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HUNT 243 > Lecture 7 - Lactation and Milk > Flashcards

Lecture 7 - Lactation and Milk Flashcards

1
Q

what are the functional units of the mammary gland

A

alveoli

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2
Q

each alveoli has a cluster of cells called what

A

secretory cells

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3
Q

what is in the centre of the cluster of secretory cells of the alveolus that secretes milk

A

a duct

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4
Q

ducts are arranged how

A

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

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5
Q

what cells surround the secretory cells and what do they do

A

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

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6
Q

the mammary gland is made up of what and how many

A

15-25 lobes

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7
Q

each lobe of the mammary gland has how many lobules

A

20-40 lobules

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8
Q

each lobule of the mammary gland is comprised of clusters of what and how many

A

40-100 alveoli

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9
Q

each lobe drains into its own what and delivers what

A

each lobe drains into its own collecting duct, delivery milk through pores to the nipple

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10
Q

alveoli are well what …. and what does this mean

A

alveoli are well vascularised so that oxytocin may reach them and cause surrounding myoepithelial cells to contract, squeezing milk out from lactocytes

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11
Q

what is the mammary gland development in puberty

A
  • ovaries mature and increase in oestrogen and progesterone initiates mammary lobular structure (lobes)
  • ductal system matures and nipple grows with pigmentation change
  • fibrous and fatty tissue increase around the duct
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12
Q

what is the mammary gland development in pregnancy ( 2 hormones that allow for further preparation)

A
  • human chorionic gonadotropin (HcG) and placental lactogen allow for further preparation
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13
Q

what is the mammary gland development in pregnancy ( a hormone that stimulates development of glands that …)

A

oestrogen stimulates development of glands that will produce milk

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14
Q

what is the ‘milk hormone’

A

prolactin

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15
Q

what is the mammary gland development in pregnancy ( a hormone that allows tubules to ….)

A

progesterone allows the tubules to elongate and epithelial cells that line the tubules to duplicate

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16
Q

what does prolactin stimulate

A

milk production via suckling (baby)

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17
Q

what is prolactin suppressed by

A

prolactin-inhibiting factors released by the hypothalamus during the last 3 months of pregnancy to allow for the body to prepare for milk production

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18
Q

what does oxytocin stimulate, what is this also known as

A

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

also known as letdown

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19
Q

what does oxytocin do during delivery of the baby

A

acts on the uterus during and after delivery, causing to to contract

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20
Q

what are the three stages of lactogenesis

A

lactogenesis 1 : colostrum

lactogenesis 2 : transitional milk

lactogenesis 3 : mature milk

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21
Q

when is colostrum produced and what is the production like

A

produced in the first couple days, low milk production

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22
Q

colostrum has high levels of :

A

white blood cells, immunoglobulin A, vitamin A

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23
Q

colostrum is high in …. and low in ….

A

high protein , low fat

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24
Q

when is transitional milk produced

A

1st couple days, up to 10 days

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25
Q

what is the milk production like for transitional milk and what is it stimulated by

A

increased milk production, stimulated by maternal hormones

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26
Q

what is the content of transitional milk like

A

higher protein and lower fat than mature milk

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27
Q

when is mature milk produced

A

begins around 10 days postpartum

28
Q

what is the milk composition like of mature milk

A

more stable

29
Q

how much mature milk is consumed by an infant on average during exclusive breastfeeding from 0-6 months

A

~780ml

30
Q

when should breastfeeding initiation begin

A

within the first hour of birth

31
Q

healthy term infants are born with reflexes to feed, what are they

A
  • suck and swallow in coordinated pattern
  • oral search reflex
  • rooting reflex
32
Q

what is the suck and swallow in coordinated pattern include

A

a gag reflex to prevent food and fluids into lungs

33
Q

what does the oral search reflex include

A

open mouth wide in proximity to breast and thrusting tongue forward

34
Q

what does the rooting reflex include

A

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

35
Q

what is the mechanics of breastfeeding (suction)

A

suction created within baby’s mouth causes the mothers nipple and areola to elongate and form a teat

36
Q

what is the mechanics of breastfeeding (jaw and tongue)

A

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

37
Q

what is the mechanics of breastfeeding (tongue, anterior and posterior) = what type of movement is this

A

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

38
Q

what initiates the swallow reflex in a baby

A

receptors in back of babys oral cavity

39
Q

what is the key to success of breastfeeding

A

proper latch and positioning

40
Q

what is meant by responsive breastfeeding

A

if the baby is left too long before being fed, it will become agitated and be very hard to feed

41
Q

what % of breast milk is water

A

about 88%

42
Q

what % of breast milk is fat

A

about 3.8%

43
Q

what % of breast milk is protein

A

about 0.9%

44
Q

what is the energy of breast milk

A

0.65-0.70kcal/ml

45
Q

what is the second largest component of breast milk and how much energy does this provide

A

fat is the second largest component and provide half the energy

46
Q

per feed : fat is what at the beginning and what at the end, and what are these called

A

fat is low in the beginning (foremilk) and high at the end (hindmilk)

47
Q

breastmilk contains cholesterol, what is this important for ?

A

essential component of cell membranes

48
Q

protein content of mature milk is … and what are the classes

A

relatively low

classes : whey, casein and non protein nitrogen

49
Q

what is the main carbohydrate in breastmilk and what does this enhance

A

lactose, enhances calcium absorption

50
Q

what are Human milk Oligosaccharides (HMOs)

A
  • complex, indigestible, medium length CHO with lactose on one end
51
Q

prebiotic is a functional ingredient of human milk, what does this stimulate

A

stimulate growth of Bifidus bacteria and inhibits Escherichia coli

52
Q

what do prebiotics in breast milk prevent

A

prevent binding of pathogenic microorganisms to the surface receptors of their target cells : preventing infection

53
Q

what are the two groups of vitamins and minerals

A

group 1 and group 2

54
Q

what are group 1 vitamins and minerals

A

affected by maternal status

55
Q

what are group 2 vitamins and minerals

A

not affected by maternal status

56
Q

in group 1 nutrients low maternal intake or stores means what for the breast milk and therefore the infant

A

reduces the amount in breast milk, affects infant development

57
Q

what is the iron concentration of breastmilk like

A

iron concentration is low but it is highly bioavailable

58
Q

what is the absorption of iron from breastmilk like, compared to cows milk based formulas

A

50% of iron in BM compared to 10% iron from cow’s milk based formulas

59
Q

what is a major determinant of anaemia risk during infancy

A

infant reserves at birth

60
Q

what is the vitamin D content of breast milk like

A

low

61
Q

why is supplementation of vitamin D in the mother not really helpful to increase vitamin D content of breast milk

A

doesn’t increase the breast milk concentrations enough

62
Q

what is the recommendation for vitamin D and breastfed infants and when would this be appropriate

A

exclusively or partially breastfed infants may benefit from vitamin D supplementation, would be appropriate from 4 weeks of age until the infant is mobile or up to 12 months of age

63
Q

what are prebiotics

A

oligosaccharides

64
Q

what are examples of group 1 nutrients

A
  • thiamin
  • riboflavin
  • vitamin B6
  • vitamin B12
  • iodine
  • selenium
65
Q

where is prolactin released from

A

the anterior pituitary

66
Q

examples of group 2 nutrients

A
  • vitamin D
  • folic acid
  • calcium
  • iron
  • copper
  • zinc

HUNT 243 (30 decks)

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