Human milk and decisions to breast feed- FINAL EXAM! Flashcards
(73 cards)
1
Q
Human Milk: Basic content highly \_\_\_\_. Volume depends on \_\_\_\_. \_\_\_\_ first affects quantity Composition affected by \_\_\_\_ \_\_\_\_. Type and amount of milk depends on \_\_\_ since \_\_\_. Mean volume \_\_\_ mls/d (Range 3-1000 ml)
A
variable demand Malnutrition severe malnutrition time, birth 750
2
Q
Human Milk potential hazards: \_\_\_\_\_reduces milk volume Alcohol reduces infant’s \_\_\_ and \_\_\_\_ development Only \_\_\_\_ approved drugs \_\_\_ can be transmitted by milk
A
Smoking
intake, psychomotor
physician
HIV
3
Q
Composition of Human Milk:
Solution of ___, ____ and ____ with suspended ___.
More than ___ recognized constituents
Composition varies, depending on:
Period of _____
___ of the day
___ __ of the infant
A
protein, sugar and salts, fat 100 lactation time Gestational age
4
Q
Types on mammary secretions: \_\_\_\_\_- Opaque fluid secreted for a few days after birth \_\_\_\_\_ milk – day _-_ \_\_ \_\_\_ milk \_\_\_ or \_\_\_\_ milk
A
Colostrum
Transitional 3-6
Pre term
Term or mature
5
Q
Volume and Composition of Colostrum:
__-__ mls per feeding depending on ____ (the number of times a female has given birth)
A
2-10
parity
6
Q
Colostrum: Compared to mature milk, it has: More \_\_\_ – \_\_\_\_ Less \_\_\_\_ Less \_\_\_ Less \_\_\_\_ (kcals) More \_\_, \_\_, \_\_\_
A
protein, immunoglobulins sugar fat energy Na, K, Cl
7
Q
Colostrum has more secretory ___ and ____.
A
IgA and lactoferrin
8
Q
Composition of Transitional Milk:
____ levels fall
____ and ____ increase
Major changes completed by day ___
At one month:
____ firmly established
No significant changes in _____
A
protein lactose and fat 10 lactation compostition
9
Q
Composition of Pre-Term Milk: compared to term milk
Higher in __ and __ ___ _
Higher in __, ___, ___, ___, ___, and ____.
Higher in ____
Higher in ___, ___ and long chain ____
Lower in ____
A
protein and non protein N Ca, Na, K, Cl, P, Mg IgA fat, MCT and long chain PUFA lactose
10
Q
What happens if the baby is premature?
A
The breast milk composition changes
11
Q
Premature and LBW infants should be on:
A
Pre term milk + a special supplement and Pre term commercial formula
12
Q
Premature = < __ weeks
A
37
13
Q
Low Birth Weight (LBW)=<____ g
A
2500
14
Q
Very Low Birth Weight (VLBW)=<____ g
A
1500
15
Q
Extremely Low Birth Weight (ELBW)=<____ g (cut off is 400 g which is less than 1 pound!)
A
1000
16
Q
Micropremies = <___-___g
A
750-800
17
Q
Premature:
Caloric needs based on kcal/kg are ___ in premature.
May not be able to breast feed but can be fed ___ ____.
May require __ or ____ (fewer kcals needed) feeding
A
higher
expressed milk
enteral or parenteral
18
Q
Enteral is ___ because it supports ___ _____ maturation
A
better
gi tract
19
Q
_____- delivering nutrients directly into the circulatory system: IV feeding
A
Parenteral
20
Q
____- delivering food via tube: tube-feeding. “nil by mouth”: naso enteral
A
Enteral
21
Q
Protein Composition of Mature Human Milk:
Approximately ___ %(cow’s milk >4%)
___ ____ synthesizes
(Casein, Lactalbumen, Lactoferrin)
The following are obtained from ___ ____:
Albumen, Immunoglobulins, Peptide hormones
About ___% Nitrogen is non protein N
_____ are present
A
1% Mammary gland maternal blood 25 enzymes
22
Q
Maternal diet has little influence on __ ____of milk.
A
protein content
23
Q
Low maternal protein intake has ___ ___.
