Feeding

Question 1

In terms of lactation what does oestrogen promote the growth of?

Answer 1

The ductile system

Question 2

In terms of lactation what does progesterone promote the growth of?

Answer 2

Development of lobule-alveolar system

Question 3

What is producing and releasing milk initiated by?

Answer 3

Placental expulsion and the sudden decrease in oestrogen/progesterone at birth (hormonal response with continuous positive feedback)

Question 4

How does oestrogen/progesterone circulating in the blood inhibit milk secretion?

Answer 4

By blocking the release of prolactin from pituitary

Making the mammary gland unresponsive to this pituitary hormone

Question 5

The ejaculatory process is initiated by which hormone?

Answer 5

Oxytocin

Question 6

What does colostrum look like?

Answer 6

Low volume (few mm at each feed)
no fat
rich in immunoglobulin

Question 7

TRUE/FALSE

Colostrum has a laxative effect which helps the baby pass meconium and prevent jaundice

Answer 7

TRUE

Question 8

TRUE/FALSE

Mature milk has the same overall daily intake of immune proteins as in colostrum

Answer 8

TRUE

Question 9

What does mature breastmilk look like?

Answer 9

Slightly blush, translucent with a thin cream layer on standing as it contains a little caesin

Question 10

Why do newborn babies need very little milk during the first 48-72h post birth?

Answer 10

Their immature kidneys are adjusting from secreting large amounts of fluid as blood volume reduces by 25%

Question 11

Milk volume in the breast increase after 20-48h. After which day do breasts feel full and tight?

Answer 11

day 3

Question 12

TRUE/FALSE

Placental products retained in utero will not effect the process of milk coming in

Answer 12

False- they will delay the process

Question 13

TRUE/FALSE

The highest fat content of the feed is right at the very beginning

Answer 13

FALSE

As the breast drains, fat is expressed into the ducts and the calorie content increases

Question 14

What does the sucking stimulus release?

Answer 14

Oxytocin

Question 15

What reflex is the release of milk often referred to as?

Answer 15

The let-down reflex

Question 16

In the are of the breast not being drained ———– and signal to breast tissue to stop milk production

Answer 16

Lactation inhibitory factors

Question 17

How long is exclusive breast-feeding recommended for?

Answer 17

First 6 months

Question 18

At what age are solid foods introduced?

Answer 18

6 months

Question 19

TRUE/FALSE
IF a breast-fed infant loses up to 10% of their birth weight in the first few days this shows that there is an inadequate feeding technique

Answer 19

FALSE

this is completely normal

Question 20

ALL babies should be given vitamin D supplements regardless of feeding method and their mothers intake TRUE/FALSE

Answer 20

8.5-10 micrograms for breastfed babies

NONE for infant-fed babies

Question 21

Healthy start vitamin drops can be given from which age?

Answer 21

6 months

Question 22

How can risk of HIV transmission be reduced?

Answer 22

ART for mother and infant
Birth by c-section
avoidance of breastfeeding

Question 23

Benefits of breastfeeding?

Answer 23

Mum
-lowers risk of breast and ovarian cancers
-lose wt faster (500kcals a day)
bonding

Baby

• IgA immunity
• Long-term outcomes (obesity, diabetes)

Question 24

How long can breast milk be stored?

Answer 24

<5 days in fridge

<2wks in freezer compartment of fridge

<6months in freezer

Question 25

What are 4 potential problems for the mother if attachment is poor?

Answer 25

Painful nipples engorgement low milk supply mastitis

Question 26

TRUE/FALSE | If attachment is effective then the chin should be indenting the breast and the baby needs a wide gaping mouth

Answer 26

TRUE

Question 27

If areola is visible when feeding there should be more above the top lip than the bottom lip TRUE/FALSE

Answer 27

TRUE

Question 28

What is engorgement?

Answer 28

Painful swelling of the breasts

Question 29

What is mastitis?

Answer 29

Red inflamed breasts

Question 30

If pain relief is needed for sore breasts then Paracetamol/aspirin/ibuprofen can be used TRUE/FALSE

Answer 30

FALSE | Aspirin implicated in Reyes syndrome

Question 31

If symptoms of painful breasts continue after 12h despite expressing milk and appropriate pain relief then treat with suitable antibiotics prescribed. What would this be?

Answer 31

Fluclox ( of clindamycin if pen allergic)

Question 32

If a breast abscess develops they are a goner, don't bother treating them TRUE/FALSE

Answer 32

TRUE | alternatively you could aspirate and surgically drain

Question 33

TRUE/FALSE | Overall breast size determines the amount fo milk produced

Answer 33

FALSE

Question 34

What are positive signs that the baby is getting sufficient milk?

Answer 34

Wt | 6+ wet and 3+ dirty nappies in 24h

Question 35

Use topical medication to treat painful nipples in the absence of nipple infection TRUE/FALSE

Answer 35

FALSE ya crazy kid

Question 36

Infant formaula is suitable for infants up to 12m. However there is a big advantage of changing to follow on formula from 6 months TRUE/FALSE

Answer 36

FALSE | it is suitable up to12m but here is no advantage of changing to follow-on milk

Question 37

How does wt gain look different in formula fed children?

Answer 37

Lose less wt in first few days following birth Gain wt more quickly around 4-6 months (increased risk of cardiovascular disease in the future)

Question 38

The cows protein in formula milk can increase the risk of juvenile onset diabetes TRUE/FALSE

Answer 38

TRUE

Question 39

What are the benefits of the whey protein that is found in breastmilk?

Answer 39

Easier to digest | Bacteriocidal effect

Question 40

What does lactoferrin do?

Answer 40

Allows iron to be absorbed

Question 41

What is used to investigate cow's milk protein allergy in infants under 6 months of age?

Answer 41

A trial of hydrolysed infant formula

Question 42

What is the whey:caesin ratio of whey dominant formulas?

Answer 42

60:40

Question 43

Microwave ovens without a specialised steamer and dishwashers are ideal to use to sterilise bottles etc TRUE/FALSE

Answer 43

BIIIG LIE Not ideal Cannot guarantee that they reach high enough temperatures

Question 44

What are the two forms that formula can come in?

Answer 44

Dried powder | Ready to feed liquid

Question 45

TRUE/FALSE | Infants are more likely to become constipated on formula milks than breast milk

Answer 45

TRUE (ESP IF MADE UP INCORRECTLY)

Question 46

What are 3 clues that the baby may use to indicate that they are hungry?

Answer 46

Mouthing Rooting Fussing

Question 47

What angle should the bottle be at to feed the child?

Answer 47

Keep the bottle tilted and sit the baby upright so that milk doe snot pool at the back of his mouth

Question 48

Why do younger infants not need to feed as often as older infants?

Answer 48

They have smaller stomachs

Question 49

What is the average milk intake from 4 days- 6 months?

Answer 49

150ml/kg body wt in a 24h period

Question 50

In hot weather why might formula fed infants become thirsty?

Answer 50

The solute load of formula is greater than that of breast milk

Question 51

In hot weather plain, cooled boiled water can be given to babies if they are thirsty TRUE/FALSE

Answer 51

FALSE can be given to infant fed babies not to breast milk ( the composition changes as needs be)

Question 52

Storing infant formula

Answer 52

Constantly below 5 degrees use within 24h (if leftover from feed discarded after 2h) use a cool box with ice bricks if need to carry prepared feeds

Question 53

Why should a microwave not be used to warm refrigerated feeds?

Answer 53

Ongoing heating- will continue to heat after removal from the microwave "Hot spots"