Lactation Flashcards

0
Q

What is colostrum like in compared to mature milk?

A

Higher in protein
Lower in carb
Lower in fat
Lower in calories

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1
Q

What is colostrum

A

The first milk secreted during the first few days post partum

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2
Q

What are some benefits of colostrum

A

Helps establish GI microflora

Protects against GI infection

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3
Q

What are the levels of Secretort IgA, lactofferin and vitamin A of colustrum in comparison to to mature milk?

A

0.5 - 0.1
0.5 - 0.2
151 - 75

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4
Q

The fluid level of maternal milk is about 80%

Will the infant need extra water ?

A

No

Water is also isotonic with maternal plasma

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5
Q

How many calories per mL with human milk ?

A

0.65 kcal/mL

But cals may vary with fat, pro and carb composition

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6
Q

Is human milk or human milk substitute lower in calories

A

Human milk lower in calories

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7
Q

What are the protein levels for mature human milk?

A

1g per 100ml
Lower than in whole cows milk
Has antiviral and microbial effects

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8
Q

What is the main protein in natural human milk?

A

Casein

And whey

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9
Q

The human milk protein is high in amino acids that he infant cannot synthesize but low in -

A

Phenylalanine

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10
Q

What provides half of the calories jn human milk

A

Fat

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11
Q

What is the effect of maternal diet on human breast milk

A

Fatty acid profile reflects dietary index of mom

Type of FA varies based on diet

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12
Q

What is the second largest component of breast milk?

First?

A

Lipids are second

Water is first

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13
Q

What component of breast milk is associated with higher IQ scores and also essential for retinal development

A

DHA

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14
Q

What is the dominant carbohydrate in human milk and how does it compare to cows milk

A

Lactose is most dominant

There is more in human milk than in cows

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15
Q

Does lactose enhance calcium absorption?

Is carbohydrate in milk effected by the diet of mom ?

A

Lactose enhances calcium absorption

There is a constant level during the day and not effected by maternal diet

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16
Q

What is an olgiosacharide

How does it help baby

A

Medium length CHO
Prevents binding of pathogenic microorganisms to gut
Which prevents infection and bacteria

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17
Q

Vitamin A in colostrum is double that of mature milk

And the yellow colour is from

A

Beta carotine

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18
Q

What is the vitamin D content like in human milk

Need to supplement ?

A

Most as 25-OH2 , vitamin D and D3
Content IS reflective of moms diet and exposure to the sun
Supplement at 400 IU a day for baby

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19
Q

Vitamin E content of breast milk is linked to

A

Milks fat content

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20
Q

Is vitamin E levels in human breast milk enough for preterm infants

A

No

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21
Q

What percent of babies breasted are at risk for K deficiency based on clotting factors

A

5%

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22
Q

Infants who did no receive k injection at birth (phylloquinone injection)

A

May be deficient

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23
Q

What are the water soluable vitamins in human breast milk reflective of

A

Mothers diet or supplement

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24
Q

What is the water soluable vitamin most at risk for deficiency in human milk

A

B6

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25
Q

Vitamin B12 and folate in breast milk are

A

Bound to whey proteins

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26
Q

Low b12 in milk seen in women who

A

Have hypothyroidism or latent pernicious anemia
Are vegans / malnourished
Have had gastric bypass

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27
Q

What is zinc bound to it Breast milk

A

Protein

Highly available

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28
Q

Sometimes there’s a defect in mammary gland uptake of zinc and may cause zinc deficiency that appears as …

A

Diaper rash

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29
Q

In general trace minerals in maternal milk aren’t affected by diet
What are the trace minerals present

A
Copper
Selenium 
Chromium
Manganese 
Molybdenum
Nickel
Fluoride
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30
Q

How can a moms variety in diet contribute to baby’s interest in solid foods

A

Because flavour in moms diet influences taste of breast milk
Flavours keep baby interested
May promote further intrigue to solid food

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31
Q

What are hormonal benefits of breast feeding

A

Increased oxytocin which stimulates uterus to return to prepregnancy status

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32
Q

Physical benefits of breastfeeding

A

Delay in monthly ovulation resulting in longer intervals between pregnancies

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33
Q

What are physiological benefits of breast feeding

A

Increased self confidence and bonding with infant

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34
Q

Nutritional benefits of breast feeding

A

Widely recognized. Nutrients are balenced. Meets infants protein needs without overloading kidneys. Contains soft easily digestible curd; a lot of the right lipids. Minerals are more bio available.

