Lactation Flashcards
What are the two stages of lactation?
Lactogenesis stage 1: mid gestation to day 2 postpartum. It prepares the breasts tissue for milk production (alveolar development).
The withdrawal of the placental steroids is responsible for the onset of lactation. E2 and P4 inhibit breast responsiveness to prolactin. After parturition the suckling stimulus then causes the release of colostrum.
Lactogenesis Stage 2
Day 3 to day 8 there is a change in the milk. Increased alpha-lactalbumin decreased sodium and chloride due to tightness of epithelial gap junctions.
Galactopoiesis - maintenance of established milk secretion..
Involution - 40 days after the last feed, due to build up of inhibiting substances.
What is the difference between colostrum and mature milk?
Colostrum contains less sugar and less fat than mature milk - less about energy.
Colostrum contains more total protein than mature milk particularly antibodies and mainly IgA (not well developed in babies).
What are the major components of milk?
Phagocytes (90%), lymphocytes (10%) and T cells (4%). 10x10^10 cells
Small soluble signalling molecules (prostaglandins, cytokines growth factors).
Enzymes, amalase and lipase
Lipids
Lactose is the major carbohydrate
Immunoglobulins - IgA
Lactoferin
Lysozyme
vitamins
water (87.5% by volume)
What are the benefits of breast feeding for mother?
Spacing out of offspring.
Weight loss after pregnancy.
Bonding to offspring, eye contact is important.
Enhances involution of the uterus
Protects against breast and ovarian cancer.
Prevents the onset of type II diabetes for the mother and reduces post-partum depression.
What are the benefits of breast feeding for baby?
Breastfeed babies do not tend to be over fed (prolactin regulation). Makes them lighter and more lean than formula fed.
It may confer a slight protection against childhood obesity.
In places with high infant mortality and morbidity - breast feeding a can reduce poor outcomes because it is sterile - reduced chances of GI infections, provides antibodies.
Protects against otitis media, the longer they are breastfeed the better.
Protective against developing atopic reactions, such as eczema. Infant intestinal mucose is leaky during the first 6-9 months that may expose the baby to allergins. IgA in the milk may prevent this access of allergens.
Protective against developing asthma.
Protects against type I and type II diabetes and obesity in later life.
Protects against sudden infant death syndrome.
Cognitive ability DHA is suggested to promote cognitio
What can be passed the the infant through breast milk?
HIV - in developed countries we can provide formula, but this is not always possible in developed countries (need to way up pros and cons).
Alcohol - babies do not suckle well after drinking alcohol milk.
Caffeine - not processed well by the baby and it can build up over a week or so. Normal caffeine intake is OK but excess is associated with sleeplessness and irritability of the infant
Nicotine - found in the urine of babies from the house of smokers. Also in those who are bottle fed.
What disease can not transmit disease?
Mastitis
Hepatitis B - as long as vaccinated
What is mastitis?
Bacterial infection of a lactiferous lobe, breast appears red and often in a triangle. Do not need to stop breast feeding, and it may actually help resolve the infection.
