Breastmilk by Dr. Olavidez (PPT) Flashcards
(118 cards)
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
2
Q
The dark area around the nipple
A
Areola
3
Q
Tube through which milk travels
A
Milk duct
4
Q
Grape-like clusters of tissue that secrete milk
A
Alveoli cells
5
Q
This causes the alveolar cells to secrete milk and swells the alveoli.
A
Prolactin reflex
Pathway:
- Nerve impulses from sucking go to brain
- The pituitary gland releases prolactin into the blood
- This causes the alveolar cells to secrete milk and swells the alveoli
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:
- Nerve impulses from sucking go to the brain
- The pituitary gland releases oxytocin into the bloodstream
- This causes muscles around the alveoli in the breast to contract and squeeze the milk to the nipple.
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
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
9
Q
Two forms of breast milk:
A
- Colostrum
2. Mature milk
10
Q
Volume of breast milk usually secreted ___________
A
600-900 mL/day
11
Q
Thick yellow fluid
A
Colostrum
12
Q
Colostrum is produced in the first ______ after birth.
A
2-4 days
Char-char: colos2rum = 2-4 days
13
Q
Colostrum in human milk provides _____ cal/100 mL
A
58-70 cal/100 mL
14
Q
High in protein, electrolytes, sodium, potassium, chloride and beta carotene
A
Colostrum
15
Q
Low in fat and carbohydrate
A
Colostrum
16
Q
Lactobacillus bifidus factor
A
Colostrum
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
18
Q
Begins between the 2nd and 4th postpartum day and is characterized by the milk “coming in” in greater quanitity.
A
Lactogenesis II
19
Q
7 to 10 days after delivery, milk is defined as __________
A
Transitional
20
Q
14 days, milk is considered ________ has a volume of ________/24 hrs
A
Mature
600-900
21
Q
Human milk is composed of ____ water.
A
87%
22
Q
Human milk has _________ calories.
A
2,730-2,940 cal/L
23
Q
Human milk is 98% triglycerides and mostly __________ and __________.
A
Palmitic and oleic acids
24
Q
50% of TAG in human milk are in the form of ______.
A
DHA (Docosahexaenoic acid)
25
Other long chain polyunsaturated FA:
Arachidonic acid, linoleic and linolenic acids
26
Transport vehicle for fat-soluble vitamins and prostaglandins
Lipid component of breastmilk
27
75% of the nitrogen containing compounds in breast milk
Proteins
28
Non-protein nitrogen components in human milk:
```
Urea
Nucleotides
Peptides
Free amino acids
DNA
```
29
2 major components of protein:
1. Casein
| 2. Whey
30
Mostly B-casein
Casein (40%)
31
Aqueous portion (60%)
Whey
32
Mainly a-lactalbumin, lactoferrin, secretory IgA
Whey
33
Increases in response to prolactin secretion
a-lactalbumin
34
Increases the production of lactose
a-lactalbumin
35
Forms a regulatory sub-unit of lactose synthase heterodimer while B-1,4 galactosyl transferase forms the catalytic component
a-lactalbumin
36
These proteins enable lactose synthase to produce lactose by transferring galactose moieties to glucose.
a-lactalbumin
37
a-lactalbumin binds strongly to _______ and _______.
Calcium and zinc
*Antibacterial and anti-tumor activity
38
Transports and promotes iron absorption
Lactoferrin
39
Bacteriostatic: inhibits growth of iron-dependent bacteria
Lactoferrin
40
Serves as nutritional protein
Lactoferrin
41
An enzyme that protects the infant against E. coli and Salmonella
Lysozyme
42
Promotes the growth of healthy intestinal flora and has anti-inflammatory functions
Lysozyme
43
Most abundant immunoglobulin in milk
Secretory IgA
44
Protects mucosal surfaces from infections by bacteria and viruses
Secretory IgA
45
Breastmilk also contains smaller amount of ________ and ________.
IgG and IgM
46
7.2 g/dL
Lactose
47
Disaccharide of galactose and glucose
Lactose
48
Dominant carbohydrate in human milk
Lactose
49
Enhances calcium absorption
Lactose
50
Glucose is an example of
Monosaccharides
51
Bifidus factor
Oligosaccharides and glycoproteins
52
Stimulate the growth of Lactobacillus bifidus bacteria in the gut
Oligosaccharides and glycoproteins
53
Inhibit the growth of E. coli and other enteropathogens
Oligosaccharides and glycoproteins
54
There are _____ bioactive enzymes
20
55
_________ in breastmilk works synergistically with lingual lipase and gastric lipase for complete digestion of human milk fat.
