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4) Nutrition Through Life > 7) Lactation and Breastfeeding (Part I) > Flashcards

7) Lactation and Breastfeeding (Part I) Flashcards

1
Q

Why may breastfeeding be referred to as exterior gestation?

A

As it provides continuity in terms of security and nourishment between the mother and infant

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2
Q

What occurs to progesterone and estrogen secretion following parturition?

A

They decrease significantly, while other hormones rise to stimulate the secretion of milk

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3
Q

What is the magic hour?

A

The recommendation that infants be placed in contact with the mother’s breast as soon as possible

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4
Q

Why is a support system crucial for successful long-term breastfeeding?

A

As psychological inhibitions (e.g. an unsupportive family) may decrease the flow of milk

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5
Q

Which conditions may result in the need of tube-feeding for the baby?

A
  • Low-birth weight infant or neurologically impaired infant

- They are not able to suckle properly on the breast

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6
Q

What stimulates the production of milk? By what cells?

A
  • The suckling stimulus stimulates the release of prolactin from the anterior pituitary
  • Stimulates milk production by alveolar cells in mammary glands
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7
Q

What is the function of oxytocin in milk let-down?

A
  • Oxytocin is released from the posterior pituitary

- Stimulates myoepithelial cells of the mammary gland to contract

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8
Q

How does breastfeeding suppress ovulation?

A
  • Decreased levels of estrogen and progesterone
  • Increased levels of prolactin
  • The rate of breastfeeding must be maintained to prevent ovulation
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9
Q

When should the mother think of using other methods of contraceptives?

A

When the baby starts to sleep through the night

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10
Q

How does breastfeeding influence the size of the uterus?

A
  • Breastfeeding stimulates the contraction of the uterus

- Results in the involution of the uterus through oxytocin release

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11
Q

What are four advantages of breastfeeding? (4)

A

1) May aid in proper jaw and tooth development
2) Bacteriologically safe, always fresh, and contains anti-infectious agents
3) Nutritionally superior
4) Associated with a lower risk of food allergies

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12
Q

Provide examples of milk compartments.

A
  • Micelles
  • Membrane-bound globules
  • Live cells
  • Protein
  • Non-protein nitrogen compounds
  • Carbohydrates
  • Lipids
  • Vitamins
  • Minerals
  • Trace elements
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13
Q

What are the three sources of milk components?

A

1) Transferred from maternal plasma
2) Synthesized from maternal secretory (alveolar) cells from maternal plasma precursors
3) Synthesized from other mammary cells in situ

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14
Q

What are the three phases of milk production? When do they occur?

A

1) Colostrum (5 to 7 days)
2) Transitional milk (7 days to 3-4 weeks)
3) Mature milk

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15
Q

How does colostrum compare to mature milk? (2)

A

1) High in protein and mineral content

2) Lower in energy, fat, and lactose content

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16
Q

What quantity of milk does colostrum provide? What does it ressemble?

A
  • The quantity is very small (2-10 mL feeding per day)

- Intense transparent yellow fluid

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17
Q

What explains the intense transparent yellow fluid of colostrum?

A

Colostrum contains 10 times the carotenoid content of mature milk

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18
Q

How does transitional milk vary from colostrum?

A

1) Quantity of protein decreases to a consistent level

2) Increase in lactose and fat

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19
Q

How does mature milk vary?

A

According to the changing infant’s needs (i.e. the time of day, or depending on the age of the child)

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20
Q

What is the composition of foremilk? Why?

A
  • Contains a high quantity of water and lactose

- Due to the increased hydration needs of the child

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21
Q

What is the composition of hindmilk?

A

Higher in fat and calories

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22
Q

Why are women advised to empty one breast before moving on to the next one?

A

To provide the infant with a greater quantity of hindmilk, and, thus, a greater quantity of fat to aid in brain development

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23
Q

What are the three immunological properties of breast milk?

A

1) May have a direct action against pathogens
2) Modulate the immune response
3) Promote the growth and maturation of the GI tract

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24
Q

How do the immunological factors contained in breast milk compare to cow’s milk and infant formula?

