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HUNT243 > Lecture 7 > Flashcards

Lecture 7 Flashcards

Lactation and Human Milk

1
Q

Lactation Physiology: Alveoli

A

Are the functional units of the mammary gland

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2
Q

Each alveolus has a cluster

A

of cells (secretory cells) with a duct in the centre to secrete milk

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3
Q

Ducts are arranged like

A

Branches of a tree with each smaller duct leading to 6-10 larger collecting ducts, leading to the nipple

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4
Q

…… surround the secretory cells and contract under the influence of …. and cause milk to be ejected into ducts

A

Myoepithelial cells

oxytocin

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5
Q

Within each lobes there are …

A

Within each lobes there are lobules within the lobules are the alveoli, there are a large number of blood cells surrounding to bring hormones to the cells

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6
Q

Mammary gland Development: Puberty

A

-Ovaries mature and increase in estrogen and progesterone initiates mammary lobular structures (lobes) complete 12-18 mo after menarche

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7
Q

What increases around the duct

A

Fibrous and fatty tissue

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8
Q

Ductal system matures and

A

Nipple grows with pigmentation change

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9
Q

Mammary Gland development: pregnancy

Human chrionic gonadotropin and ……

A

Human chrionic ganadotropin and placental lactogen allow further preparation

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10
Q

Mammary Gland development: pregnancy

Estrogen stimulates

A

Development of glands that will produce milk

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11
Q

Mammary Gland development: pregnancy

Progesterone allows

A

The tubules to elongate and epithelial cells that line the tubules to duplicate

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12
Q

Lactation hormones

A

Prolactin
Oxytocin

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13
Q

Prolactin stimulates

A

Milk production via suckling (baby)

Suppressed by prolactin inhibiting factors released by the hypothalamus during the last 3 mo pregnancy to allow for the body to prepare for milk productiomn

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14
Q

Oxytocin stimulates

A

Ejection of milk from the milk gland into ducts via suckling (baby)

also known as ‘Letdown’

feels like tingling, tightning or shooting pain 1min=contraction in milk ducts

also acts on the uterus during and after delivery, causing it to contract (shrink back to pre-pregnancy size)

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15
Q

Lactogenesis

A

Milk production

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16
Q

Lactogenesis 1

A

Colostrum
- Produced in 1st few days
- Low milk production
- High levels of white blood cells, immunoglobulin A, Vitamin A
- High protein, low fat

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17
Q

Lactogenesis 2

A

Transitional milk
- Produced after 1st couple of days up to - 10 days
- Increased milk production, stimulated by maternal hormones
-Higher protein and lower fat than mature milk

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18
Q

Lactogenesis 3

A

Mature Milk
-Begins around 10 days postpartum
-780ml consumed by infants on average during exclusive breastfeeding from 0-6months
-Milk composition is more stable

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19
Q

Breastfeeding initiation

A

within the first hour of birth

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20
Q

Healthy term infants with reflexes to feed

A

Suck and swallow
Oral search reflex
Rooting reflex

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21
Q

Suck and swallow in a coordinated pattern

A

Includes a gag reflex to prevent food and fluids into the lungs

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22
Q

Oral search reflex

A

Open mouth wide in proximity to breast and thrusting tongue forward

23
Q

Rooting reflex

A

Turn to head to side when stimulated on side of upper or lower lip

24
Q

Mechanics of breastfeeding :
Suction created …..

A

within babys mouth causes the mothers nipple and areola to elongate and form a teat

25
Q

Mechanics of breastfeeding :
Babys jaw

A

moves her tongue toward the areola, compressing it and causing milk to travel from the milk ducts to babys mouth

26
Q

Mechanics of breastfeeding :
Baby then raises anterior

A

portion of tongue and depresses and retracts posterior portion of tongue= peristaltic motions forming a grove in the tongues that channels milk to back of oral cavity

27
Q

Mechanics of breastfeeding :
Receptors in back of babys

A

Oral cavity initiate swallow reflex

28
Q

Mechanics of breastfeeding :
Key to success

A

Proper latch and positioning

29
Q

Establishing breastfeeding

A

-Skin-to-skin contact
-Staying hydrated
-Responsive feeding
-Emptying breasts -removal signals production

30
Q

The more the baby is feeding on the breast the more

A

milk that is being made

31
Q

Typical milk production

A

600ml in first month 750-800ml by 4-5 month

can range from 450 to 1200ml per day in one infant

Inreases to meet demand (twins, triplets -no problem

32
Q

Lactation support

A

Midwives and Lactation Consultants

33
Q

How much water makes up breastmilk

A

about 88% of water

34
Q

women need to remain …. during pregnancy

A

Hydrated (drink to thirst)

35
Q

where does the energy in the breastmilk come from

A

The largest component is fat (lipids).

