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Bloc I - Reproduction > Sept12 A3-Breastfeeding > Flashcards

Sept12 A3-Breastfeeding Flashcards

1
Q

lactation consultant def

A

any health prof trained in breastfeeding medicine

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2
Q

right way to breastfeed

A

exclusively breastfeed infants for first 6 months of life and then breastfeed + complementary foods up to 2 years and beyond

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3
Q

problem of taking meds + breastfeeding

A

no prob. most meds post partum are compatible with breastfeeding

  • Abx
  • pain meds
  • etc
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4
Q

when to use infant formula instead of breast milk

A

only in some medical conditions where have to supplement the infant or maternal HIV or taking specific meds

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5
Q

glandular tissue of mammary glands extends where

A

up to axilla. so normal to have swelling there when lactate

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6
Q

areola def

A

area around the nipple

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7
Q

basic unit of mature glandular tissue secreting milk (milk secreting cells)

A

alveoli

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8
Q

architecture of mammary gland

A
  • each cluster of alveoli is surrounded by myoepith cells. eject milk in lactiferous ductules
  • each ductule merges into larger duct
  • open into nipple pore
  • 1 lobe = 1 duct
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9
Q

neurovasc supply of breast

A
  • internal mammary a.
  • lateral thoracic a.
  • intercostal nerves
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10
Q

mammogenesis steps (in a woman’s life)

A
  1. 4-week old embryo: milk strk is formed from a raised area of ectoderm
  2. 5 weeks embryo: ectoderm depresses into underlying mesoderm forming the milk line (or ridge)
  3. birth: breast contains milk ducts
  4. puberty: estogen and GH promote formation of alveoli and ductules
  5. tissue grows and prolif at each menstrual cycle bc of E and P
  6. complete dev only at pregnancy
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11
Q

lactogenesis I def

A

-first breastmilk prod between 15-20 weeks gestation UNTIL 2 days PP

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12
Q

hormones involved in lactogenesis 1

A
  • prolactin for nipple growth
  • human placental lactogen for areolar growth
  • estrogen (for prolif and diff of ductal system)
  • progesterone for dev of lobes and alveoli
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13
Q

lactogenesis 2 def

A
  • days 3 to 8 PP

- is the onset of mature milk secretion

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14
Q

why does the breast not secrete milk during pregnancy (secrete = production)

A

progesterone made by placenta inhibits prolactin

  • at birth, placenta removed, P falls
  • prolactin is uninhibited
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15
Q

main hormone involved in breast milk biosynthesis

A

prolactin

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16
Q

P falls after birth, what about estrogen?

A

also falls, and then stays steady

17
Q

(IMP) main hormones of lactation

A
  • prolactin

- oxytocin

18
Q

(IMP) prolactin charact and fct

A
  • prod by ant pit
  • dopamine (prolactin inhibiting factor is another name) inhibits it. TSH stimulates it
  • fct = initiation and maintenance of milk prod
19
Q

(IMP) oxytocin charact and fct

A
  • prod by hypothalamus and stored in post pit
  • released by post pit
  • released IN RESPONSE TO BEAST SENSORY STIMULATION
  • fct = contraction of myoepithelial cells and ejection of milk
20
Q

(IMP) what’s the milk ejection reflex

A
  1. breast suckling. stimulus for oxytocin release
  2. oxytocin released by post pit
  3. causes contraction of myoepith cells and milk ejection
21
Q

breast milk secretion in lactogenesis II vs after it

A
  • lactogenesis II = endocrine control (HP axis)

- after lactogensis II = autocrine control. supply-demand principle

22
Q

(imp?) autocrine control of breastfeeding after lactogen II

A
  1. supply-demand principle: more sucking and milk removal = more milk further produced
  2. when the breast is full of milk, it produces feedback inhibitor of lactation to inhibit milk PRODUCTION
23
Q

lactogenesis III def

A

day 9 PP to end of lactation and start of breast involution

24
Q

when breast involution starts PP

A

40 days after last breastfeed (ductules become smaller and go dormant)

25
Q

name of baby’s first milk + charact

A

colostrum

  • prod in day 1-3 PP (comes just before lactogenesis II)
  • differs from mature milk bc has low lactose and water, high protein, WBCs, surface IgA to coat the gut, etc.
26
Q

what stims start of lactogenesis II

A

drop in progesterone II which causes prolactin to be uninhibited

27
Q

colostrum other + effects on baby

A

laxative. helps them empty out meconian stool (black, green tarry) so can start having normal yellow stool

28
Q

milk components

A
  • lot of water
  • fat (TGs, FFAs)
  • lactose
  • proteins (high whey:casein ratio, essential aa, enzymes to help digestion)
  • vitamins, minerals, micronutrients
  • immunomodulatory components
29
Q

immunomodulatory components in mature milk

A
  • WBCs
  • antiinflam factors (PGs, cytokines)
  • GFs and hormones to promote immune def in gut
  • oligosacch and glycoconj to protect against parasites
  • Igs, lysozymes, lactoferrin to protect against specific bacteria and parasites
30
Q

(imp) short term benefits of breastfeeding + main one

A
  • decreased morbidity and mortality
  • decreased risk of infection (gastro, resp, otitis, sepsis) IS THE MAIN WAY***
  • establishment of healthy infant microbiome
  • decreased risk of sudden infant death syndrome
  • decreased asthma, allergies and eczema (atopy)
31
Q

(imp) long term benefits of breastfeeding

A
  • decreased risk of diabetes, obesity, hypercholesterolemia
  • increased dev, cognition, IQ
  • less risk of childhood cancers of blood
  • decreased risk of certain chronic diseases (celiac, etc.)
  • decreased risk of dental carries and malocclusion
32
Q

short term benefit of breastfeeding on the mom

A
  • bonding
  • less PP bleeding bc of oxytocin release
  • earlier return to pre pregnancy weight
  • lactational amenorrhea is 99.5% effective contraception (means breastfeed exclusively, every 4 hours, in infant <6 mo)
33
Q

long term benefits to the mom from breastfeeding

A

decreased risk of

  • breast ca
  • ovarian ca
  • endo ca
  • CVD
34
Q

prolactin importance in lactogenesis III

A

less imp bc now lactation and milk prod is autocrine

Bloc I - Reproduction (57 decks)

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