Chronic protein deficit will have an ___
__ __ ___ of breast milk is ideal for human infant
A
little effect
effect
Amino acid content
24
Q
Lipid Composition of Mature Human Milk: \_\_\_% triglycerides Compared to cow’s milk, higher levels of: \_\_\_\_ \_\_\_\_\_\_ \_\_\_\_\_
A
90%
Cholesterol
N-6 PUFA
N-3 PUFA
25
Maternal diet affects type of ___.
fat
26
Type of fat in maternal diet milk affects ___ ___.
lipid composition
27
Maternal ___ ____ affects milk lipid content
energy restriction
28
____ levels higher than cow’s milk
Carnitine
29
Lipases in breast milk aid ___ ____.
fat digestion
30
Carbohydrate in Mature Human Milk:
Lactose stimulates beneficial microorganisms in ___ ____
Lactose improves ___ ___
e.g. Calcium
Other ____ present in small amounts
infant gut
mineral absorption
sugars
31
Maternal diet and carbohydrate:
Doesn’t influence _____
Lactose intolerant mothers have lactose in their ___.
Infants born to lactose intolerant mother’s are not ___ ____.
lactose
milk
lactose intolerant
32
Minerals in Mature Human Milk:
It’s all about ______. This is why formula has to have higher ____ content.
bioavailability
| mineral
33
Cow’s milk higher in some ____.
macrominerals (Na, Ca, and P)
34
Breast milk contains _____.
Zinc and iron and others
(aka: trace elements)
Micromineral content ____, but bioavailability is ____.
microminerals
low
high
35
Iron:
___ bioavailable in breast milk than from cow’s milk
Breast fed infants require supplement at ___ months (AND)
more
| 5
36
Calcium:
___ compared to cow’s milk
Level ____ by maternal diet
__ ___in mother if mother’s diet is inadequate
Her bone will be ____ after weaning
____ aid to maintain bone health in lactation
```
low
unaffected
Bone loss
renewed
Hormones
```
37
Fat Soluble Vitamins are affected by ___ ___ and ____.
maternal intake and stores
38
```
Vitamin D:
Levels in breast milk ___
Milk content affected by:
_____ diet
Maternal ___ ___
```
low
maternal
sun exposure
39
```
Vitamin A:
Levels affected by ___ ___.
Good sources for mother
____
Fruits and vegetables high in ___ ___.
```
maternal diet
milk
beta carotene
40
Vitamin E:
Breast milk Levels ____ than in cow’s milk
Vitamin E in formula now ____ breast milk
higher
| matches
41
Vitamin K:
Levels ___ compared to cow’s milk
Infant gut ____ so no synthesis by microbes
Most get an intramuscular ___ at birth
low
sterile
dose
42
Water Soluble Vitamins:
| Values increase with ___ ___ and ___.
maternal intake and plateau
43
Water soluble Vitamins:
Vitamin B6
Levels in breast milk may be __ ___ to meet the AI for infants
too low
44
Water soluble Vitamins:
Vitamin B12
Not significantly affected by __ ___.
Milk of strict ___ (___) )may be deficient
maternal diet
| vegetarians (vegans
45
Resistance Factors in breast milk:
Favor the growth of beneficial ____.
Antiviral activity Immune factors reduced with ___ ___.
_____transferred to infant
bacteria
maternal malnutrition
Antibodies
46
Anti infectious Factors in Human Milk:
__ ___ – antagonist to pathogenic bacteria. Lactose and calcium are involved.
Secretory IgA, IgM, IgE, IgD, and IgG – ____.
____ ___ – specific for staph infection
Bifidus factor
same
Antistaphylococcus factor
47
Anti infectious Factors in Human Milk:
____– a protein that binds iron and therefore inhibits bacterial growth (some bacteria need iron)
_____ – this enzyme kills streptococci and enteric bacteria.
_____– promotes phagocytosis of bacteria
Lactoferrin
Lactoperoxidase
Complement
48
Anti infectious Factors in Human Milk:
_____ – inhibits viral replication
_____ – lyses bacteria
__ ___ ____ - B12 not available to bacteria
Interferon
Lysozyme
B12 binding protein
49
Anti infectious Factors in Human Milk:
_____ - synthesize IgA
_____ – synthesize complement, lactoferrin, lysozyme, carry out phagocytosis and probably other things
Lymphocytes
| Macrophages
50
Human Milk:
| It also contains "___" ____ to protect functional proteins from digestion
“anti” proteases
51
___ ___ ___ (___) and ___ ___ protects the infant against a wide range of infectious and other diseases.
Human Breast Milk (HBM)
| beast feeding
52
Advantages of Breast Feeding:
___ ___ designed for ____ ___
____ normal for mammals
Breast feeding has advantages for ____ and ___.