Lipase
56
Important during the months after birth when pancreatic enzyme and bile salt levels are low.
Enzymes
57
Bioactive hormones:
```
Thyroxine
Prolactin
Erythropoetin
Epidermal growth factor
Insulin
Leptin
Gastrin
```
58
For gastrointestinal motility
Prostaglandins
59
Breastmilk contains __________ which contains NEUTROPHILS, MACROPHAGES and LYMPHOCYTES.
4000 cells per cubic mm
60
Most concentrated in colostrum but continue to be present in transitional and mature milk.
Cellular components
61
Help prevent infection of the breast tissue
Neutrophils
62
Involved in providing immuno-protection
Macrophages (2000-3000 per cubic mm)
Lymphocytes (400 per cubic mm)
63
Secrete lysozyme, kill bacteria, active in phagocytosis
Macrophages
64
Released first
Foremilk
65
Hindmilk is released _______ minutes into the feeding
10-20 minutes
66
Lower in fat
Foremilk
67
Higher in fat
Hindmilk
68
Higher in carbohydrate
Foremilk
69
Resembles cream
Hindmilk
70
Lower in carbohydrate
Hindmilk
71
Amount of fat in FOREMILK
1.7%
72
Amount of fat in HINDMILK
5.5%
73
Amount of protein in FOREMILK
0.9%
74
Amount of fat in HINDMILK
0.7%
75
Drugs contraindicated during breastfeeding:
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
This promotes mother and child bonding
Breastfeeding
77
It prevents uterine bleeding in the mother after delivery
Breastfeeding
78
Breastfeeding is a natural form of ______________.
Family planning
79
This reduces the risks of breast and ovarian cancer in the mother.
Breastfeeding
80
This saves time and precious expenses need not be used for buying milk powder and health care
Breastfeeding
81
This provides the best possible nutrition to the young child.
Breastfeeding
82
It is essential for the optimal physical, emotional and mental development of the child
Breastfeeding
83
NEWBORNS:
Feed _______ minutes per breast.
Every _______ hours.
________ feedings per day.
5-10 minutes
2-3 hours
10-12 feedings per day
84
Feed less frequently but for a longer duration at each feeding session.
One month or more
85
One month or more:
______ minute per breast every _____ hours.
20-40 minute
| 3-4 hours
86
Feed for 20-40 minutes per breast so 3-5 times per day.
By 6 months
87
Contraindications to breastfeeding:
1. Active/untreated TB
2. Mom takes radioactive compound (cancer for chemotherapy)
3. Mom takes illegal drugs/narcotics
4. HIV infection
5. Galactosemia
88
Breastfeeding is not contraindicated:
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
25-37 C
4 hours
90
15-25C
8 hrs
91
Below 15C
24 hours
92
Milk should not be stored above ________.
37C
93
Refrigerated (2-4C)
8 days
94
If temperature of the refrigerator is not kept constant
3-5 days
95
Freezer compartment of a refrigerator
2 weeks
96
Freezer of a 2 door refrigerator (-20C)
3 months
97
Deep freezer
6 months
98
Thawed in refrigerator
24 hours
99
Treatment for full breast
Frequent feeds
100
Milk has “come in”
Full breast
101
Hot heavy and hard
Full breast
102
Milk flowing well
Full breast
103
Sometimes feels lumpy
Full breast
104
Normal fullness
Full breast
105
Breast is overfull
Engorged breast
106
Partly filled with milk
Engorged breast
107
Partly with tissue fluid and blood
Engorged breast
108
Interferes with milk flow
Engorged breast
109
Breast is shinny
Edematous
110
Painful
Engorged breast
111
Milk does not flow well
Engorged breast
112
In engorged breast, the nipple is
Stretched tight
113
Poor attachment or wrong attachment
Sore nipple
114
Candidiasis
Sore nipple
115
Not properly positioned pump
Sore nipple
116
Too much stretching of nipple caused by the pump/wrong position
Sore nipple
117
It is recommended for women who do not know their status and whore are HIV negative
Breastfeeding
118
When replacement feeding is ____________________, avoidance of all breastfeeding by HIV-infected mothers is recommended.
AFASS (Acceptable, Feasible, Affordable, Sustainable and Safe)
