lactation ch6

Question 1

what is prolactin

Answer 1

necessary for milk secreation to occur- anterioe pituitary gland

Question 2

lactogenesis

Answer 2

milk production/initiation- prolactin

Question 3

galactopoiesis

Answer 3

milk secreation- prolactin

Question 4

milk ejection

Answer 4

release reflex from breasts- oxytocin

Question 5

alveoli

Answer 5

15-20 lobes are found in the alveoli, it syntheses and secreates milk

Question 6

where does the milk go after the alveoli

Answer 6

down the ductules to the lactiferous ducts (1 per loab= 15-20 in all)
then goes to the lactiferous sinus and stored as foremilk

Question 7

foremilk

Answer 7

nostly water and sugar- 30-90 seconds (2-3% fat)

Question 8

hindmilk

Answer 8

ongoing- 3-7% fat

Question 9

colostrum

Answer 9

day 1-3 : high in beta carotene(2x as high as mature milk), protein,minerals,antibodies, wbc, low in cho and fat. have macrophages, t and b lymphocytes, neutrophils (also present in mature milk

Question 10

transitional milk

Answer 10

day 3-6

Question 11

mature milk

Answer 11

day 10 : high in fat, lactose, low in protein, low in minerals

Question 12

oxytocin

Answer 12

posterior pituitary gland, let down response uterus shrinks down

Question 13

cholestrol in bm compared to formula

Answer 13

36ml/cup compared to no

Question 14

carb in bm compared to form

Answer 14

38-42% vs 42% in form

Question 15

fat in bm vs form

Answer 15

55% vs 48-50%

Question 16

protein in bm vs farm

Answer 16

20% as cassein and 80% a whey- is a soft curd

form: 40% cassein 60% whey (too much cassein like in milk 80% can damage intestine - blood loss)

Question 17

what are some of the componds of milk

Answer 17

whey protein- stays soluble (cassein does not) whey protein contain milk and serum protein , enzymes (aid in digestion and protection against bacteria) and immunoglobulin. also has hormone, vit and min components of whey- lactoferin

Question 18

how much kcals do lactating women need

Answer 18

750ml of milk takes 550kcal with an80-90% efficiency= 630kcals
200 from fat stores, 430 from food

Question 19

why is vit k shot important

Answer 19

for prothrombing activation - infants have a sterile tract

give shot to prevent intra-cranial hemarrhagin

Question 20

iron

Answer 20

50% of the fe is absorbed 0.01mg/oz

Question 21

benefits to the mother to breast feed

Answer 21

oxytocin, birthcontrol, bonding, lose weightn, devreased risk of breast and ovarian cancer

Question 22

nutritional benefit to baby

Answer 22

optimal nutrition, isosmotic, low protein as to not overload the kidney with nitrogen, whey is soft, esssential fats like cholesterol lcfa like DHA , minerals are protein bound so better availability, immunoglobulin, bifidus factor, lactobacillus, growth factors and hormones (insulin), reduces the risk of sudden infant death mortality , reduces illness (ear infection, GIT, RESPIRATORY), DESEASES LATER IN LIFE LIKE CELIAC DESEASE, ibd, DIABETES, LEUKIMIA, ATHMA, ECZEMA,, healthy weight , higher IQ, cost

Question 23

what is the primary 90% immunoglobulin

Answer 23

secretory immunoglobulin a- (sIgA)

Question 24

what affects the amount of milk a baby will need

Answer 24

infant weight, caloric density of the milk, and age

Question 25

what affects how much milk is produced

Answer 25

infant demand, and pumpimg

Question 26

breast reduction surgery

Answer 26

92% have trouble with bf, breast augmentation also have trouble making enough due to compression of the ducts

Question 27

why should you use multiple position to feed the baby

Answer 27

improper can cause pain , damage to nipple and breast tissue

Question 28

rooting reflex

Answer 28

turning to the side when stimulated on the side of the upper or lower lip

Question 29

what does a baby do when its hungry

Answer 29

bring hands to their mouths and and suck on them and move head side to side b(rooting)- late sign is crying

Question 30

how many feedings per day

Answer 30

8-12 every 1 1/2 hours the stomach empties

Question 31

what is the normal weightloss of infant

Answer 31

7% in first 5 days malnoursihed babies are sleepy, weak cry, few wet diapers. healthy has 6 diapers a day 3-4 soft yellowish poos a day- pale yellow urine