Human milk
human infants
lactation
mother and infant
53
```
Advantages for the Infant:
Designed exclusively for ____.
______ superior
_____ safe
Provides ____
Stimulates ____ _____ system
Decreases risk of ____ ____
Prevents or reduces ____ of ____
Promotes proper ___ ___
Decreases risk of ____ ____
Promotes ___-___attachment
```
```
humans
nutritionally
bacteriologically
immunity
infant immune
infectious diseases
risk allergy
facial development
childhood obesity
maternal-infant
```
54
Advantages for the Mother:
Promotes recovery from _____.
- Promotes uterine involution
- Decreases bleeding
- Increases period of anovulation (no ovulation…birth control, in a way)
```
Promotes attachment to the ____
Increases ___ ____
Allows for daily ___ ____
Eliminates work involved with ___ ___
Decreases risk of ____ and ___ ____
Promotes ____ ____
More ____
```
```
pregnancy
infant
self esteem
rest periods
formula feeding
breast ovarian cancer
weight loss
economical
```
55
The incidence of breast feeding was at an all time low in ____.
1970
56
```
Incidence varies by _____:
____
____
____ level
____ status
```
```
mother
race
income
educational
marital
```
57
Incidence of breast feeding:
| ___ ___ are also a factor
Regional differences
58
Incidence increasing due to changes in ___ ___ and ___.
medical opinion and attitude
59
AAP (___ ___ of ____) actively recommends breast feeding
American Academy of Pediatrics
60
```
The decision to breast feed:
Usually made early in ____.
Complex ____. involved
Concerns of ____ should be addressed
Techniques that work include
Emphasizing benefits
Prenatal preparation
Education
Choosing a baby friendly hospital
```
pregnancy
factors
mother
61
```
Decision to breast feed:
Lactation should be supported by:
___ ___ professionals
____ ___, especially the father
____ influences
```
Health care
Family members
Outside
62
```
Deciding to breastfeed:
Techniques that work include
Emphasizing ____
_____ preparation
____
Choosing a ___ ___ hospital
```
benefits
Prenatal
education
baby friendly
63
```
Breast-Feeding in the Post-Partum Period:
Mother should be _____
Mother and infant taught ____
(Position for ___)
(Importance of ___ ___)
```
comfortable
correct
feeding
latching on
64
```
Breastfeeding in post partum period:
Breast feeding abandoned due to:
Lack of ______
___ hospital stays
Outdated ___
Delays between ____ and____
Time ____
___ ____availability
```
```
knowledge
Short
policies
birth and initiation
limitations
Commercial formula
```
65
____ access to breast important
Frequent
66
Frequent Feeding will build up ____ ___.
milk supply
67
Feeding on schedule _____.
detrimental
68
Newborns need to nurse ___-___times/day for adequate nutrition
10-12
69
```
Frequent and prolonged feeding will increase:
___ output
____ weight gain
___ of breast feeding
___ between feeding
```
milk
infant
duration
time
70
Supplementing with formula will ___milk supply
decrease
71
```
Lactogenesis 1:
During _____
__ weeks before delivery
____ produced but not yet secreted
Progesterone inhibits ___
For our application we will say it ends when ___, ___ and ___ drops
```
```
pregnancy
12
Colostrum
secretion
progesterone, estrogen and hPL
```
72
Lactogenesis II and III:
Begins when __ ends
Lots of __ in this liquid as well as other important factors
Change in ___ and ___ over these two stages
II is result of rapid drop in ___, ___ and ___.
At the very initiation of II, ___ which contains white blood cells and antibodies, especially Immunoglobulin A (IgA)
Over the first ___ weeks after the birth, colostrum production slowly gives way to mature breast milk.
```
I
fat
composition and quantity
estrogen, progesterone and hPL
colostrum
two
```
73
Iron supplements may interfere with the ___ ___-___ ___.
lactoferrin anti-infective properties
