6 - Nutrition during Lactation

Question 1

Process of Mammary gland development

Answer 1

Puberty: Ovaries Maturation - Estrogen and Progesterone Hormone increased - Lobular structure in the mammary gland is starting to develop - Ductal system is matured
Pregnancy: Luteal and Placental hormones is produced - Milk glands starting to develop - Tubules elongation and epithelial cells duplications

Question 2

Hormones that stimulate Milk glands development ____ and tubules elongation & epithelial cells duplication stimulate by _______

Answer 2

Estrogen ; Progesterone

Question 3

Characteristic of Ductal system Maturation

Answer 3

Increase of Fibrous and Fatty tissues around the ducts

Question 4

6 hormones that contributing to breast development and lactation

Answer 4

Estrogen
Progesterone
Growth Hormone
Placental Lactogen
Prolactin
Oxytocin

Question 5

Estrogen has a role of ______ during lactation and in which stage of lactation is occur?

Answer 5

Ductal Growth ; Mammary gland differentiation with menstruation

Question 6

Progesterone has a role of ______ during lactation and in which stage of lactation is occur?

Answer 6

Alveolar development; After onset of menses and during pregnancy

Question 7

Human Placental Lactogen has a role of ______ during lactation and in which stage of lactation is occur?

Answer 7

Alveolar Development; Pregnancy

Question 8

Prolactin has a role of ______ during lactation and in which stage of lactation is occur?

Answer 8

Alveolar development and Milk Secretion; Pregnancy and Breastfeeding (trimester of pregnancy to weaning)

Question 9

Oxytocin has a role of ______ during lactation and in which stage of lactation is occur?

Answer 9

Letdown->Ejection of milk; From the onset of milk secretion to weaning

Question 10

There are 3 steps of Lactogenesis, define each steps of lactogenesis.

Answer 10

Lactogenesis I: 2nd and 3rd trimester extends through 0-2 days od postpartum - Colostrum production ( High in sigA & vitamin K) - Lactose and protein increase
Lactogenesis II: 2-5 postpartum - Increased blood flow into mammary gland - increase the volume of milk when baby increase suckling
Lactogenesis III: 10 days postpartum - Foremilk ( increase water and lactose) Hindmilk ( increase fat and energy) - Milk composition more stable

Question 11

Components of Milk

Answer 11

Lactose
Milk fat
Immunoglobulin
Other plasma proteins and componenst
water
Sodium
Potassium
Chloride

Question 12

Lactose is produced in ____ and secreted in ___

Answer 12

Secretory cells; Ducts (exocytosis)

Question 13

Milk Fat is coming from ____ and secretes in ___

Answer 13

Triglycerides from mothers’ blood and new fatty acid in the breast; ducts

Question 14

Immunoglobulin is coming from ____ and secretes in ___

Answer 14

Mothers’ blood and taken into alveolar cells; ducts

Question 15

Water, Sodium. Potassium, and Chloride are using _____ to transport

Answer 15

Passive Diffusion

Question 16

Pathway for Other plasma components and Leukocytes is ______

Answer 16

Paracellular Pathway (Pass directly between Cells)

Question 17

Letdown Reflex Mechanism

Answer 17

Stimuli pass through the nerves into the hypothalamus - oxytocin hormone release from posterior pituitary gland

Question 18

4 types of stimuli that cause letdown reflex

Answer 18

Infant suckling
Hearing a baby cry
Sexual Arousal
Nursing Thinking

Question 19

Hormones that cause contraction of myoepithelial cells is ______

Answer 19

Oxytocin

Question 20

Milk secretion is caused by _____ hormones and milk ejection is caused by _____

Answer 20

Oxytocin; Prolactin

Question 21

During Lactation the mothers need additional ___ kcal for first 6 months and ____ kcal per day afterwards

Answer 21

330;400

Question 22

Common Nutritional problems during lactation are

Answer 22

Inadequacy of folate, thiamin, vitamin A, calcium, iron, and zinc

Question 23

Effect of Protein-calorie malnutritions is ________

Answer 23

Decrease Volume of milk

Question 24

Advantages of Breastmilk rather than Formula milk

Answer 24

Protects infants from infectious and chronic diseases
Changeable over a single feeding, over a day, according age of infant
Contains hundreds of components

Question 25

Nutrition in Breastmilk are

Answer 25

``` Colostrum Water Energy Lipids Protein Milk Carbohydrates Water&Fat Soluble vitamins Minerals ```

Question 26

Benefits of consuming Colostrum

Answer 26

Have the highest of mononuclear cell that provides immune protection

Question 27

Breast milk is _____ to plasma

Answer 27

Isotonic

Question 28

Water allows suspension of several components, include

Answer 28

``` Milk Sugar Proteins Immunoglobulin A sodium Potassium Citrate Magnesium Calcium Chloride Water-soluble vitamins ```