A
  • Most immune factors are not found in infant formula

- Lower concentrations are found in cow’s milk

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25
Q

How are whey proteins structurally different than caseins?

A

They are resistant against proteolysis and acid denaturation

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26
Q

Why are whey proteins resistant against proteolysis and acid denaturation?

A

Because they contain anti-proteases (e.g. sulfhydryl oxidases)

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27
Q

What is the major function of anti-proteases in whey protein?

A
  • May protect bioactive proteins, enzymes, and immunoglobulins by preserving their disulfide bonds
  • Whey proteins contain multiple disulfide bonds, providing a rigid structure that is difficult to digest by proteases
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28
Q

What are the abundant antibodies in breast milk directed against?

A
  • Bacteria
  • Bacterial toxins
  • Viruses
  • Fungi
  • Food proteins that may cause allergies
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29
Q

Which antibodies are contained within the mammary gland?

A
  • IgA
  • IgM
  • IgE
  • IgI
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30
Q

Which antibody is contained in the maternal plasma?

A

IgG

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31
Q

Which antibody forms 90% of secretory antibodies? What does it arise from?

A
  • IgA

- B-cells of the maternal small intestine and respiratory tract

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32
Q

Why is IgA particularly protective against many pathogens?

A

As the B-cells originate from maternal sites where there is a high exposure to pathogens

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33
Q

____ within the GI tract is resistant to proteolysis, acting on the mucosal surfaces of the GI tract.

A

IgA

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34
Q

What is the bifidus factor? What is its major function?

A
  • Nitrogen-containing carbohydrate

- Promotes the growth of lactobacilli, decreasing the risk of diarrheal diseases in children

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35
Q

What are lactobacilli?

A

An important probiotic bacterium that may antagonize the survival of enterobacteria

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36
Q

Studies have demonstrated that breastfed babies have a lower risk of developing diarrhea during childhood, due to what?

A

Due to the promotion of lactobacilli by the bifidus factor

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37
Q

What is the dominant bacteria in the lower GI of breastfed infants? What is their major function?

A
  • Lactobacilli

- They secrete organic acids and inhibit the growth of pathogen bacteria

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38
Q

What is necrotizing enterocolitis?

A
  • An infection that destroys intestinal tissue
  • Causes acute inflammation of the intestinal mucosa
  • It is the most common intestinal disease in premature babies
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39
Q

What health issues may cause full-term babies to develop necrotizing enterocolitis? How?

A
  • Bacterial growth that erodes the intestinal wall

- Heart defect: disruption of oxygen or blood flow to the intestine, causing necrosis of the intestinal tissue

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40
Q

What occurs when necrotizing enterocolitis leads to perforation?

A

Waste products and bacteria within the intestine enter the bloodstream or the abdominal cavity

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41
Q

How is breastfeeding related to necrotizing enterocolitis?

A

Breastfeeding may reduce the risk of developing necrotizing enterocolitis

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42
Q

Which antimicrobial enzyme is found in human breast milk but not in cow’s milk?

A

Lysozyme

43
Q

What is lactoferrin? What is its function in breast milk?

A
  • Lactoferrin is a whey protein
  • Produced by milk lymphocytes
  • Inhibits siderophilic bacteria (require iron to survive)
44
Q

Differentiate apo-lactoferrin and holo-lactoferrin.

A
  • Apo-lactoferrin (unconjugated) competes for iron and forms 80% of the lactoferrin in breast milk
  • Holo-lactoferrin is conjugated with iron
45
Q

What is the major function of lactoperoxidases?

A

Kill Streptococci and enteric bacteria

46
Q

What is the major function of lipases in breast milk?

A
  • Enhance fat breakdown in the gut

- Their products (FFAs and MAGs) have anti-viral properties

47
Q

What is the major function of interferons in breast milk? What produces interferons?

A
  • Produced by milk lymphocytes

- Inhibit intracellular viral replication

48
Q

What is the major function of neutrophils in breast milk?

A
  • Form 90% of white blood cells in milk

- Responsible for phagocytosis and intracellular killing of microbes

49
Q

What is the major function of macrophages in breast milk?

