Exam 2 terminology (lactation) Questions and Answer

Exam 2 terminology (lactation) Questions and Answer Lactation consultant A breast-feeding specialist who shows breast-feeding mothers how to stimulate adequate milk flow and how to position babies properly so they can nurse LaLeche League an international nonprofit breastfeeding advocacy group. Local chapters hold meetings to provide breastfeeding information and support. Areola dark-pigmented area surrounding the breast nipple Sebaceous glands secrete sebum (oil) into the hair follicles where the hair shafts pass through the dermis Nipple projection from the breast into which the lactiferous ducts open Colostrum a specialized form of milk that delivers essential nutrients and antibodies in a form that the newborn can digest Lactogenesis production of milk Lactose glucose + galactose Prolactin stimulates milk production MER Milk ejection reflux Oxytocin A hormone released by the posterior pituitary that stimulates uterine contractions during childbirth and milk ejection during breastfeeding. Casein milk protein Whey proteins mixture of proteins in milk that remain soluble after addition of acid or rennet Latch-on Attachment of the infant to the breast for feeding. List psychological benefits of lactation for the mother reduces anxiety, which is likely associated with the hormone prolactin [2]. Other studies have discovered that breastfeeding directly decreases the symptoms of depression and that early cessation of breastfeeding eliminates this benefit List physical benefits of lactation for the mother. reduce the mother's risk of breast and ovarian cancer, type 2 diabetes, and high blood pressure. economic advantages of lactation to the family and society. lower medical costs by reducing physician fees, hospital costs, prescription drugs, medical supplies How do breastfeeding mothers compare to bottle-feeding mothers with regard to postpartum physical activity and weight loss? exclusive breastfeeding promotes greater weight loss than mixed feeding among mothers even in the early postpartum period List benefits of breastfeeding for the infant. -Contains antibodies that protect against illnesses and infection -Antioxidants, hormones, enzymes, growth factors -Decrease risk of asthma, lymphoma, diabetes, ear infections, diarrhea, vomiting, hospital admissions, illness and obesity -IQ Explain the differences between morbidity and mortality rates between breastfed and bottle-fed infants in the US and developing countries. Compared to breast-fed infants, formula, fed infant, space, a higher morbidity, then breast-fed. Can allergens be transmitted in human milk? What precautions should the mother take if there is a history of food allergies in the family? Yes they can. Avoid food if see a reaction Why would you want to put human milk in a kid's eye? an effective treatment for eye infections such as conjunctivitis. How have trends in breastfeeding incidence changed after World War 2? (no numbers - just trends) Changing, social, legal thoughts of breast-feeding. They don't want to breast-feed anymore as much as they used to Without memorizing the exact percentages, what are the Healthy People 2020 Goals related to breastfeeding? Healthy People 2020 aims to increase breast-feeding rates to 82% "ever breast-fed," 61% at 6 months and 34% at 1 year; exclusive breast-feeding goals are set for 44% by 3 months and 24% at 6 months. Describe the anatomy of the human breast. Each breast has 15 to 20 sections, called lobes. They are arranged like the petals of a daisy. Each lobe has many smaller structures called lobules. These end in dozens of tiny bulbs that can produce milk. What changes do the breasts experience during pregnancy and lactation? (in general) Darkened veins along with your breasts (due to the increased blood supply to your breasts). Around month three, your breasts may start leaking a yellowish, thick substance known as colostrum. Some women may leak earlier, some never at all. Nipples stick out more, and the areolas and nipples will grow larger. How does size of the breasts affect the success of breastfeeding? There is no evidence that the size of the breast affects the lactation process. However, if a woman has a small breast, it may be harder for her baby to latch on. Describe the first week postpartum in terms of the lactation process. your breasts become fuller and warmer and that your milk slowly changes to a bluish-white color Discuss the roles of prolactin and oxytocin in the breastfeeding process. Where are they produced? What triggers their production? When it reaches the lactocytes in your breasts, the prolactin causes these cells to start assembling all the amazing components needed to make breastmilk. Oxytocin stimulates the tiny myo-epithelial cells in the alveoli to contract and squeeze the milk into the lactiferous ducts. How long can a woman continue to breastfeed? Up to two years old and maybe after Can a woman who has never been pregnant breastfeed? How does this happen? Human milk is secreted through your mammary glands, which are located in your breasts. Lactation is hormonally driven and occurs naturally in people who are pregnant. It can also be induced in those who are not pregnant. Lactation will continue as long as milk is being removed from your breasts. Describe the differences between colostrum and mature milk. Compared with mature milk, colostrum contains more minerals and protein, but less sugar and fat. How does human milk differ from cow's milk with regard to total protein, casein, and whey proteins? Cows milk has less of all What's the difference between hind-milk and fore-milk? For milk is more watery and high end volume. For milk is the milk in the beginning of the feeding and hindmilk is the milk at the end. What lipids are in human milk and what is their importance for the infant? glycerophospholipids (e.g., phosphatidylethanolamine, phosphatidylcholine) and sphingolipids provide an important source of essential fatty acids and cholesterol. They're also necessary for the growth (and weight gain) of your baby and the development of your child's brain and vision. The fats in your breast milk may also play a role in controlling your baby's appetite. What is the special role of lactose in human milk? Hope the calcium in milk How does the Ca and P content of human milk compare to cow's milk? Compared to cow's milk, human milk contains less protein (3.5% in cow's milk), and especially a proportion of casein (on total protein) lower, max 50% (80% in milk of cow) Compare iron content and iron absorption rates of human milk, cow's milk, and infant formulas. 