Question 29

Milk Production of first month postpartum is _____ml per day and 4-5 months ___-___ ml per day

Answer 29

600;750-800

Question 30

Lipid composition in Breast milk

Answer 30

DHA Trans Fatty acids Cholesterol

Question 31

3 effects of maternal diet on fat composition

Answer 31

Does not vary according to maternal diet Fatty acid profile reflects the variation of dietary fatty acid intake during pregnancy and postpartum Low fat and low adequate calories from carbohydrate and protein then medium-chain fatty acid is synthesized in breast

Question 32

3 types of protein in breast milk

Answer 32

Casein Whey protein Nonprotein Nitrogen

Question 33

5 types of Milk Carbohydrates

Answer 33

``` Lactose Oligosaccharides Monosaccharides (glucose) Polysaccharides Protein-bound carbohydrates ```

Question 34

4 fat soluble vitamins in Breastmilk

Answer 34

Vitamin A Vitamin D Vitamin E Vitamin K

Question 35

Vitamin that response to the content of maternal diet

Answer 35

``` Thiamin Riboflavin Vit B6 Bit B12 Choline ```

Question 36

Folate is bound to ______ in human milk and it's less influenced by _______

Answer 36

Whey protein; Maternal Intake

Question 37

The highest amount of Mineral in Breast milk is _____

Answer 37

Calcium

Question 38

Why minerals are lower in breast milk rather than other mammalian milk?

Answer 38

Reduce the workload on kidneys

Question 39

Benefit of breastfeeding in hormonal level for mothers

Answer 39

Increased level of oxytocin - stimulates uterine contraction Ovulation Delay - the long interval between pregnancies Minimize maternal postpartum blood lost

Question 40

Benefit of breastfeeding in Physical level for mothers

Answer 40

Uterus size return to nonpregnant size | Lower risk of breast and ovarian cancer & rehumatoid arthritis

Question 41

Benefit of breastfeeding in Psychological level for mothers

Answer 41

Increased self-confidence | Facilitated bonding with infants

Question 42

5 Sectors of Breastfeeding Advantages for Infants

Answer 42

``` Nutritional Immunological Health status Growth & deveopment Economic Cost ```

Question 43

Benefits in immunological sector for infants are

Answer 43

Creating T and B-Lymphocytes Secretory immunoglobins (sigA, sigG, sigM, sigE, sigD) Histocompatibility antigens T-cell product Many nonspecific factors (complement, Bifidus factor) Carrier Proteins ( lactoferrin, transferring, it B12-binding protein and Corticoid-binding protein) Enzymes (Lysozyme, lipoprotein lipase, leukocyte enzymes)

Question 44

Benefits in Nutritional sector for infants are

Answer 44

``` Give appropriate growth and development Meet nutritional requirement Does not cause overloading kidneys Have essential fatty acids Meet minimal mineral demand ```

Question 45

Benefits of Breast feeding in Health sector for infants are

Answer 45

Lower infant mortality Reduce morbidity and mortality due to poor sanitation and water supplies EBF up to 4 months reduces gastrointestinal illness Lower the respiratory infection up to 72% Protect against chronic childhood diseases ( celiac disease, inflammatory bowel disease, diabetes, leukemia, asthma, atopic dermatitis, and eczema)

Question 46

Challenges of Breastfeeding

Answer 46

``` Sore nipples & flat or inverted nipples Hyperactive Letdown Hyperlactation Engorgement Plugged duct Mastitis Low supply of milk ```

Question 47

How to prevent sore nipples & flat or inverted nipples

Answer 47

Proper positioning of the baby on the breast

Question 48

Withdraw of Hyperlactation Breastfeeding to the infant

Answer 48

The infant may choke, cough, or gulp

Question 49

Factors that cause Low Breast Milk supply

Answer 49

Real or perceived insufficient milk supply Seldomly breastfeeding or pumping Inefficient emptying of the breast High stress levels

Question 50

6 Program for Breastfeeding promotion

Answer 50

Prenatal breastfeeding education and support Breastfeeding support for individuals Role of Health care in supporting breastfeeding Lactation support in hospitals and birthing centers The workplace Public health support of breastfeeding

Question 51

The Baby-Friendly Hospital Initiative Program

Answer 51

``` Written breastfeeding policy Train all health care staff Inform the benefits and management Help mothers to initiate breastfeeding half one hour birth Show mothers how to breastfeed and show how to maintain lactation Give infants only breast milk Practice rooming in with infants Encourage breastfeeding on demand Give no artificial pacifiers or nipples Establish breastfeeding support groups ```

Question 52

How public health support of breastfeeding

Answer 52

Legislate to protect a woman's right to breastfeed | Legislate Woman's rights in public and on federal property, express milk at work, and exempt from jury duty.