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2ND SEM BIOCHEMISTRY > Breastmilk by Dr. Olavidez (PPT) > Flashcards

Breastmilk by Dr. Olavidez (PPT) Flashcards

1
Q

Each mammary gland forms a _____ of the breast which consists of a single major branch of alveoli and milk ducts that end at the nipple pore.

A

Lobe

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2
Q

The dark area around the nipple

A

Areola

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3
Q

Tube through which milk travels

A

Milk duct

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4
Q

Grape-like clusters of tissue that secrete milk

A

Alveoli cells

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5
Q

This causes the alveolar cells to secrete milk and swells the alveoli.

A

Prolactin reflex

Pathway:

  1. Nerve impulses from sucking go to brain
  2. The pituitary gland releases prolactin into the blood
  3. This causes the alveolar cells to secrete milk and swells the alveoli
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6
Q

This causes muscles around the alveoli in the breast to contract and squeeze the milk to the nipple.

A

The milk ejection/oxytocin reflex

Pathway:

  1. Nerve impulses from sucking go to the brain
  2. The pituitary gland releases oxytocin into the bloodstream
  3. This causes muscles around the alveoli in the breast to contract and squeeze the milk to the nipple.
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7
Q

Human milk is:

a. hypotonic
b. isotonic
c. hypertonic

A

Isotonic

  • Milk and plasma are of similar ion concentration
  • Milk is basically a suspension of fat and protein in carbohydrate mineral solution
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8
Q

Designed to protect infants against chronic childhood diseases

A

Human milk

Ratio:

  • Breastmilk has T lymphocytes, B lymphocytes, neutrophils, macrophages and epithelial cells aid in protection
  • IgA immunoglobulins
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9
Q

Two forms of breast milk:

A
  1. Colostrum

2. Mature milk

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10
Q

Volume of breast milk usually secreted ___________

A

600-900 mL/day

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11
Q

Thick yellow fluid

A

Colostrum

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12
Q

Colostrum is produced in the first ______ after birth.

A

2-4 days

Char-char: colos2rum = 2-4 days

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13
Q

Colostrum in human milk provides _____ cal/100 mL

A

58-70 cal/100 mL

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14
Q

High in protein, electrolytes, sodium, potassium, chloride and beta carotene

A

Colostrum

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15
Q

Low in fat and carbohydrate

A

Colostrum

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16
Q

Lactobacillus bifidus factor

A

Colostrum

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17
Q

Breast tissue development and secretion of colostrum and milk begins by 12th week of pregnancy and extends until shortly after delivery.

A

Lactogenesis I

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18
Q

Begins between the 2nd and 4th postpartum day and is characterized by the milk “coming in” in greater quanitity.

A

Lactogenesis II

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19
Q

7 to 10 days after delivery, milk is defined as __________

A

Transitional

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20
Q

14 days, milk is considered ________ has a volume of ________/24 hrs

A

Mature

600-900

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21
Q

Human milk is composed of ____ water.

A

87%

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22
Q

Human milk has _________ calories.

A

2,730-2,940 cal/L

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23
Q

Human milk is 98% triglycerides and mostly __________ and __________.

A

Palmitic and oleic acids

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24
Q

50% of TAG in human milk are in the form of ______.

A

DHA (Docosahexaenoic acid)

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25
Q

Other long chain polyunsaturated FA:

A

Arachidonic acid, linoleic and linolenic acids

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26
Q

Transport vehicle for fat-soluble vitamins and prostaglandins

A

Lipid component of breastmilk

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27
Q

75% of the nitrogen containing compounds in breast milk

A

Proteins

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28
Q

Non-protein nitrogen components in human milk:

A 
Urea
Nucleotides
Peptides
Free amino acids
DNA
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29
Q

2 major components of protein:

A
  1. Casein

2. Whey

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30
Q

Mostly B-casein

A

Casein (40%)

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31
Q

Aqueous portion (60%)

A

Whey

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32
Q

Mainly a-lactalbumin, lactoferrin, secretory IgA

A

Whey

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33
Q

Increases in response to prolactin secretion

A

a-lactalbumin

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34
Q

Increases the production of lactose

A

a-lactalbumin

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35
Q

Forms a regulatory sub-unit of lactose synthase heterodimer while B-1,4 galactosyl transferase forms the catalytic component

A

a-lactalbumin

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36
Q

These proteins enable lactose synthase to produce lactose by transferring galactose moieties to glucose.

