Lactation Flashcards
What are the three stages of breast milk?
Colostrum, transitional, and mature milk
What are typical breast milk production volumes?
Birth: 22 ounces per day
Six months: 30 ounces per day
Twelve months: 25 ounces per day
What is colostrum?
It is the initial milk that a woman produces. It is yellow in color and high in IgA and lactoferrin –important for immune protection.
High in protein and lower in fat.
Describe transitional milk.
Produced after the colostrum, from about day 2 to day 14, transitional milk has a higher fat content and a lower IG content.
In mature milk, about half of the calories are _________.
lipids; the other half are proteins –primarily whey
What carbohydrates are in mature milk?
Glucose and galactose
There are trace elements of ____________ in mature milk.
iron (lower than the total amount in formula but more bioavailable) and zinc
What are foremilk and hindmilk?
Foremilk is the first milk that comes out and hindmilk comes out later. Hindmilk is higher in fat.
In general, malnourished mothers have ____________.
the same concentrations of fat, protein, and carbohydrates, but they produce less overall
Research has shown that infants who breastfeed have better responses to ____________.
vaccinations
Breastfed infants have been shown to have lower incidence of _____________.
Infections: OM, gastroenteritis, and URIs
Allergies: Eczema
SIDS
Diabetes
Death (in fact, breastfeeding has been shown to be the best way to decrease mortality in children younger than 5 years)
What are the immediate effects of breastfeeding on mothers?
Oxytocin leads to decreased risk of hemorrhage
Amenorrhea leads to decreased iron loss
More rapid return to prepartum weight
What are some medical contraindications to breastfeeding?
Maternal HIV infection
Drugs
Galactosemia
The baby-friendly hospital initiative has been shown to ____________.
increase the rate of breastfeeding even up to 1 year of age
The AAP recommends that children breastfeed for _____________.
at least 6 months exclusively and up to one year with food supplementation
What is the “golden hour”?
The first hour after birth, during which the AAP and WHO recommend starting to breastfeed (primarily because infants are awake during the first hour and then fall asleep).
Infants are designed to survive on _____________ for the first couple days.
the colostrum
They have fat stores to last for a couple days while the mom’s milk comes in.
Infants typically lose weight during the first ________ days of life.
5 (while they survive on their fat and the colostrum)
What are typical problems that arise during the first couple weeks of breastfeeding?
Mother positioning
Difficulty attaching
Mother not recognizing the baby’s signals
Why do infants get jaundice with difficulty feeding?
They need to dispose of bilirubin by stooling, and they won’t stool if they don’t eat.
Primary lactation failure (i.e., not making milk) is _______________.
very rare; most reports of deficient milk production are due to inadequate milk removal
Protein content is higher in _____________.
infant formula
Some evidence suggests that formula increases the risk of obesity because ______________.
bottles are designed to be extremely easy for infants to get milk from; as such, it’s hypothesized that bottles take away a step of self-regulation
How does infant growth compare between formula and breastmilk?
Same for the first three months and the formula-fed infants get heavier
Breastmilk banks are typically used in __________.
NICUs
Breastmilk is low in ____________. It’s thought that this is because infants’ kidneys are not as functional.
sodium
The are omega-______ in breastmilk.
3s
Breast-fed infants have more ___________ in their GI tracts.
commensal (“good”)
Note: this is thought to occur from the “bifidus factor” that supports non-pathogenic Lactobacillus.
How many calories does it cost the mother to produce breastmilk?
500 calories per day
What is the relationship between maternal diet and the contents of the breastmilk?
Electrolyte and mineral content is independent of maternal intake (with the exceptions of iodide and selenium), while vitamin content depends on maternal intake.
The AAP recommends continuing breastfeeding through _________ and the WHO recommends it through __________.
the first year of life; the second year of life
One reason the WHO’s is longer is that water is less safe for young children worldwide.
The largest constituent of breast milk is ____________.
water
What’s the typical timeline for neonatal metabolism?
- Glycogen stores last for the first twelve hours.
* Glucagon rises and releases triglycerides and stimulates gluconeogenesis.
