Pregnancy, nutrition and lactation

Question 1

How many more calories/day does a woman need in her 3rd trimester?

Answer 1

~200

Question 2

What are 3 supplements for pregnancy?

Answer 2

Vitamin D
Folic acid
Protein

Question 3

What is the role of vitamin D?

Answer 3

Enhances intestinal absorption of calcium and phosphate

Question 4

What given prevents vitamin D deficiency?

Answer 4

10mcg cholecalciferol

Question 5

Who is most at risk of a vital D deficiency?

Answer 5

Low sun exposure
Obesity
South Asian
Malnutrition

Question 6

What can vitamin D deficiency lead to?

Answer 6

Rickets
Bone fragility
Obstetric complications

Question 7

What does folic acid supplementation reduce the risk of?

Answer 7

Neural tube defects

Question 8

What is the role of folate?

Answer 8

Acts as a cofactor for enzymes involved in DNA and RNA biosynthesis

Question 9

What is the dose for folic acid?

Answer 9

400mcg or 5mg if increased risk

Question 10

Give 4 things to be avoided in pregnancy

Answer 10

Vitamin A supplementation
Alcohol
Too much caffeine
Foods (cheeses etc)

Question 11

What is lactation key for? (3)

Answer 11

Nutrition
Immunity
Bonding

Question 12

What are the 3 types of breast milk and when do they occur?

Answer 12

Days 1-3: colostrum
Days 3-14: transitional
Days 14+: mature

Question 13

What is colostrum?

Answer 13

High fat and nutritious first milk

Question 14

Why is it good that colostrum has a small volume?

Answer 14

Allows babies to get rid of excess fluid without overloading kidneys

Question 15

What 5 things is colostrum high in?

Answer 15

Antibodies
WBCs
Growth factors
Vitamin A
Vitamin K

Question 16

What are the roles of immunoglobulins in lactation?

Answer 16

Maternal immune response creates IgAs against microbes in environment
Secreted into breast milk

Question 17

What is the role of lysosomes in lactation?

Answer 17

Bacterial and anti-inflammatory action

Question 18

How does lactation provide contraception?

Answer 18

Prolactin suppresses ovulation by suppressing gonadotrophin release

Question 19

Describe the prolactin response

Answer 19

1. baby suckles
2. impulses sent from breast to brain
3. prolactin secreted by anterior pituitary and sent to breast
4. lactocytes produce milk

Question 20

Describe the oxytocin reflex in lactation

Answer 20

1. baby suckles
2. impulses sent from breast to brain
3. oxytocin secreted by posterior pituitary and sent to breast
4. myoepithelial cells contract and expel milk

Question 21

What is the role of FIL?

Answer 21

Feedback inhibitor of lactation

Causes lactocytes to ignore signals from prolactin when breast full

Question 22

Why is frequent feeding needed?

Answer 22

read notes here
Prolactin receptor theory
FIL

Question 23

Give 2 risks of not breastfeeding

Answer 23

Increased risk of gastroenteritis
pH imbalance
Increased risk of obesity, T1/2DM, dental malocclusion, respiratory tract infection, SIDS