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ESA 4 - Reproductive System > Lactation > Flashcards

Lactation Flashcards

1
Q

Where are the mammary glands found?

A

Embedded in breasts

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2
Q

Where are the mammary glands found?

A

Embedded in breasts

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3
Q

What are the mammary glands made up of?

A

15-24 lobulated masses of tissue, with fibrous and adipose tissue, and blood vessels, in between

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4
Q

What are the lobes of the mammary glands made up of?

A

Alveoli
Blood vessels
Lactiferous ducts

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5
Q

What is found on the surface of the alveoli of the mammary glands?

A

Contractile machinery

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6
Q

Where are the lactiferous ducts of the mammary glands found?

A

Lining the alveoli

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7
Q

What do the sinuses/lacunae of the lactiferous ducts lead to?

A

The nipple pores

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8
Q

Are mammary tissue and breast tissue the same thing?

A

No

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9
Q

How does development of the mammary tissue begin?

A

In utero, with invagination of the epithelium which takes some melanin

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10
Q

Describe the mammary tissue at birth?

A

Only a few ducts present

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11
Q

What happens to the mammary tissue at puberty?

A

Ducts sprout and branch, and alveoli begin development

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12
Q

What happens to mammary tissue with each menstrual cycle?

A

Changes in breast tissue occur with changes in oestrogen and progesterone

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13
Q

What is the result of oestrogen increase in pregnancy on the mammary tissue?

A

Causes development of ducts and alveoli, and the connection of the myoepithelial cells

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14
Q

What are the physiological stages of lactation?

A
  1. Preparation of breasts - mammogenesis
  2. Synthesis and secretion from the breast alveoli - lactogenesis
  3. Ejection of milk - galactokinesis
  4. Maintenance of lactation - galactopoiesis
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15
Q

When does mammogenesis occur?

A

During pregnancy

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16
Q

What happens in mammogenesis?

A

Hypertrophy of ductular-lobular-alveolar system
Prominent lobules form
Alveolar cells differentiate

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17
Q

When are the breasts capable of milk production?

A

From the 2nd trimester

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18
Q

What happens to the milk thats produced by the breasts?

A

It is secreted into the lumen of alveolar ducts

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19
Q

What happens to the breast towards the end of pregnancy?

A

Nipple becomes erect
Areola enlarges and becomes darker
Montgomery tubercles form
Breast becomes more sensitive

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20
Q

What is the purpose of the arerola enlarging and becoming darker towards the end of pregnancy?

A

So baby can see them when feeding

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21
Q

How do montgomery tubercles form?

A

Fusion of sebaceous glands with mammary lobules

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22
Q

What is the purpose of Montgomery tubercles?

A

Produce sebum which lubricates the nipples and prevents them from cracking during feeding
Produce pheromones which helps baby determine where the nipple is

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23
Q

Why does the breast become more sensitive towards the end of pregnancy?

A

Due to production of sensory neurones under the influence of oestrogen

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24
Q

How much milk is secreted during pregnancy?

A

Little

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25
Q

Why is only a little milk secreted during pregnancy?

A

Because there is a high progesterone/oestrogen ratio in early gestation which favours growth, not secretion

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26
Q

What does a high progesterone/oestrogen ratio stimulate in the breast?

A

Proliferation and growth of adipose

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27
Q

What is the importance of the proliferation and growth of breast adipose in pregnancy?

A

It is the raw material for milk

28
Q

How does a high progesterone/oestrogen ratio stop milk secretion?

A

It prevents the production of the prolactin receptor in the alveoli

29
Q

Where does lactogenesis take place?

A

In the alveolar cells

30
Q

Where is the fat for lactogenesis synthesised?

A

In the SER

31
Q

How is the protein secreted in lactogenesis?

A

Via Golgi apparatus

32
Q

What are the constituents of breast milk?

A 
Fat
Protein
Sugars
Neutrophils
Macrophages
33
Q

How do neutrophils and macrophages get into the breast milk?