A

a-lactalbumin

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37
Q

a-lactalbumin binds strongly to _______ and _______.

A

Calcium and zinc

*Antibacterial and anti-tumor activity

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38
Q

Transports and promotes iron absorption

A

Lactoferrin

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39
Q

Bacteriostatic: inhibits growth of iron-dependent bacteria

A

Lactoferrin

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40
Q

Serves as nutritional protein

A

Lactoferrin

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41
Q

An enzyme that protects the infant against E. coli and Salmonella

A

Lysozyme

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42
Q

Promotes the growth of healthy intestinal flora and has anti-inflammatory functions

A

Lysozyme

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43
Q

Most abundant immunoglobulin in milk

A

Secretory IgA

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44
Q

Protects mucosal surfaces from infections by bacteria and viruses

A

Secretory IgA

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45
Q

Breastmilk also contains smaller amount of ________ and ________.

A

IgG and IgM

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46
Q

7.2 g/dL

A

Lactose

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47
Q

Disaccharide of galactose and glucose

A

Lactose

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48
Q

Dominant carbohydrate in human milk

A

Lactose

49
Q

Enhances calcium absorption

A

Lactose

50
Q

Glucose is an example of

A

Monosaccharides

51
Q

Bifidus factor

A

Oligosaccharides and glycoproteins

52
Q

Stimulate the growth of Lactobacillus bifidus bacteria in the gut

A

Oligosaccharides and glycoproteins

53
Q

Inhibit the growth of E. coli and other enteropathogens

A

Oligosaccharides and glycoproteins

54
Q

There are _____ bioactive enzymes

A

20

55
Q

_________ in breastmilk works synergistically with lingual lipase and gastric lipase for complete digestion of human milk fat.

A

Lipase

56
Q

Important during the months after birth when pancreatic enzyme and bile salt levels are low.

A

Enzymes

57
Q

Bioactive hormones:

A 
Thyroxine
Prolactin
Erythropoetin
Epidermal growth factor
Insulin
Leptin
Gastrin
58
Q

For gastrointestinal motility

A

Prostaglandins

59
Q

Breastmilk contains __________ which contains NEUTROPHILS, MACROPHAGES and LYMPHOCYTES.

A

4000 cells per cubic mm

60
Q

Most concentrated in colostrum but continue to be present in transitional and mature milk.

A

Cellular components

61
Q

Help prevent infection of the breast tissue

A

Neutrophils

62
Q

Involved in providing immuno-protection

A

Macrophages (2000-3000 per cubic mm)

Lymphocytes (400 per cubic mm)

63
Q

Secrete lysozyme, kill bacteria, active in phagocytosis

A

Macrophages

64
Q

Released first

A

Foremilk

65
Q

Hindmilk is released _______ minutes into the feeding

A

10-20 minutes

66
Q

Lower in fat

A

Foremilk

67
Q

Higher in fat

A

Hindmilk

68
Q

Higher in carbohydrate

A

Foremilk

69
Q

Resembles cream

A

Hindmilk

70
Q

Lower in carbohydrate

A

Hindmilk

71
Q

Amount of fat in FOREMILK

A

1.7%

72
Q

Amount of fat in HINDMILK

A

5.5%

73
Q

Amount of protein in FOREMILK

A

0.9%

74
Q

Amount of fat in HINDMILK

A

0.7%

75
Q

Drugs contraindicated during breastfeeding:

A
  1. Alcohol
  2. Nicotine
  3. Caffeine
  4. Marijuana and other narcotics
  5. Cytotoxic drugs
  6. Ergotamine
  7. Lithium
  8. Phenobarbital
  9. Atenolol
  10. Acebutolol
  11. Radioactive isotopes
76
Q

This promotes mother and child bonding

A

Breastfeeding

77
Q

It prevents uterine bleeding in the mother after delivery

A

Breastfeeding

78
Q

Breastfeeding is a natural form of ______________.

