lactation

Question 1

what are Canadian recommendations for breastfeeding

Answer 1

• optimal method of feeding
• encourage exclusively for at least first 6 months
• start introducing solids at 6 months — especially iron foods
• provide 10ug vitamin d supplement starting a birth

*corrected age- if preterm
- no reason to stop at 2 years

Question 1

what are the benefits to breastmilk

Answer 1

• perfect temperature
• cost effective
• good healing properties- can rub on cuts

Question 2

how to give baby vitamin d supplement

Answer 2

• drops on nipple, soother, bottle
• starting at birth
  10ug daily

Question 3

what is colostrum

Answer 3

• milk before lactation starts
  **nutrition and immune supporting properties

** very nutrient dense, very important

Question 4

how does breast milk transition?

Answer 4

• first two weeks
• increase in energy, lactose, fat, water soluble vitamins
• less protein and fat soluble vitamins
  6% protein
  55% fat
  39% carbs
• help prevent baby from infections

Question 5

what is the composition of Breast milk

Answer 5

21-26 kcal/oz

protein 6%
fat 55%
carbs 39%

has enough micronutrients (besides from vitamin d)

Question 6

nutrient composition of carbs

Answer 6

mostly lactose
- digested easily

oligosaccharides
- decrease binding of bacteria and toxins

• if baby intolerant to lactose- other taking out of diet should fix the issue

Question 7

nutrient composition of protein

Answer 7

• very low concentration
• dont have string kidneys yet
• important water balance
• more protein the more water you need
• appropriate amino acid amounts

Question 8

what is the bidifus factor in breastmilk

Answer 8

• microbial growth factors
• n- containing sugar
  nitrogen helps baby produce non essential amino acids and produce their own proteins
• more growth of bacteria- protects baby
• decrease growth of pathogenic bacteria (bad stuff)

help intestinal bacteria– build childs immune system

Question 9

nutrient composition of lipids

Answer 9

** composition of fat changes depending on mothers diet and intake of omega 3 fat// and transfer also effected by mothers diet

• should keep DHA of omega 3 intake high– help cognitive development

Cholesterol– not present in formula
- help lower blood cholesterol later in life

Question 10

nutrient composition in breastmilk

Answer 10

• all needs met besides vitamin d
• vitamin k- supplemented at birth

vitamin a, d, e, k, b12, folic acid and zinc are all important

Question 11

how much vitamin d should be supplemented

Answer 11

10 ug or 400 iu per day
- dropped recommended

Question 12

5 characteristic of breast milk

Answer 12

1. immunoglobulin
2. lipase activity
3. lysozyme
   4.lactoferrin
4. intestinal growth factor

Question 13

what are the stages for milk production

Answer 13

1st- 3rd trimester
- Milk forms and protein increases

2nd- 2-3 days post pardum
- Milk composition and volume changes

3rd- 10 days post pardon
- Stable milk supply

Question 14

what are mammary glands

Answer 14

• functional units are alveoli- have secretory cells with a duct at the centre– small ducts combine into large ducts and come together at the nipple
• these glands develop during puberty
• during pregnancy increase in estrogen allows development of glands that produce milk

Question 15

which hormone is responsible milk production

Answer 15

• prolactin
• suppressed in third trimester
• When demand- start sucking- turns OFF INHIBITORY - therefor initiating milk production

Question 16

which hormones helps “let down reflex”

Answer 16

• oxytocin
• Allows milk to be released from breast
• Etc. looks at picture of baby, smell top of baby head— realizes oxyoctin and more breastmilk
• Promotes urine contraction- help uterus return to size

Question 17

what’s the difference between fore milk and hind milk

Answer 17

foremilk
- front of breast
- low fat, high nutrients
- benches thirst

hindmilk
- thicker
- higher in fat (fullness)

Question 18

what is engorgement? how is it caused? solution?

Answer 18

breast overkill with milk
caused.
infrequent or ineffective milk removal

Question 19

plugged milk duct solution

Answer 19

when milk remains in duct and causes blockage

• painful knot

Question 20

what is mastitis?
causes?

Answer 20

inflammation of the breast

• missing feeds, tight bra, plugged duct that not resolved

Question 21

positive and risks for breastfeeding pre terms

Answer 21

easier to digest than formula
more protein, lower lactose than in formula

drawback
- may gain weight slower
- poor bone mineralization
- haven’t developed adequate suck and swallow reflexes

Question 22

how much extra calories do mom need while breastfeeding

Answer 22

first 6 months. 330 extra (including energy for weight loss calculated in)
second 6 months. 400 call extra

Question 23

why do breast overfill with milk?

Answer 23

• infrequent or ineffective removal
• solutions– warmth and pressure, breastfeed more, pump less