Test 2

Question 1

First thing infant receives?

Answer 1

Colostrum

Question 2

Synthesis of milk?

Answer 2

Inhibited by presence of estrogen and progesterone

Question 3

Colostrum

Answer 3

• Yellowish fluid
• Low in fat and lactose
• Rich in protein and vitamin A
• Contains maternal antibodies
• Early source of vitamin K

Question 4

Mature Milk

Answer 4

• Varies between two breasts

- Varies over time of day; more fat in evenings

Question 5

Foremilk

Answer 5

More dilute milk released eary in a feed

Question 6

Hindmilk

Answer 6

More energy and nutrient dense milk later in feed

Question 7

Milk Carbohydrates

Answer 7

Contains lactose (80% CHO) and oligosaccharides (20%)

Question 8

Oligosaccharides in Milk

Answer 8

Act as prebiotics in the infant gut and promote colonisation of colon
- Prevent diarrheal infection

Question 9

Lactose in Milk

Answer 9

Synthesized by alveolar epithelial cells from glucose

Question 10

Milk Lipids are mostly?

Answer 10

Triglycerides

Question 11

Fatty Acids in milk

Answer 11

• Circulating FFA (chains over16 carbons)

- De novo pathways (chains up to 16 carbons)

Question 12

De novo synthesis is from?

Answer 12

• Glucose

- Short carbon chains (acetyl CoA)

Question 13

Production of milk proteins

Answer 13

Major milk proteins are synthesized de novo in the alveolar epithelial cells (caseins, a-lactalbumin, B-lactoglobin

Question 14

Endocrine control of lactation

Answer 14

Coupled endocrine control over synthesis and release of milk

Question 15

Progesterone and estrogen stimulate…?

Answer 15

Alveolar proliferationa nd duct lengthening/branching

Question 16

Progesterone and estrogen inhibit…?

Answer 16

Production of mature milk

Question 17

Oxytocin

Answer 17

• Released in response to stimulation of mechanoreceptors in nipple (nerve signal)
• Stimulates ejection of milk

Question 18

Let-Down Reflex

Answer 18

Ejection due to oxytocin is necessary because infant cant suck milk from nipple

Question 19

Prolactin Releasing Hormone

Answer 19

In response to same nerve signal that stimulates oxytocin release
- Stimulates milk synthesis in alveolar cells

Question 20

Maternal Requirement for Lactation

Answer 20

• 640 kcal/day in first 6 months
• 510 kcal/day after 6 months
• SO…500 kcal/day extra calories come from diet

Question 21

Protein Requirement for Lactation

Answer 21

• 11g protein/day in first 6 months

8g/day after 6 months

Question 22

Breastfeeding

Answer 22

Process of feeding baby human milk

Question 23

Ever breastfed

Answer 23

Infant has been breasfed on at least 1 occasion

Question 24

Exclusively breastfed

Answer 24

Infant has only ever been fed with breast milk

Question 25

Where/who is breastfeeding more common in/with

Answer 25

- Older women - Women educated beyond age 18 - Women from ethnic minority groups - Women from higher socioeconomic classes

Question 26

Reasons for stopping breastfeeding

Answer 26

- Engorgement (mature milk replaces colostrum) - Sore nipples (poorly latched, discomfort) - Infections (Mastitis, candida albicans) - Most issues can be overcome

Question 27

Promotion of Breastfeeding

Answer 27

- Health professionals - Specialist charities - Peer support

Question 28

The Baby Friendly Hospital Initiative

Answer 28

- Worldwide - UNICEF/WHO - Implement policies/practices that promote breastfeeding

Question 29

Breastfeeding advantages for mothers

Answer 29

- Reduction in risk of breast cancer | - Reductio in risk of ovarian cancer

Question 30

Breastfeeding advantages for babies

Answer 30

- Optimal form of nutrition - Lower risk of infection - Protection from SIDS - Protection against allergies - Lower risk of obesity

Question 31

Causes of obesity in childhood

Answer 31

- Supply vs demand - Result of interplay between genes/environment - Require obesogenic environemtn

Question 32

Obesogenic Environment

Answer 32

- Human genome that favors energy storage due to evolution | - Turns into genetic predisposition for obesity

Question 33

Dietary patterns more strongly associated than energy intake obesity

Answer 33

- Absolute energy intake is poor predictor of BMI | - Heavier children consume more energy bc larger

Question 34

Dietary Drivers of obesity

Answer 34

- Meal frequency - Portion size - Energy density

Question 35

Breakfast-Skipping Study

Answer 35

Skipping breakfast results in greater energy intake over whole day, with more carb-rich snacks - Increases obesity risk

Question 36

Physical Activity/Sedentary Behavior and Obesity

Answer 36

- Transport networks favor motor vehicles - Parental perception of danger outside - Busy family lifestyles leave little room for walking - School curriculum favors academic subjects over PE - Out of school activities not open to all (cost, location)

Question 37

Causality and obesity?

Answer 37

Low activity may both drive and be consequence of obesity (obese dont want to exercise bc more difficult)

Question 38

TV and obesity?

Answer 38

- 2+ hours a day associated with risk of obesity | - Impact due to changes in food intake rather than reduce physical activity

Question 39

Obesity and Physical impact on health

Answer 39

- Obese children grow/mature more rapidly - Causes major skeletal defects - Elevated blood pressure -> hypertension - More asthma/respiratory problems

Question 40

Obesity and Metabolic impact on health

Answer 40

- Elevated LDL cholesterol, elevated triglycerides, glucose intolorance, insulin resistance - Rising trends in obesity have been associated with increases in childhood diabetes

Question 41

Obesity and Psychological/emotional impact

Answer 41

- Low self esteem - More prone to psychological problems - Viewed unfavorable by others