Physiological changes of Lactation Flashcards
Who is New born ?
Who are Neonate ?
- First 24 hrs of Life
Who are Neonate ?
From birth to under 4 weeks( <28 days)
Who are called Term Neonates?
Between 37 to < 42 gestational week
Who are Preterm neonates ?
< 37 gestational week
Who are post term neonates ?
> or equal to 42 gestational week
Who are called Infant?
child under one
What is the normal weight of the baby?
2.5 to 3.5
What is considered as Low Birth Weight (LBW) ?
<2500 GRAM
What is very Low Birth Weight ?
<1500 gram
What is extremely Low Birth Weight ?
<1000 gram
What are the physiological changes at birth ?
- infant’s adjustment to birth to the environment
- Resp
- Cvd
What is Intra - uterine Life ?
During pregnancy,the placenta
- supply - oxygen & nutrient (oxygen)
- eliminate -carbon dioxide & other waste
- Protect against shocks & temp changes ( amniotic fluid )
- Provides antibodies that gives protection agaisnt certain harmful microbes
What is extra - uterine Life ?
After birth, the infant adapts to the outside environment, the main changes that happens during this time is respiratory & cardiovascular.
During the resp adjustment, when is the development of lungs?
- changes that happen end of the 4th week
- changes happen by the end of 8th week
- Lungs are formed by the 8th week during pregnancy
How long does alveoli take to form completely ?
8 years
How long does Lung take to form completely ?
7 years
This is the reason asthma on childhood is very common & will recover once they’re 7/8 years old because it’s a developmental process
How many pnuemocytes ?
2 Pnuemocytes
* Type 1 Lung Alveoli
* Type 2 Lung Surfactant
What does the Type 1 pnuemocyte does ?
Forms the Lung cell alveoli
What does Type 2 Pnuemocyte ?
They form the surfactant, which lines the alveoli
What is Surfactant ?
Phospho - lipid rich
fluid
What is the function of Surfactant ?
To reduce the surface tension
What do you do for the mother with Premature babies ?
We give them Glucocorticoid injection which helps during labour
What are the transitions that happen at birth?
- Loss of metabollic support
- Infant is to begin breathing
- Child begins to breathe within seconds and has a respiratory rhythm within less thanm an 1 minute
How many mechanisms involved ?
3
What is mechanical initiation of Breathing ?
At birth, the walls of the alveoli are at first collapsed because of Viscid fluid ( surface tension) fill them up
How much negative inspiratory pressure is required to oppose the effects of collapsed alveoli at birth ?
More than 25 mmHg of negative inspiratory pressure in the lungs is required to oppose the effects and to open the alveoli for the first time.
Can the respiration get affected after alveoli is open during mechanical initiation ?
Yes, due to weak respiratory movements
How much does a infant’s first inspiration?
they are extremely powerful, could create 60mmHg negative pressure in the intrapleural ( the first breathe is with effort and the rest comes as normal)
What is Fetal lung fluid & how is it cleared from the airspaces?
One part of the fetal lung is filled with liquid - it’s mucus
What is the Fetal lung fluid is produced by ?
Fetal Lung epithelium through the active transport of chloride
When does the fetal lung fluid start to produce ?
From week 6 of gestation & goes out after birth
How will the fetal’s fluid from the lung goes out ?
As the chest passes through the birth canal, the lungs are compressed
about 60-110ml of fluid will be squeezed out of the lungs as the chest is compressed
What happens to the remaining fluid in the lung?
As soon as the Neonate start to breathe , rest of the fluid evaporates or reabsorbed by the circulatory system (blood vessels & lymphatics surrounding the lungs) or mainly by the sodium.
Which electrolyte enters the apical surfaces of type 2 cells and is pumped into the interstitium with water & other electrolytes passively ?
Sodium
- What are the Chemical Mechanisms/Events that take place ?
1) Cutting the cord, to remove the oxygen supply
2) Asphyxia occurs
3) Reduced O2 & CO2 and low pH (Acidosis)
4) stimulates the respiratory cnetre in the medulla & the chemoreceptors in carotid artery to initiate breathing by increasing the force and depth of respiration.
What are the sensory & thermal events ?
- Decrease in environemental temperature after delivery is a major stimulus of breathing.
- Furthermore, tactile nerve in the skin is stimulated
- Visual changes happen
- Auditory- sound changes
Where is the tactile nerve ending ?
Skin that are stimulated
How does visual change ?
Visual change from a dark world to one of light
How does auditory work ?
Audiotory- sound in the extrauterine environment stimulates the infant
What is the degree of hypoxia that an infant can tolerate ?
In adults, failure to breathe for only 4 minutes often causes of death but neonates can survive upto 10 minutes without breathing
What are the hormones that stops the active chloride mediated scretion of fetal lung fluid ?
- Cortisol
- Thyroid hormones
- Catecholamines
What are the problems with breathing at birth ?
Atelectasis meaning alveolar collapse ( collapsed lung )
What condition does the preterm birth associated with ?
Atelectasis & this can lead to Respiratory Distress Syndrome (RDS)
Babies that are born preterm are more likely to develop RDS - have tachypnoea ( more than 40)
Also assoc with DM ( child might have too much of cortisol assoc with pre-term labour)
What is the normal Respiration Rate for infant ?
30 to 40
RR of new born is ?
30 - 40
What happens in Gestational Diabetes ?
They will have extra fluid which lead to increase in too much strectch on the uterus and this can lead to preterm labour.
How to treat tachypneoa ?
Oxygen therapy