A
  • Form 10% of white blood cells in milk

- Responsible for the synthesis of complement proteins, lactoferrin, lysozymes, as well as carry-out phagocytosis

50
Q

What is the major function of complement proteins in breast milk?

A
  • Responsible for the attack of the plasma membranes of pathogens
  • Aid in inflammatory processes
  • Promote opsonization
51
Q

What is the major function of fibronectin in breast milk?

A

Increases phagocytosis

52
Q

Which hormones stimulate the synthesis of intestinal enzymes and the maturation of the gut mucosa?

A
  • Cortisol
  • Thyroxine
  • Insulin
53
Q

What is the major function of prostaglandins as a growth factor in breast milk? Why is it important?

A
  • Stimulate mucus secretion and cell division
  • Important as the mucosal barrier of the infant is extremely immature, and it is the first line of defence within the GI tract
54
Q

What is the major function of polyamines as a growth factor in breast milk? What are examples of polyamines?

A
  • Growth factors that increase cell replication

- Example: spermine and spermidine

55
Q

What is the major function of insulin-like growth factor as a growth factor in breast milk?

A

Increases the rate of gut maturation

56
Q

What is the major function of vitamin E as a growth factor in breast milk?

A

Stimulates the immune system

57
Q

The _______ content in milk is directly proportional to the growth rate of the animal.

A

protein

58
Q

How does the growth rate of humans compare to other mammals? What may explain this disparity?

A
  • Humans possess an extremely low-growth rate

- The protein content in human breast milk is also low

59
Q

What are caseins?

A
  • Complexes of caseinates found in micelles, in combination with calcium, magnesium, and phosphates
  • Phosphoproteins that occur solely in milk
60
Q

What minerals do caseins carry? Why?

A
  • Calcium, magnesium, and phosphorus

- The micelle structure allows caseins to carry an ample amount of minerals

61
Q

What is whey protein?

A

The thin liquid remaining after the removal of the acid participate of the curd

62
Q

How does the whey-to-casein ratio in humans compare to cow’s milk?

A
  • 60:40 (whey:casein)

- 40:60 (whey:casein)

63
Q

How does a greater quantity of whey protein as opposed to casein in breast milk benefit infants?

A
  • Whey forms a soft curd in the stomach

- Increased absorption within the underdeveloped infant GI tract

64
Q

What are other benefits of whey as opposed to casein?

A
  • Contains a higher proportion of nucleotides
  • Better balance of essential amino acids
  • Decreased risk of allergic reactions
65
Q

How does a-lactalbumin concentration compare between cow and human milk?

A

Human milk has greater a-lactalbumin

66
Q

How does lactoferrin concentration compare between cow and human milk?

A
  • Human milk has lactoferrin

- Cow’s milk does not

67
Q

How does B-lactoglobulin concentration compare between cow and human milk?

A
  • Human milk does not have B-lactoglobulin

- Cow’s milk does

68
Q

How does serum albumin concentration compare between cow and human milk?

A

Human milk has greater serum albumin

69
Q

How does IgA concentration compare between cow and human milk?

A

Human milk has MUCH greater IgA

70
Q

How does IgG concentration compare between cow and human milk?

A

Cow’s milk has greater IgG

71
Q

How does non-protein nitrogen concentration compare between cow and human milk?

A

Human milk has greater non-protein nitrogen

72
Q

What is lactalbumin? Where is it synthesized?

A
  • Component of lactose synthetase

- Synthesized in the mammary gland

73
Q

Which minerals does lactalbumin supply?

A

Calcium and zinc

74
Q

Which minerals does xanthine oxidase supply?

A

Iron and molybdenum

75
Q

Which mineral does glutathione peroxidase supply?

A

Selenium

76
Q

Which minerals does alkaline phosphatase supply?

A

Zinc and magnesium

77
Q

Which mineral does lactoferrin supply?

A

Iron

78
Q

The iron present in the environment of the GI tract are taken up by ___-lactoferrin to protect bacterial growth.