70% in breastmilk, 30% in cows milk and 10% is infant formula Can the mineral content of human milk be influenced by the mother's diet? the mineral content of human milk is generally considered less related to maternal dietary intakes Is the vitamin content of human milk influenced by the mother's diet? No Explain the recommendations for vitamin D for the breastfed infant. Pediatrics recommend breastfed and partially breastfed infants be supplemented with 400 IU per day of vitamin D beginning in the first few days of life. Why is a one-time injection of vitamin K given to infants right after birth? To get enough bacteria to their intestine. They don't have enough. How long should a baby be breastfed? Through at least 1 year is ideal! Describe the process of attaching the baby to the breast. How do you know if the baby is latched on properly? Aim your baby's lower lip away from the base of your nipple. Baby's lips should be turned outward like a fish. Your baby should lead into the breast chin first and then latch onto your breast. Your baby's tongue should be extended, and your breast should fill your baby's mouth How do you know when a baby is hungry? Cry and put hands in mouth How long should an infant be allowed to nurse at each breast? Up to 20 mins or longer How many times a day do newborns eat? 8-12 times per day for about the first month What are some signs that a baby is thriving? They seem calm and relaxed during feeds. What are some signs that a baby is becoming malnourished and/or dehydrated? Decrease muscle mass, fatigue, weight, loss, feeling cold Can a baby get tooth decay from breastfeeding? No Which requires more calories and nutrients - pregnancy or lactation? Breast-feeding What would be your recommendations for a woman who wants to diet for weight loss during lactation? Drink lots of water, limit caffeine. Eat protein and fiber, rich whole foods keep taking your prenatal. How does maternal exercise affect lactation? Exercise Won't Decrease Your Milk Supply or Change its Taste Under what circumstances might a lactating woman need nutritional supplements? If vegan or vegetarian What is the main ingredient of milk? water What are the components of the Best Start Three-Step Counseling Strategy? Ask open ended questions about breast-feeding Affirm the mother's feelings Share information What are key points about breastfeeding that should be taught prior to the birth? Consistent context, right after birth... Be familiar with the components of the WHO Code for marketing of breastmilk substitutes. The main points in the Code include: • no advertising of breast-milk substitutes and other related products to the public; • no free samples to mothers or their families; • no promotion of products, i.e. no product displays, posters, calendars, or distribution of promotional materials; • no donations of free or subsidised supplies of breast-milk substitutes or related products in any part of the health care system; • no company-paid personnel to contact or to advise mothers; • no gifts or personal samples to health workers; • no pictures of infants, or other pictures or text idealising artificial feeding, on the labels of the products; • information to health workers should only be scientific and factual; • information on artificial feeding should explain the importance of breastfeeding, the health hazards associated with artificial feeding and the costs of using artificial feeding ; • all products should be of a high quality, and unsuitable products, such as sweetened condensed milk, should not be promoted for babies. Be familiar with the Baby-Friendly Hospital initiative (and Texas Ten-Step) and hospital practices that encourage successful breastfeeding. Peer counselors are more than just support for your patients; they are your partner in helping and encouraging mothers to breastfeed. When you refer mutual clients, WIC peer counselors: Teach basic breastfeeding skills to new moms. Educate mothers on the benefits of breastfeeding for both mom and baby. Share research-based breastfeeding information, best practices and their own valuable insight. Make appropriate referrals to physicians, hospitals, lactation consultants, and other providers when needed. Provide clinic and phone consults. Help with breast pumps, as needed. Make hospital and home visits, where available. What are worksite practices that can support lactation? Flexible work schedules to provide time for milk expression. Access to a private location for milk expression. Access to a nearby clean and safe water source and sink for washing hands and rinsing out any breast-pump equipment. How well do breastfeeding promotion programs work? may plausibly reduce neonatal mortality by 3% and post neonatal mortality by 7% when the program is directly delivered to parents What is Wellstart International and what do they do? To advance the knowledge, skills and ability of healthcare providers, regarding the promotion, protection and support of breastfeeding Describe each of the following problems. List possible causes and recommended management of each problem. a. Sore nipples- poor latch b. Poor MER c. Engorgement d. Plugged milk duct e. Mastitis a. Sore nipples- b. Poor MER c. Engorgement d. Plugged milk duct e. Mastitis Left over milk, poor latch. Describe recommendations for medication management during breastfeeding. Avoid taking medications you don't necessarily need, What advice should be given to lactating women regarding the following: a. Environmental contaminants b. Smoking c. Caffeine d. Alcohol e. Marijuana a. Environmental contaminants b. Smoking c. Caffeine d. Alcohol e. Marijuana All of these drugs do enter breastmilk to some extent and can have a detrimental effect on the production, volume, composition and ejection of breastmilk, as well as a direct adverse effect on the infant. Breastfeeding mothers should be encouraged to restrict their intake of these so-called recreational drugs. Why are HIV positive women in the US told not to breastfeed, whereas, in developing countries, WHO recommends that HIV positive women should breastfeed? the benefits of breastfeeding outweigh the risk of HIV transmission in areas where resources are limited.