Human Lactation Flashcards
(47 cards)
What is the WHO and NH&MRC recommended breastfeeding time?
The first 6 months of life and continuing with complementary feeding up to age of 2 years or beyond.
How many ducts are there per lactating breast?
9 ducts (4 - 18), they are approximately 2 mm in diameter and they are easily compressible.
What makes up breasts
63% glandular tissue
37% fatty tissue
What type of glandular tissue exists in breasts?
Lactiferous ducts draining the secretory tissue go to the nipple and there they intertwine (left hand side of nipple doesn’t necessarily have lactiferous ducts from left side of breast)
Secretory tissue all the way back up into the breast from nipple.
Cooper’s ligaments hold everything to the subcutaneous fat at the back of the breast.
What are the possible consequences of breast reduction surgery?
Removal of secretory tissue
Reduce number of patent milk ducts.
What are possible consequences of breast augmentation?
Decrease nipple sensation (particularly periareolar incision)
Can lead to lactation insufficiency.
What does nipple piercing lead to?
Can cause scar tissue to block milk ducts.
What happens in urine during pregnancy?
Lactose output in urine increases as a result in increased lactose synthesis.
What hormone level rises with breast lactose synthesis?
Blood prolactin
What regulates nipple and areola growth in pregnant women?
Areola growth: Placental lactogen
Nipple growth: Prolactin
What increases risk of breast ptosis (sagging)?
It increases with each pregnancy.
Breastfeeding does not seem to worsen these effects.
What should be kept in mind regarding premature delivery?
At this stage secretory differentiation has occurred. (breasts can synthesize lactose)
Small babies are initially unable to breastfeed
Milk production needs to be initiated and established by pumping early and pumping often. (breast pump)
What are the benefits of breastfeeding for the baby?
‘Gold Standard’ infant food
Facilitates growth and development
Protects against illness
What are the benefits of breastfeeding for the mother?
Recovery from childbirth
Body weight loss
Suppression of maternal fertility
Cholesterol clearance
Diabetics - glucose control
Breast and ovarian cancer risk reduced
Self esteem
What are the community benefits of breastfeeding?
Reduced health care costs
Reduced pollution and energy costs (cow’s milk, cans, teats, etc)
Land clearance for farmland
Methane production from cows
What is human milk composed of?
- 5% fat
- 1% protein
- 8% lactose
- 2% ash
What is the function of breastmilk in babies’ CNS?
Higher DHA in parietal cortex of brains of breastfed infants.
Some evidence of improved visual acuity and cognitive development
What is the function of breastmilk in babies’ immune system?
Contains immunoglobulins
Lactoferrin
Lysozyme
Lipids
Oligosaccharides
Cytokines
Cells
What effect does maternal diet have on breast milk?
Quality of milk is not affected by available food (very low threshold before milk is affected)
Protein increase in diet increases protein in milk
Type of fatty acids mother eats ends up in milk
No effect on lactose
Zinc, Mn, Se, F, and Iodine all increase with more consumption in milk.
All vitamins affect milk
What are the pathways for milk secretion?
Membrane pathway
Golgi vesicles (proteins like casein)
Fat globules (medium chain fatty acids)
Transcellular pathway (long chain fatty acids)
Paracellular pathway (Na+ and Cl- travel through this pathway. During pregnancy junctions between cells are open, during initiation of lactation they close.)
Which drugs are often transferred in milk?
Drugs need to either have:
High concentration
Low molecular weight
Lipid soluble
If they are bound to a protein they cannot enter milk
What initiates lactation?
Requires withdrawal of progesterone. (check progesterone levels in ladies with delayed lactation)
Requires presence of prolactin, insulin and corticosteroids
How are progesterone vs lactose levels in mothers of babies with vaginal delivery and C-section?
Progesterone drops right after birth and lactose increases immediately after the drop.
How does lactose affect milk volume?
Increase in lactose = increase in milk production