A

apo

79
Q

___-lactoferrin provides iron to the infant.

A

Holo

80
Q

What are the two major proteins in human milk?

A
  • Serum albumin

- IgA

81
Q

What are the two major proteins in cow’s milk?

A
  • B-lactoglobulin

- Serum albumin

82
Q

Which protein is responsible for most of the antigenicity of cow’s milk? Is it present in human milk?

A
  • B-lactoglobulin

- It is not present in human milk

83
Q

Bovine serum albumin is different than human serum albumin. What has bovine serum albumin been linked to?

A

Type I diabetes

84
Q

Which antibody is closely associated with infant colic? Which type of milk contains this antibody?

A
  • IgG

- Contained largely in cow’s milk

85
Q

What is infant colic?

A
  • Inconsolable crying and abnominal distress and distension

- The baby cries for at least half an hour consecutively for at least three times a week

86
Q

What is the major advantage of the high quantity of non-protein nitrogen in human milk?

A

May be advantageous in terms of digestibility

87
Q

Breast milk contains a (low/high) quantity of taurine.

A

high

88
Q

Which characteristics explain the high quantity of taurine in breast milk?

A

1) Required for bile acid conjugation
2) Putative neurotransmitter
3) Conditionally essential amino acid in the newborn

89
Q

Breast milk contains a (low/high) quantity of methionine, and a (low/high) quantity of cysteine.

A

low

high

90
Q

Breast milk contains a (low/high) quantity of phenylalanine, and a (low/high) quantity of tyrosine.

A

low

low

91
Q

What characteristics explain the low concentration of methionine and high concentration of cysteine in breast milk?

A
  • Allows the utilization of cysteine without the metabolism of methionine
  • Important as the metabolism of methionine is impaired in newborns
  • Cystathionase is late to develop, which is responsible for the breakdown of homocysteine to cysteine (preventing accumulations of toxic methionine)
92
Q

What characteristics explain the low concentration of phenylalanine and low tyrosine of cysteine in breast milk?

A
  • Tyrosine aminotransferase and para-hydroxyphenyl pyruvate oxidase are late to develop
  • An excess of these amino acids may adversely affect the CNS, as they are neurotoxic
93
Q

What is the major effect of an excess of blood methionine?

A

May adversely affect the CNS

94
Q

When is cow’s milk recommended to infants?

A

Cow’s milk is NOT recommended to infants

95
Q

How is IgE linked to the onset of allergies from cow’s milk?

A
  • IgE binds to food proteins to form a complex that binds to receptors on mast cells and basophils
  • Causes the release of cytokines, interleukins, and platelet-activating factor to provoke an inflammatory response via histamine release
96
Q

How is a cow’s milk allergy managed in an infant?

A

By utilizing formula containing casein or whey protein hydrolysates

97
Q

If an infant develops a reaction to cow’s milk protein, then they are likely to develop a reaction to ___ milk protein.

A

soy

98
Q

Why is soy milk protein not recommended for infant consumption?

A
  • Lower bioavailability of minerals (zinc, calcium, iron), as phytic acid complexes with these minerals, which prevents their absorption
  • Decreased calcium and phosphorus retention
  • Decreased bone density
99
Q

Which breast milk protein provides protective effects against milk allergies?

A
  • IgA aids in the blockage of whole food proteins from absorption by binding them
  • The reticuloendothelial system clears out the food protein-IgA complex
100
Q

How does colostrum provide protective effects against milk allergies?

A
  • Infants have leaky junctions within their GI tract, which allows antigens to pass through
  • Colostrum hastens the closure of leaky junctions
101
Q

What is Heiner’s syndrome? How does it primarily present itself?

A
  • Rare hypersensitivity to unheated cow’s milk protein

- Presented primarily as a pulmonary and infectious disease

102
Q

Is Heiner’s syndrome an allergic reaction or an immunologically-mediated response? What is it associated with?

A
  • Immunologically-mediated response

- GI blood loss, iron deficiency anemia, failure to thrive

103
Q

What is taurine?

A

Non-protein nitrogen component

4) Nutrition Through Life (19 decks)

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