Question 32

what is benefit on dental carries and breast milk

Answer 32

bm has infection-fighting components that inhibit (not always) and can have straighter teeth and less cases of sleep apnea

Question 33

which vit and mins should be supplemented

Answer 33

fe: AI: 0.3mg vit k shot at birth , 400iu of vit d and 600iu after a year

Question 34

colic

Answer 34

a healthy baby crying for more than 3 hours a day- believed that it is the due to the mothers diet- cows milk, onions cabbage brocoli and chocolate increases this symptoms were decreases after avoidance, peanuts, milk, eggs,wheat, soy, fish probiotic supplements in bm decreases it

Question 35

what are the barriers to breastfeeding

Answer 35

lack of knowledge, social norma, poor family and social support, lactation problems, embarrasement, employment and child care, barriers related to health services

Question 36

when was breastfeeding at its lowest

Answer 36

1950 and 1960- 30% rose dramatically in 1970s

Question 37

what are supportive hospital practices

Answer 37

birth facilities policies that create a supportive enviro for breastfeeding begins prenataly and continue through discharge and includes: skin to skin contact (right away after birth place the mother with the baby with no bedding or clothing btw them. teach about breastfeeding (feeding cues) early and frequent breastfeeding (help them start breastfeeding as soon as possible - pacifiers are only for surgeries) rooming in: encourage them to room together and teach them the benefits (better quality and quantity of sleep and more oppertunities in bf active follow-up after discharge (staff schedule inperson breastfeeding follow-up visits to check-up on breastfeeding)

Question 38

who influences bf

Answer 38

fathers, grandparents, mothers, sisters, friends, doulas, social network, peer groups (good)

Question 39

what are the 10 steps in successfull bf!!!!!!!!!!!!

Answer 39

1have written bf policy that is routinely communicated to all health care staff 2: train all the staff in the skills necessary to implement the policy 3/: imform all pregos about the benefits and management of bf 4: help initiate bf within 1/.2 hour of birth 5: show moms how to bf and how to maintain if they are seperated 6: dont give any food or water to a baby 7: practice rooming in 8: encourage bf on demand 9: dont give artificail nipple or facifiers 10: refer mothers to support groups

Question 40

what is world health organisation's internation /UNICEF code on the marketing of BM substitutes

Answer 40

no advertising of substitutes no free sample/supplies no promotion of products through health care facilities no company sales representatives to advise mothers no gifts or personal samples to health workers no gifts or pictures idealising formula feeding, including picture of infants on the labels of the infant milk containers information to health workers should be scientific and factual all info on artificial feeding including labels should explain the benefits of bf and the cost and hazards associated with the formula feeding unsuitable products should not be promoted for babies manufacturers and distributers should comply with the code of provision even if countries have not adopted laws or other measure

Question 41

the workplace

Answer 41

lack ofon site daycare, not enough maternity leave, rigid workschedules, rigid work scedule, employer who lack the knowledge- federal states anywhere on federal property they can bf, women at work who continue to breastfeed miss less work due to less hospital visits and sick days

Question 42

important elements of worksite lactation support programs

Answer 42

prenatal lactation education tailored for working women corporate policies providing info for all employees on the benefits of bf and on why their bf coworkers need their support education for personelle about the services available to support to support bf women adequate breaks, flexible work hours, job sharring, and part time work private mothers room for expressing milk in a secure and relaxing enviro access to hospital grade autocycling breastpump at the work place small refrigerator for the safe storage of bm subsidising or purchase of individually owned portable breast pumps for employees access to lactation professional on-site or by phone to give breastfeeding education, counselling, and support during pregnancy after delivery and when returning to work coordination with on cite or near site child care programs so the infant can be breastfed during the day support group for working mothers with children

Question 43

when can a bottlke be introduces

Answer 43

4 weeks- 2 feeding a day continue the breat to make milk

Question 44

in the community increase

Answer 44

get the support from community leaderships and to establish a multidisciplinary breastfeeding task force with representatives from teh hospitals, doctors, birthing centers, home visitors...

Question 45

barriere to bf in community

Answer 45

lack of acess to reliable and culturally apropriate sources of information and social support, cultural perception on bottle feeding as the norm, aggresive marketing of formula and laws that prohibit bf in public

Question 46

WIC national bf promotion project identifie wha t 3 messages to increase bf

Answer 46

1: helping women feel comfortable 2: tips on how bf at can work arounbd a busy schedule 3: the involvement of family and friends to make bf a success