A

Family planning

79
Q

This reduces the risks of breast and ovarian cancer in the mother.

A

Breastfeeding

80
Q

This saves time and precious expenses need not be used for buying milk powder and health care

A

Breastfeeding

81
Q

This provides the best possible nutrition to the young child.

A

Breastfeeding

82
Q

It is essential for the optimal physical, emotional and mental development of the child

A

Breastfeeding

83
Q

NEWBORNS:

Feed _______ minutes per breast.
Every _______ hours.
________ feedings per day.

A

5-10 minutes
2-3 hours
10-12 feedings per day

84
Q

Feed less frequently but for a longer duration at each feeding session.

A

One month or more

85
Q

One month or more:

______ minute per breast every _____ hours.

A

20-40 minute

3-4 hours

86
Q

Feed for 20-40 minutes per breast so 3-5 times per day.

A

By 6 months

87
Q

Contraindications to breastfeeding:

A
  1. Active/untreated TB
  2. Mom takes radioactive compound (cancer for chemotherapy)
  3. Mom takes illegal drugs/narcotics
  4. HIV infection
  5. Galactosemia
88
Q

Breastfeeding is not contraindicated:

A
  1. Hepatitis B surface antigen-positive
  2. Hepatitis C virus
  3. Febrile
  4. Exposed to low-level environmental chemical agents
  5. CMV
  6. Tobacco
  7. Jaundice or hyperbilirubinemia
89
Q

25-37 C

A

4 hours

90
Q

15-25C

A

8 hrs

91
Q

Below 15C

A

24 hours

92
Q

Milk should not be stored above ________.

A

37C

93
Q

Refrigerated (2-4C)

A

8 days

94
Q

If temperature of the refrigerator is not kept constant

A

3-5 days

95
Q

Freezer compartment of a refrigerator

A

2 weeks

96
Q

Freezer of a 2 door refrigerator (-20C)

A

3 months

97
Q

Deep freezer

A

6 months

98
Q

Thawed in refrigerator

A

24 hours

99
Q

Treatment for full breast

A

Frequent feeds

100
Q

Milk has “come in”

A

Full breast

101
Q

Hot heavy and hard

A

Full breast

102
Q

Milk flowing well

A

Full breast

103
Q

Sometimes feels lumpy

A

Full breast

104
Q

Normal fullness

A

Full breast

105
Q

Breast is overfull

A

Engorged breast

106
Q

Partly filled with milk

A

Engorged breast

107
Q

Partly with tissue fluid and blood

A

Engorged breast

108
Q

Interferes with milk flow

A

Engorged breast

109
Q

Breast is shinny

A

Edematous

110
Q

Painful

A

Engorged breast

111
Q

Milk does not flow well

A

Engorged breast

112
Q

In engorged breast, the nipple is

A

Stretched tight

113
Q

Poor attachment or wrong attachment

A

Sore nipple

114
Q

Candidiasis

A

Sore nipple

115
Q

Not properly positioned pump

A

Sore nipple

116
Q

Too much stretching of nipple caused by the pump/wrong position

A

Sore nipple

117
Q

It is recommended for women who do not know their status and whore are HIV negative

A

Breastfeeding

118
Q

When replacement feeding is ____________________, avoidance of all breastfeeding by HIV-infected mothers is recommended.

A

AFASS (Acceptable, Feasible, Affordable, Sustainable and Safe)

2ND SEM BIOCHEMISTRY (33 decks)

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