A

Can enter the alveolar space (lumen)

34
Q

What is the purpose of the neutrophils and macrophages in the breast milk?

A

Protect against bacterial infection

35
Q

What is produced soon after birth (0-3 days)?

A

40ml/day of colostrum

36
Q

How does colostrum differ from breast milk produced later?

A

Less water, fat, and sugar
More protein, particularly immunoglobulins (IgA, IgM, IgG)
Contains white cells

37
Q

How many grams of immunoglobulins are there in colostrum?

A

19g

38
Q

What is the purpose of the immunoglobulins in colostrum?

A

Coat intestinal mucosa preventing bacteria from entering intestinal cells

39
Q

Why can’t you give a newborn cows milk?

A

Contains a lot of the protein casein, which the neonate can’t digest, and so gives colic, GI proteins, and watery diarrhoea

40
Q

What happens to the breast milk over the first two weeks?

A

Composition gradually changes to mature milk

41
Q

What is the composition of ‘intermediate milk’?

A 
90% water
7% sugar (lactos) 
3% fat
Proteins 
Minerals and vitamins
Endocannabinoids
42
Q

What proteins are found in the intermediate milk?

A

Lactalbumin
Lactoglobulin
Lacotoferrin

43
Q

What is the purpose of the endocannabinoids in breast milk?

A

Binds to cannaboid receptors, causing the baby to feel full, and so stop suckling, and feel sleepy

44
Q

What stimulates breast tissue growth?

A

High progesterone and oestrogen in pregnancy

45
Q

What allows secretion of breast milk?

A

Fall in steroids

46
Q

What promotes milk secretion?

A

Prolactin

47
Q

What is prolactin?

A

Polypeptide hormone

48
Q

What secretes prolactin?

A

Anterior pituitary gland

49
Q

What is prolactin secretion controlled by?

A

Dopamine from hypothalamus (inhibits)

50
Q

How do factors promoting secretion of prolactin exert their effects?

A

They reduce dopamine secretion

51
Q

What factors increase prolactin?

A

TRH

Oestrogen

52
Q

How does oestrogen cause the secretion of prolactin?

A

It causes lactotroph hyperplasia, which means there are more cells producing prolactin

53
Q

When is TRH produced?

A

When baby suckling

54
Q

Other than the anterior pituitary, where else is prolactin produced?

A

Decidua

55
Q

What does deciudal prolactin stimulate?

A

Colostrum

56
Q

Is decidual prolactin inhibited by dopamine?

A

No

57
Q

What is pituitary prolactin secretion promoted by?

A

Suckling - potent neuroendocrine reflex

58
Q

What does suckling at one feed do?

A

Promotes prolactin release, which causes production of the next feed, which accumulates in alveoli and ducts

59
Q

What is required to maintain milk production?

A

Sufficient suckling stimulus at each feed

60
Q

What happens if there is no suckling?

A

Milk production ceasses gradually, and there is turgor induced damage to secretory cells

61
Q

How can milk production be maintained by suckling?

A

Free feeding 1-3 hours apart/day

62
Q

How do babies get the milk from the breast?

A

They do not suck milk about of the breast, it is ejected by a ‘let down’ reflex

63
Q

How does the let down reflex work?

A

Baby suckling stimulates receptors on nipples, signal to hypothalamus causes oxytocin, which leads to milk ejection

64
Q

How does oxytocin lead to milk ejection?

A

Myoepithelial cells surround the alveoli, and are contracted by oxytocin to squeeze milk out of the breast

65
Q

Where is oxytocin release from?

A

Posterior pituitary

66
Q

How does galatopoeisis occur?

A

Oxytocin release is a neuro-endocrine reflex from suckling/expressing systems

67
Q

What stimulates the oxytocin neuro-endocrine reflex?

A

Anticipation of feed

Fondling the baby

ESA 4 - Reproductive System (31 decks)

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