newborns and infant feeding

Question 1

what causes breast to start developing during pregnancy

Answer 1

release of oestrogen and progesterone during menstrual cycles

Question 2

what is the role of oestrogen production during pregnancy

Answer 2

• stimulates elongation of tubular ducts (with growth hormone)
• promotes fat storage

Question 3

what is the role of progesterone during pregnancy

Answer 3

stimulates the development of glands to secrete milk (with prolactin)

Question 4

what are the anatomical parts of the breast (5)

Answer 4

• alveolus
• lobules
• lactiferous duct
• lactiferous sinuses
• nipple and areola

Question 5

what is the alveolus

Answer 5

milk-secreting cells

Question 6

what are lobules

Answer 6

branches of alveoli

Question 7

what are the lactiferous ducts

Answer 7

channels that connect the lobes to the nipples where the milk is expressed

Question 8

what are the lactiferous sinuses

Answer 8

this is where milk can be stored, and is to be ejected when the baby suckles

Question 9

what are the nipples and areola

Answer 9

smooth muscle cells at the tip of the breast.
help suckling baby to grip the nipple

Question 10

what is the role of prolactin during lactation

Answer 10

acts on the alveolar cells to synthesise and secrete milk
produce in response to the emptying of the breasts and infant suckling

Question 11

what are the issues with incomplete feeding during breastfeeding

Answer 11

may results in decreased milk supply

Question 12

what is the role of oxytocin during lactation

Answer 12

hormone that causes the release of the milk

Question 13

how does oxytocin result in the release of milk

Answer 13

suckling causes the hypothalamus to produce oxytocin.
Myoepithelial cells around the alveoli respond by contracting ad sending milk through ducts to the nipple

Question 14

what is the role of oxytocin during labour

Answer 14

stimulate uterine contractions, which readies the breaks for immediate feeding after birth

Question 15

what are the components of breast milk and where in the body are the from

Answer 15

• lactose –> newly synthesised in alveolar
• ions (sodium and potassium) –>transported into alveoli via active transport
• proteins –> can be synthesised or transported from maternal circulation

Question 16

where is milk fat made

Answer 16

lipid droplets are made in alveolar cells
lipids made from maternal circulation or newly synthesised

Question 18

what causes the change in composition of human milk

Answer 18

• feed duration
• time of day
• infants age
• maternal nutritional status
• gestational age of delivery

Question 19

what are the 3 types of milk produced during lactation, and at what days

Answer 19

1. colostrum –> first 3 days
2. transitional milk –> days 3-14
3. mature milk –> day 14 onwards

Question 20

what is the purpose of colostrum milk

Answer 20

• small amounts of milk to not overflow the infants stomach
• immuno-protective role
• mild laxative effect to help with the first bowel movements

Question 21

what are the bioactive components of colostrum and what are their roles

Answer 21

immunoglobulin A and lactoferrin
protect against microorganism exposure

Question 22

what is foremilk

Answer 22

• the first milk released
• watery-bluish colour to quench thirst
• lower in fat
• lactose rich
• sweeter to trigger the desire to fee

Question 23

what is hindmilk

Answer 23

milk released after full letdown
- yellowish colour
- rich in fat
- energy and nutrient dense for contentment during feeding

Question 24

what are the carbs in breast milk

Answer 24

• 80% of the carbs are lactose
• Human milk oligosaccharides (HMOs)

Question 25

what are HMOs

Answer 25

act are prebiotics to encourage bacterial growth in the colon - over 130 types

Question 26

what are the types of protein in breast milk

Answer 26

- caesin (20-30% early lactation and 50% in late lactation) - whey (70-80% early lactation and 50% late lactation) - non-protein nitrogen )20-50% nitrogen in milk)

Question 27

what is casein protein

Answer 27

- large, hydrophobic protein - forms micelles with calcium phosphate - form clots in infants stomach

Question 28

what is whey protein

Answer 28

- smaller, hydrophilic - easily digestible - serum protein, enzymes, and lactoferrin

Question 29

role of fats in human milk

Answer 29

provide energy used in development of the CNS

Question 30

why does fat content change between women

Answer 30

based on body fat and weight gain during pregnancy

Question 31

what affects fatty acid composition of breast milk

Answer 31

mothers diet and nutritional status

Question 32

why is vitamin D important in breast milk

Answer 32

- infant body stores deplete within 8 weeks - low Vit D can increase the risk for inadequate bone mineralisation and conditions such as rickets

Question 33

why is vitamin K important in breast milk

Answer 33

low vit K increases risk of haemorrhagic disease

Question 34

how do we try to prevent vit k deficiencies in infants

Answer 34

intramuscular injection of vit k to all newborns

Answer 35

what minerals are found in human milk