1
Q
human milk is bacteriostatic, what does that mean?
A
- inhibits bacteria from growing and reproducing
2
Q
what substances does oligosaccharides inhibit the proliferation of:
A
- fungal, viral pathogens, bacteria
- indirectly modifies the cellular response of the infants epithelial and immune cells
3
Q
how long can human milk be stored for at room temperature?
A
- 4-6 hours
4
Q
each mothers milk is:
A
- unique
- changes to meet the needs of the infant
- changes with gestational age and health of infant, time of day
5
Q
what is something that does not change about milk
A
the quality
6
Q
what is different in milk for preterm infants
A
- higher in protein and anti-infective properties
7
Q
stage 1 of lactation
A
- production of colostrum in third trimester and 2-4 days after birth
8
Q
what is considered the ‘first immunization’
A
- colostrum
9
Q
what is in colostrum
A
- lactose (excrete meconium, prevents hypoglycaemia)
- laxatives
- whey/casein (protein)
- 10 amino acids
- stem cells
- immunoglobulins
10
Q
stage II of lactation
A
- start of copious milk secretion
- days 2-3 to 8 days PP
11
Q
stage 3 of lactation
A
- secretion of mature milk
12
Q
changes in breast milk through the day
A
- breasts feel fuller in the morning
- higher in fat content in the night (helps with sleep)
13
Q
maternal diet with breast milk
A
- the amount of fat in the most diet does not affect the amount of fat in human milk but type of fat influences the fatty acids
14
Q
how does the infant change what is in the breast milk?
A
- by their salivary amylase
15
Q
if breast feeding 2 different children
A
- each breast can accommodate for each child and produce what is needed for each
16
Q
what happens when the mom gets sick?
A
- her immune system will create antibodies in response to the pathogens the infant is exposed to
17
Q
when does breast development occur during pregnancy
A
- around 5 weeks gestation due to the placenta to cause lobules and alveoli to develop
18
Q
mammogenesis
A
- rapid development of additional glandular tissue and ducts and darkening of areolar pigments
19
Q
lactogenesis 1
A
- lactating colostrum
- onset of milk secretion and continues for the first few days
- influenced by hormone prolactin
- progesterone inhibits milk production
20
Q
Lactogenesis II
A
- the stage of the full secretory activity of alveolar cells and the production of milk
- copious milk 2-3 days after birth
- milk coming in
- under the endocrine control
21
Q
what are the benefits of colostrum
A
- decreases permeability of infants gut - prevents large particles from entering
- helps the gut mature
22
Q
galactopoiesis (lactogenesis 3)
A
- maintaining milk production
- by day 10 it is mature milk
- under autocrine control (dependent on infant sucking/removal)
23
Q
involution
A
- termination of milk production
- takes 40 days after last feed
24
Q
what is polymastia
A
- accessory mammory tissue in the axilla along the primitive milk line
- occurs in 0.22-6%
25
how to fix polymastia
- with patience, time, cold therapy and will involute on its own
26
what is polythelia
- accessory or supernumerary nipple
- occurs in 1-5%
- associated with renal or other organ developmental anomalies
- most common on axilla or thorax
27
what are the main nutritive components in breast milk and their %;
- lactose: 7%
- fat 4%
- Protein and other: 1%
- water 87%
28
infant do not need what in the first 6 months of life?
- water as breast milk is mainly composed of water
29
what triggers moms to feel thirsty when breastfeeding?
- oxytocin
30
components of carbohydrates
- lactose (40% of bodies cal needs)
- oligosaccarhides
31
what does lactose aid in
- metabolizes into galactose and glucose
- energy for brain growth
- prevents hypoglycaemia
- increases calcium absorption
- facilitates the passage of meconium
32
oligosaccharides aids in
- protecting the gut from harmful organisms py promoting growth of bifidus factor
- promote colonization with lactobacillus bifidus (probiotics)
- prevents NEC, inhibits growth of pathogenic bacteria
33
what are the main proteins
- whey and casein
34
whey aids in
- smooth protein
- form soft curds that are easily digested
- Contains lactoferrins, lysozyme
35
lactoferrin
- an iron building protein
- high in human milk
- is bacteriostatic - deprive pathogens of iron preventing overgrowth
- promotes lactobacillus bifidus enhancing iron absorption
- is higher in preterm milk
36
lysozyme
- main component of whey
- breaks down outer cell wall of gram positive and negative bacteria
- higher con. in human milk over bovine
-
37
casein aids in
- absorption of iron
38
what is the main source e of energy for the infants
- fat (50%)
39
long chain polyunsaturated fatty acids has good effects on infant:
- growth, cognitive development, membrane function, vision function, and neurological development
40
what is the most variable component of breast milk
- fat
- increases throughout a feed and as they get older
41
why is long chain polyunsaturated fatty acid important for moms?
- estimated 30% of human milk are from maternal diet
- foods: fish oil, marine algae, linseed, canola, egg yolk
42
what are the 2 main types of WBCs in human milk
- phagocytes 90%
- lymphocytes 10%
43
phagocytes function to:
- engulf and absorb pathogens
- produce ;lactoferrin and lysozyme
- arrive first at an inflamed site (mastitis)
44
lymphocytes (B & T lymphocytes) function to:
- involved in creating antibodies targeted against specific microbes
- kill infected cells directly or sends chemical message
- strengthen an infants own immune response
45
what causes the infants thymus gland from growing
- breast feeding
- where T-lymphocytes to fully mature
46
what do immunoglobulins play a role in?
- mucosal immunity
- respiratory, GI tracts
47
leptin hormone functions to regulate:
- body fat
- food intake and body weight
- hunger and appetite
- metabolism of sugar and lipids
48
adiponectin hormone functions to:
- metabolism sugars and lipids
- mediation of insulin in peripheral tissues
49
what is important about the initial microbiome
- key determinant of human health
- is the foundation for immune development
50
prolactin developed from
- once placenta is out and progesterone has decreased
- prolactin secreted from anterior pituitary gland
- stimulate alveoli to secrete milk
51
how does prolactin increase?
- increase with sucking
- increase with sleep
52
oxytocin developed from
- posterior pituitary
- stimulate alveoli to eject milk into ducts
53
what does oxytocin do
- causes uterine contractions
- milk flow into ducts
- calming effects, decrease stress, and attachment
- bonding
54
primary insufficiency (mammary hypoplasia)
- low glandular tissue
- primary cause of failed lactogenesis II
- no changes during pregnancy
54
what are the key principles in supporting milk production (3 E's)
- Early and often
- Effective feeding
- Exclusive breastfeeding
55
physical symptoms of mammary hypoplasia
- widely spaced and tubular-shaped breasts
- large areola
- freq asymmetric breasts
56
nipple conditions slowing milk production
- inverted nipple
- difficulty latching
57
hormonal issues affecting milk supply
- retained placental products
- PCOS
- low thyroid
- Sheehan syndrome (pituitary gland)
NSPN 7150
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