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Scientific Basis of Midwifery > Properties of Breastmilk > Flashcards

Properties of Breastmilk Flashcards

1
Q

What are the main properties of breastmilk?

A
  • Species specific
  • Adapted to meet nutritional and anti-infective requirements of baby
  • A ‘living’ food - ‘white blood’
  • Adapts throughout BF continuum
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2
Q

How is breastmilk adapted for a baby that is preterm?

A

Contains more energy, lipids and proteins

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3
Q

Give some factors that influence breastmilk composition

A
  • Stage of lactation
  • Gestational age
  • Stage of feeding (beginning or end)
  • Baby’s demand
  • Degree of fullness/emptiness of breasts
  • Variation of breastmilk maturation during lactogenesis
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4
Q

How does the breastmilk adapt if the baby is ill?

A

Cells in mother can detect the illness and produce antibodies to transfer in breastmilk

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5
Q

What is colostrum?

A
  • Lower in volume
  • Anti-infective and anti-viral properties
  • Rich in protein and minerals
  • Lower in carbohydrates and fat
  • Important for priming and protecting baby’s gut
  • Has a laxative effect
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6
Q

Why is colostrum lower in volume?

A

Allows baby to learn how to suck and swallow while breathing

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7
Q

Why does colostrum have a laxative effect

A

Increases bowel movements because meconium contains many RBC so body needs to get rid of it as digested products of RBC can cause jaundice

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8
Q

What is the average volume of milk?

A
  • Colostrum = 7-14ml/ feed (37ml in first 24 hours)
  • By day 5 = 500ml/24 hours
  • By 6 months = 800ml/24 hours
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9
Q

How much weight should newborns be putting on per day?

A

10g/kg

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10
Q

What is the nutritional value of breastmilk?

A
  • BF is interactive and helps infant determine composition of feed
  • 80% water
  • Contains fat, lactose, protein, vitamins and micronutrients
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11
Q

Describe the fat content in breastmilk

A
  • Main source of energy
  • Provides half of breastmilk calories
  • Most variable component
  • 98-99% triglycerides
  • Long chain polyunsaturated fatty acids
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12
Q

Describe the fat gradient

A
  • Low fat at beginning of feed to quench thirst

- More fat at end of feed to satisfy hunger

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13
Q

Describe the carbohydrate content of breastmilk

A
  • Lactose
  • Oligosaccharides
  • Galactose
  • Fructose
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14
Q

Describe lactose

A
  • Accounts for majority of carbohydrates
  • Affected by maternal diet
  • Enhances calcium absorption
  • Metabolises readily into galactose and glucose
  • Requires lactase to be converted
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15
Q

What are the 2 main types of protein in breastmilk?

A

Whey and casein

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16
Q

Describe the quantities of whey and casein proteins

A
  • Casein low in early lactation, then rapidly increases
  • Whey highest in early lactation, then rapidly falls
  • Ratio whey:casein
    Early lactation = 90:10
    Mature milk = 60:40
    Late lactation = 50:50
17
Q

Describe whey proteins

A
  • Form soft curds
  • Quickly digested
  • Continuous nutrient flow
  • Play important role in immunological defence
  • Examples: Serum albumin, Lactoferrin, Lysozyme
18
Q

Describe casein proteins

A
  • Form a tough, less digestible curd

- Requires high energy expenditure for incomplete digestion

19
Q

Describe the vitamins and micronutrients in breastmilk

A
  • Vary with maternal diet
  • Vitamins A and E
  • Vitamin K in small amounts
  • Little vitamin D
  • Small amount of iron
  • Lactoferrin
20
Q

Why does vitamin K content increase?

A

Rises at lactation matures and baby’s gut is colonised with bacteria

21
Q

What is lactoferrin?

A

Iron transfer factor - absorbed into blood and is an anti-infective (sits in gut and ‘catches bugs’)

22
Q

What are the anti-infective properties in breastmilk?

A
  • Healing properties (sticky eyes)
  • Bifidus factor
  • Transfer factors (e.g. lactoferrin)
  • WBC
  • Viral fragments
  • Oligosaccharides
  • Anti-inflammatory molecules
  • Influence on gut pH
23
Q

Describe the layers of protection that breastmilk provides

A
  • Top tier; secretory antibodies
  • Fatty acids and lactoferrin
  • Oligosaccharides
24
Q

Describe immunoglobulins

A
  • Antibodies from previous maternal infections
  • slgA (secretory immunoglobulin A) - coats and lines the digestive tract
  • Entro-mammary and broncho-mammary pathways
25
Q

What does breastmilk contain that formula doesn’t?

A
  • Enzymes
  • Growth factors
  • Anti-parasites
  • Anti-viruses
  • Hormones
  • Antibodies
26
Q

What do both breastmilk and formula contain?

A
  • Water
  • Protein
  • Carbohydrates
  • Fat
  • Vitamins and minerals
27
Q

Describe milk marketing

A
  • Food Standards Agency monitors formula
  • If additives are found to be beneficial, they have to be added to all formula
  • No milk that is better than another
  • Milk companies adapt statistics to make them look better

Scientific Basis of Midwifery (22 decks)

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