types of protein in human milk?
whey
casein
these proteins in human milk allow it to be ________
easily digestible
whey is ______ in water
includes enzymes that ______ and ________
EX:_____
soluble
aid in digestion and protect against bacteria
ex: lactoferrin - carries iron in a form that is easy to absorb
casein is the main protein in _____ milk
digestive products help keep ____ soluble and help with its absorbtion
mature
calcium
what is the dominant carb in breast milk
lactose
what does lactose do for the baby
enhances calcium absorbtion
what do oligosaccharides do for the baby from breastmilk
prevents binding of pathogenic microbes
prevents diarrhea
vitamin A has about twice the concentration in _____
some is in the form of ______ hence the color
colostrum
beta-carotene
vitamin D in milk depend on ______
maternal exposure to sunlight
vitamin ___ levels are related to milk’s fat content
the levels are adequate for infants with the exception of ______
E
premies
about 5% of breastfed infants are at risk for deficiency based on vitamin ___ dependent clotting factors
deficiency can cause ______
K
prick in heal when they are born to inject vitamin K
hemorrhage
vitamin B12 and folate are bound to _____ so they are less influenced by maternal diet
low B12 in women who_____
whey proteins
have hypothyroidism or latent pernicious anemia
are vegans or malnourished
have had gastric bypass
_____ content is related to growth rate of infant. concentration decreases over first four months, except for __________
minerals
magnesium
lower mineral content is easier for the _____ to process
kidneys
exclusively breastfed infants have very low risk of anemia despite _____
low iron content in milk
zinc is important for _____ and is
_____, so it is highly available
there is a rare defect in mammary gland uptake of zinc that may cause deficiency that appears as _______
human growth
bound to protein
diaper rash
in general trace mineral are not altered by mother’s diet, except for _______
flouride
does the flavor of breastmilk change ?
yes, it changes woth changes in the mothers diet
hormonal benefits of breastfeeding
increased oxytocin stimulates uterus contractions to return to prepregnancy status
physical benefits of breastfeeding
delay in monthly ovulation
may have lower risk of breast and ovarian cancer, and arthritis
psychosocial benefits of breastfeeding
increased self-confidence and bonding with infant
what is analgesic effect
reduction of infant pain from breastmilk
it was determined that of 90% of families in the united states breastfed for 6 months, _____ per year could be saved
13 billion
milk synthesis is related to
amount of time that infant nurses
- if you skip feeding, supply can get messed up
milk supply with pumping or expressing milk
insufficient milk production is common among women who express milk
may need 8-12 expressions a day
breast pump can be used for ____
- relieving engorgement
- stimulating and increasing milk production
- collecting milk for sick infant
- provided milk for donation
certain pumps are covered by ________
insurance
on countertop…
freshly expressed or pumped for ______
thawed from frozen for ______
4 hours
1-2 hours
In refrigerator
freshly expressed or pumped for ______
thawed from frozen for ______
up to 4 days
up to 1 day
freezer
freshly expressed or pumped for ______
thawed from frozen for ______
6 months is best and 12 is okay
never refreeze
leftover milk from a baby feeding can be used within ____
2 hours
can women breastfeed after breast reduction or augmentation surgery?
greater chance of lactation insufficiency
- location and amount of tissue removed determines ability
is there an effect of breast implants
silicone concentration of breast milk is not elevated
what are some feeding cues?
- rooting, turning the head
- increasing alertness, rapid eye movement
- flexing of arms and legs
- hand to mouth
- sucking on fist or finger
- mouthing motions of lips and tongue
gag reflex
prevents infant from taking food and fluid into lungs
oral search reflex
infant opens mouth wide when close to breast and thrusts tongue forward
rooting
turning the head, especially with searching movements of the mouth and subtle body movements
women can use their _____ to shape and position the breast so the infant can easily latch
hand
types of breastfeeding holds
lay back hold
football or clutch hold
cross cuddle hold
how to get attatchment
nose opposit to nipple
touch babys botttom lip to the breast
babys lips should be out and all areoli in their mouth
how do you know if the baby had enough?
they will be relaxed when detatched
allow infant to nurse on one breast as long as they want to ensure they get ______
the hindmilk with high fat
stomach emptying occurs in ____ hours for breastfed infants.
_____ feeding a day is normal for newborns
1.5 hours
8-12
normal weight for newborns is up to ____ percent in first ____ days
weightloss of above ___% should indicate an evaluation of milk transfer is needed
7%
5 days
10%
malnourished infants become _____,_______,______,_____
sleepy
non responsive
have a weak cry
few wet diapers
by day 5-7, infants should have _____ wet diapers and ____ soiled diapers
6
3-4
all children should be seen by a dentist ____ after first tooth erupts or at _____ of age
6 months
1 yr
vitamin supplements needed for breastfeeding infants
vitamin K
Vitamin D (400 IU/day) beginning at 2 months old
- usually a liquid dropper u use and drop into babys back of mouth
breastfeeding account for _____ calories spent in first 6 months and then ____ after that. During exclusive feeding, protein intake should be ______ by ______ then ____ later
500 kcal
400 kcal
increased
21 g/day
14 g/day
fluid demands increase when breastfeedin so women should _____
drink to thirst and evaluate urine
vegan should include _______ and plant sources of ________ while breastfeeding
fortified soy products
vitamin B12
what is th4e definition of colic
3 bouts of high pitched crying for more than 3 hrs/day and for more than 3 days per week for more than 3 weeks in a well nourished, otherwise healthy baby
colic usually starts after week ____ and resolves by _____
2 weeks
4 months
what MAY help colic
avoid allergen food like soy, eggs, wheat, fish
what is rooming-in
allowinf mother and infant to remain together 24 hours per day during the birth hospitalization
what is the practice of placing the infant directly on the mother or other caregiver in an effort to maximize surface to surface contact
skin to skin care
health benefits for both the mother and newborn in skin to skin
help initiate breastfeeding
stabilize glucose levels
maintaining infant body temperature
allows baby to colonize same bacteria as mother
it is recomended not to introduce pacifer until _______
pacifiers can also reduce the risk of _____
breastfeeding is established
SIDS
workplace support for breastfeeding
rigid work schedules
not enough paid maternity leave
lack of on site locations to pummp