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35
Q

Immunological benefits

A

Lower infant mortality in developing countries

Fewer acute illnesses

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36
Q

Reductions in chronic illnesses is a benefit of breast feeding

A

Reduce risk of celiac disease and IBS

Reduce risk of allergies and asthmatic disease

37
Q

How does breast feeding correlate to childhood obesity

A

Typically breast fed infants are leaner at 1 yr of age

38
Q

How does breast feeding elicit cognitive benefits

A

Studies show an increase in cognitive ability even after adjusting for family environment
DHA

39
Q

Does breast feeding have an analgesic effect on baby?

A

Yes there is a reduction of infant pain

40
Q

How can there be a socioeconomic benefit of breast feeding

A

Decreased need for medical care

And buying formula not an issue

41
Q

What is milk synthesis related to

A

How vigorously an infant nurses
How much time the infant is at the breast
How many times per day an infant nurses
Milk synthesis rate is variable between breasts and between feedings

42
Q

How can you tell if baby is hungry

A

Infant bringing hands to mouth / sucking on them, moving head from side to side crying is a late sign of hunger

43
Q

Why is it important to allow the baby to nurse on one breast as long as the want

A

To ensure they get hindmilk with it’s high fat content that provides satiety
High lactose content my cause diarrhea

44
Q

How many feedings per day is normal

How often does stomach emptying occur

A

10-12

Emptying occurs in 1.5 hours

45
Q

What vitamins should infants be supplemented with

A

Vitamin k at birth
Vitamin D - exclusively breasted infants need supplements at 2 months
No recommendations for fluoride or iron

46
Q

Energy intakes vary with activity level for newborns

But what is the DRI for the first 6 months and after

A

500 per day for 1st 6 months

400+ per day afterward

47
Q

Protein calorie malnutrition results in reduction in

A

Milk volume but not quality

48
Q

Does exercise inhibit milk production or infant growth ?

A

No

49
Q

What does the maternal diet need to be like when breast feeding

A

Supplements not needed if women well nourished
Women shout drink to thirst
Functional foods are fine

50
Q

What is zinc bound to it Breast milk

A

Protein

Highly available

51
Q

Sometimes there’s a defect in mammary gland uptake of zinc and may cause zinc deficiency that appears as …

A

Diaper rash

52
Q

In general trace minerals in maternal milk aren’t affected by diet
What are the trace minerals present

A
Copper
Selenium 
Chromium
Manganese 
Molybdenum
Nickel
Fluoride
53
Q

How can a moms variety in diet contribute to baby’s interest in solid foods

A

Because flavour in moms diet influences taste of breast milk
Flavours keep baby interested
May promote further intrigue to solid food

54
Q

What are hormonal benefits of breast feeding

A

Increased oxytocin which stimulates uterus to return to prepregnancy status

55
Q

Physical benefits of breastfeeding

A

Delay in monthly ovulation resulting in longer intervals between pregnancies

56
Q

What are physiological benefits of breast feeding

A

Increased self confidence and bonding with infant

57
Q

Nutritional benefits of breast feeding

A

Widely recognized. Nutrients are balenced. Meets infants protein needs without overloading kidneys. Contains soft easily digestible curd; a lot of the right lipids. Minerals are more bio available.

58
Q

Immunological benefits

A

Lower infant mortality in developing countries

Fewer acute illnesses

59
Q

Reductions in chronic illnesses is a benefit of breast feeding

A

Reduce risk of celiac disease and IBS

Reduce risk of allergies and asthmatic disease

60
Q

How does breast feeding correlate to childhood obesity

A

Typically breast fed infants are leaner at 1 yr of age

61
Q

How does breast feeding elicit cognitive benefits

A

Studies show an increase in cognitive ability even after adjusting for family environment
DHA

62
Q

Does breast feeding have an analgesic effect on baby?

