Lactation Flashcards

1
Q

What are two functions of the breasts?

A
  • Nutrition of the young

- Spacing of pregnancies

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2
Q

Where do the lactiferous ducts join the skin?

A

At the nipple

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3
Q

What causes the granular texture on the surface of the areola?

A

Sebaceous glands

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4
Q

What comprises the majority of breast tissue?

A

Adipose tissue from the pectoral fat pad

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5
Q

What is the function of Cooper’s ligaments?

A

Lift and support to the breasts

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6
Q

Breasts are modified ____ glands and are derived from _____ that arise between the axilla, armpit and groin

A

Sweat glands

Milk crests

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7
Q

Describe the embryological development of the breast.

A
  • Development starts ~6wks gestational age
  • Primary bud is a downgrowth of the dermis
  • Secondary bud develops into primary buds and form the lactiferous ducts
  • Breast bud lumen develops as gestation progresses
  • Canalisation induced by placental steroids
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8
Q

What is witch’s milk and why does it form?

A
  • Breasts are fully developed at birth and could produce milk
  • Exposure to placental steroids and maternal hormones can cause production of witch’s milk
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9
Q

What effect does oestrogen and progesterone have on the breast during puberty?

A
  • Promote growth of alveolar buds during menstrual cycle

- Successive cycles cause increased growth

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10
Q

What effect do the following hormones have on breast development and lactation?

  • Oestrogen
  • Progesterone
  • Prolactin
  • Growth hormone
  • Insulin and cortisol
A
  • Oestrogen: mitogen, essential for growth
  • Progesterone: branching of ducts
  • Prolactin: milk prod., alveolar development
  • Growth hormone: same family as prolactin
  • Insulin and cortisol: alveolar cell growth
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11
Q

What prevents milk production from occurring during pregnancy?

A

Inhibition by progesterone

  • Prevents production
  • Prevents milk ejection (smooth muscle relaxant)
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12
Q

What effect does baby suckling on the nipple have on hormone production?

  • Prolactin
  • Dopamine
  • VIP
  • Oxytocin
A
  • Induces secretion of prolactin by anterior pituitary
  • Decreases dopamine secretion
  • Induces secretion of VIP (vasoactive intestinal peptide), acts on lactotrophs
  • Synthesis and secretion of oxytocin from the posterior pituitary
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13
Q

What is the effect of oxytocin on the breast?

A

Induces contraction of myoepithelial cells of alveoli, causing injection of milk into ducts

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14
Q

What is the effect of prolactin on the breast?

A

Induces production of milk proteins

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15
Q

Through what mechanism does prolactin suppress FSH and LH?

A

Thought to be through effect on kisspeptin neurons in the hypothalamus

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16
Q

Where do supernumeroury nipples/breasts usually form?

A

On the embryonic milk ridge

17
Q

What are the four stages of lactation?

A
  1. Lactogenesis stage I
  2. Lactogenesis stage II
  3. Galactopoesis
  4. Involution
18
Q

What occurs in lactogenesis stage II?

A
  • PP 3-8 days is the start of large scale milk production

- Increase in a-lactalbumin, decreased Na and Cl in milk

19
Q

What causes dec. Na and Cl in milk in lactogenesis stage Ii?

A

Tight junctions in alveolar epithelium - reduce passage of salts

20
Q

What is galactopoesis?

Lactation

A

Maintenance of established milk secretion

21
Q

What is involution?

Lactation

A
  • Cessation of breast milk production approx 40 days after last feed
22
Q

How does the composition of colostrum compare to mature milk?

A
  • Less fat and sugar
  • More protein
  • Rich in antibodies, mainly IgA
23
Q

How dose lactose content in breast milk compare to cows’ milk? What is the significance of this?

A
  • 6.8g vs 3.3g

- Lactose is an energy source and used for myelination

24
Q

How does the casein:lactalbumin ratio compare in human and cows milk? What is the significance of this?

A
  • 1:2 vs 3:1

- A-lactalbumin increases production of lactose (enzyme inducer)

25
How does the linoleic acid content compare in human and cows milk? What is the significance of this?
- 8.3% of fat vs 1.6% of fat | - Obtained exclusively by diet
26
Water comprises ___% of breast milk volume
87.5%
27
Which components of breast milk help protect baby from infection?
- IgA - Lactoferrin - Lysozyme - Small signalling molecules - Phagocytes/lymphocytes/T cells
28
Humans take approx. ___ months to double birth weight
4-6 months
29
Does breast size affect milk production?
No, just milk storage
30
What are 3 benefits of breastfeeding for the mother?
• Spacing of offspring • Bonding to offspring • Enhances involution of the uterus • Protection against diabetes • Protection against post-partum depression • May protect against breast cancer May protect against ovarian cancer (esp. if feeding for longer than 12 months)
31
During the first ___ months of life the infant intestinal mucosa is permeable to proteins
6-9
32
Breast feeding reduces risk of the baby developing asthma to ___
0.7
33
What are some benefits of breastfeeding for the baby?
Protects against: - Childhood obesity - Infectious disease - GI infection - Otitis media - Atopy - Asthma - Adult obesity - Increases cognitive ability
34
Which infectious diseases can be transmitted via breast feeding?
- HIV - Mastitis - Hepatitis B
35
How does the concentration of alcohol in maternal plasma relate to that in maternal milk?
Similar in milk and maternal plasma
36
How does alcohol affect breast feeding?
- Babies do not suck as well | - May lead to feeding problems
37
What effect does excess caffeine consumption have on babies?
Sleeplessness and irritability
38
What is mastitis?
Inflammation of a lactiferous lobe