-Fat is low in beginning (foremilk) and high at the end (hindmilk)
-Correlated with the mothers diet, including trans fatty acid intake
-Contains cholesterol, essential component of all cell membranes

36
Q

Protein in breastmilk

A

Protein content of mature milk is relatively low
Classes: Whey, casein and non-protein nitrogen (nucleotides)

37
Q

Carbohydrate in Breastmilk

A

Mostly lactose which enhances calcium absorption

38
Q

Oligosaccharides ???

A

Human milk oligosacharides

Prebiotic -a function ingredient of human milk
- Stimulate growth of bifidus bacteria and inhibits Escherichia coli
-Prevent binding of pathogenic microorganisms to the surface receptors of their target cell= preventing infection

39
Q

Vitamins and minerals

A

Micronutrient categories based on the effect of maternal intake and status on the micronutrient content of breast milk

40
Q

Vitamins and minerals:
Group 1

A

Affected by maternal status

41
Q

Vitamins and minerals:
Group 2

A

Not affected by maternal status

42
Q

Group 1 nutrients:
Low maternal intake or ……… which affects ……..

Breastmilk can be restored by……
Infant stores are low and …..

A

stores reduce the amount in breast milk
- affects infant development

-Breastmilk concentration can be restored by increasing maternal intake
-Infant stores are low and readily depleted, depend on adequate supply form breast milk

43
Q

Influence of maternal intake and status on breastmilk

A

If the supplementation of certain nutrients increased the deficiency of the status decreases

44
Q

Iron in human milk

A

Iron concentration is low in human milk but is highly bioavailable

45
Q

Iron in breast milk compared to formula

A

Approximately 50% of iron in BM is absorbed compared to 10% or iron from cows milk based infant formulas

this is why they put a lot of iron into infant formulas because they know that only 10% can be absorbed

46
Q

Human milk contains an important substance called …..

A

Lactoferrin
-Lactoferrin is a protein with an anti-tumor effect, and has been found to significantly inhibit the growth of some cancerous cells

-It also helps our little ones to absorb their own Iron stores

-It binds to the iron inn their body, which prevents it from being accessed by harmful micro-organisms that need iron to survive

47
Q

Iron deficiency: infants reserves at birth….

A

Infants reserves at birth is a major determinant of anemia risk during infancy

48
Q

Breast milk provides sufficient iron until the infant is

A

6 months

49
Q

Sustained Iron deficiency may be associated with…

A

irreversible and detrimental effects on intellectual and motor performance (irreversible)

50
Q

Vitamin D in Breastmilk

A

Breastmilk is low in Vitamin D (20-70 IU/L)
- Infant formula is fortified with 200 IU/L

51
Q

Low Vitamin D status in infants can result in

A

Rickets =soft , weakened bones

52
Q

To increase the Vitamin D content of breast milk requires…

For every….

A

The mother to consume high dose supplmental vitamin D

For every 1000 IU/day of vitamin D consumed by the mother breast milk vitamin D concentration increases by approximately 10IU/L

53
Q

A study carried out in auckland with Vitamin D showed

A

The mothers supplement was sufficient to help the mothers status but not the babies, so now it is recommended that each baby that is breastfed then they need to be given the supplement directly

54
Q

Recommendation: NZ Supplementation of Vitamin D for breastfed infants

A

-Exclusively or partially breastfed infants may benefit from vitamin D supplementation

-Vitamin D supplementation is appropriate until the infant is mobile, or up to 12 months of age

-Should be offered as a prescription by 4 weeks of age

HUNT243 (9 decks)

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