IBCLC - Breastmilk Composition and Function Exam questions and answers 2024 already graded A

Carbohydrates (calories) 40% of calories in BM come from carbohydrates Fats (calories) 50% of calories in breastmilk come from fats WHO Guidelines to Optimal Infant Feeding 1. BF directly at mother's breast 2. EBM from the mother 3. EBM from a donor 4. Artificial infant milk (formula) Protein (calories) 10% of calories in breastmilk come from protein Carbohydrates 7% of breastmilk is carbohydrates Fats 4% of breastmilk is fats Protein 0.8-1% of breastmilk is protein Breastmilk composition is not constant; varies with: 1. Stage of lactation 2. Breastfeeding pattern 3. Season 4. Parity 5. Lactation period/infant age A-lactalbumin (protein) A major protein found in human milk whey. * assists in processing lactose Human milk is... Low in protein and high in fat and carbohydrates What are the 5 whey proteins? 1. A-lactalbumin (Major protein - provides significant amino acids) 2. Serum albumin 3. Lactoferrin *protective factors - inhibits bacteria growth in gut *transports iron and aids in absorption *antibacterial *essential growth factor for lymphocytes *promotes growth of L-bifidus 4. Immunoglobulins (IgA - protects from viruses, bacteria and allergies) 5. Lysosomes (protects against and Salmonella; promotes growth of healthy gut flora) What are the 2 main proteins in milk? 1. Whey (60%) - digests fastest 2. Casein (40%) - forms soft curd - nutritive (b-casein) What gives breastmilk it's bluish colour? Whey protein What % of protein in breastmilk is whey? 60% What % of protein in breastmilk is casein? 40% What are the main fats in breastmilk? 1. Triglycerides (98%): (Oleic acid, Palmitic acid, Linoleic & Linolenic acid) 2. Phospholipids 3. Essential fatty acids What is the approximate protein content of breastmilk? 9 mg/dL What is the gastric half-emptying time of breastmilk? 48 minutes What is the gastric half-emptying time of formula? 78 minutes What %age of non-protein nitrogen (NPN) makes up the protein in breastmilk? 20-25% What are the main carbohydrates in breastmilk? 1. Lactose (primary) - glucose & fructose 2. Oligosaccharides (consists of monosaccahrides and promotes growth of Lactobacillus Bifidus - (beneficial gut bacteria) A-lactalbumin (protein) - function in the mammary gland a-lacalbuman participates in lactose synthesis by creating an osmotic "drag" to facilitate milk production and secretion. Does the maternal diet affect total concentrations of fat, protein or lactose in the breastmilk? No - the maternal diet does not affect these macronutrients in breastmilk. Does the maternal diet affect fatty acids, micronutrients and vitamins in the breastmilk? Yes - maternal diet DOES affect the fatty acid profile, several micronutrients and water-soluable vitamins in the breastmilk What are the main functions of fats in breastmilk? 1. Needed for mental, CNS and visual (retinal) development 2. Increases digestability, absorption & mineral balance 3. Transport vehicle for fat-soluble micronutrients and vitamins What are the main functions of protein in breastmilk? 1. Provide essential amino acids for growth 2. Provide protective factors 3. Carriers for hormones and vitamins 4. Provide enzymatic activity 5. Provide other biological activities What are the main facts about cholesterol in breastmilk? 1. Cholesterol is a fat 2. Constant level - maternal diet does not affect it 3. 100-200 mg/L 4. It is needed for formation of stable cell membrane structure What is the function of growth factors (IGF, EGF, TGF) in breastmilk? 1. Promote GI maturation 2. Prevent inflammation 3. "early life programming" - feeding cues A-lactalbumin (protein) - infant benefits 1. Binds to calcium and zinc and facilitates the absorption of essential minerals 2. Provides well-balanced supply of essential amino acids to the growing infant 3. Prevents infections - provides antibacterial and immunostimulatory properties and cause apoptosis of tumour cells (kills cancer cells) What is the function of lyzosome, lactoferrin and immunogloulins? They have a major role in providing bacteriostatic and bacteriocidal properties to breastmilk.