A

Yes there is a reduction of infant pain

63
Q

How can there be a socioeconomic benefit of breast feeding

A

Decreased need for medical care

And buying formula not an issue

64
Q

What is milk synthesis related to

A

How vigorously an infant nurses
How much time the infant is at the breast
How many times per day an infant nurses
Milk synthesis rate is variable between breasts and between feedings

65
Q

How can you tell if baby is hungry

A

Infant bringing hands to mouth / sucking on them, moving head from side to side crying is a late sign of hunger

66
Q

Why is it important to allow the baby to nurse on one breast as long as the want

A

To ensure they get hindmilk with it’s high fat content that provides satiety
High lactose content my cause diarrhea

67
Q

How many feedings per day is normal

How often does stomach emptying occur

A

10-12

Emptying occurs in 1.5 hours

68
Q

What vitamins should infants be supplemented with

A

Vitamin k at birth
Vitamin D - exclusively breasted infants need supplements at 2 months
No recommendations for fluoride or iron

69
Q

Energy intakes vary with activity level for newborns

But what is the DRI for the first 6 months and after

A

500 per day for 1st 6 months

400+ per day afterward

70
Q

Protein calorie malnutrition results in reduction in

A

Milk volume but not quality

71
Q

Does exercise inhibit milk production or infant growth ?

A

No

72
Q

What does the maternal diet need to be like when breast feeding

A

Supplements not needed if women well nourished
Women shout drink to thirst
Functional foods are fine

73
Q

How long does the academy of pediatrics say you should breastfeed (and academy of nutrition and dietetics )

A

1 yr *

74
Q

How long does the US surgeon general say they should exclusively breastfeed

A

6 months exclusive

12 months with food

75
Q

Factors influencing breast feeding initiation and duration

A

Obesity , overweight and obese prior to pregnancy + excess prenatal weight gain breastfeed for shorter duration
Socioeconomic - both low income and more affluent mothers need breastfeed ing support

76
Q

Healthy people 2020 breastfeeding objectives

A

^ # of infants breastfeed
^ duration of breastfeed
Increase works it lactation programs
Reduce formula supplementation in first 2 days of life
Increase births in facilities providing recommended care for breastfeeding moms

77
Q

Why is breast feeding support essential in the first weeks after delivery

A

Lactation is being established

That is why distribution of free formula samples is discouraged

78
Q

A paediatrician, nurse or other knowledgable Health care practitioner should see all breastfed infants at____

A

2-4 days of age

79
Q

Barriers to breastfeeding in the workplace

A

Lack of on site daycare
Insufficiently paid maternity leave
Rigid work schedules
Lack of understanding/ knowledge by employers
Legislation is in progress to support breastfeeding or pumping in the workplace

80
Q

In order to establish a multidisciplinary task force to help with breastfeeding promotion, who could help

A

Physicians, hospitals and birthing centres, public health, home visitors , government industry and school boards
Journalists

81
Q

T or f, breast feeding will make it slower to return to prepregnancy weight

A

f

82
Q

What are some community related barriers to breastfeeding

A

Lack of access to reliable and culturally appropriate sources of information and social support
Cultural perceptions of bottle feeding as the norm
Aggressive marketing via formula companies
Laws prohibiting breastfeeding in public

83
Q

Major component of breast milk is ___ while the 2nd is

A

Water

Lipids

84
Q

Breast milk is isomotic which means

A

Is has he same concentration of molecules as mothers body plasma

85
Q

What is secretory immunoglobulin A

A

One of the primary proteins in colostrum

86
Q

What is prolactin

A

Hormone by pituitary that stimulates milk productions

87
Q

What is oxytocin

A

Pituitary hormone secretion causing milk let down

88
Q

What Are alvioli of the breast

A

Functional unit

Rounded oblong cavities in breast

89
Q

Secretory cells else

A

Cells in milk gland responsible for secreting milk components into ducts

90
Q

Myoepithelial cells

A

Specialized cells that line alveoli

Contract to cause milk to be secreted I to duct

91
Q

Describe hindmilk

A

Milk at end of feeding that contains higher amount of human fat milk