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Questions and Answers
During which stage of development do breasts develop lobules and alveoli?
During which stage of development do breasts develop lobules and alveoli?
What contributes to the growth of the breast at puberty?
What contributes to the growth of the breast at puberty?
Which of the following is NOT a reason a woman might be hesitant to breastfeed?
Which of the following is NOT a reason a woman might be hesitant to breastfeed?
What is the primary function of the mammary gland?
What is the primary function of the mammary gland?
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What hormonal change triggers breast development during pregnancy?
What hormonal change triggers breast development during pregnancy?
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What is the primary reason for breastfeeding, as stated in the content?
What is the primary reason for breastfeeding, as stated in the content?
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What is the aim of the International Code of Marketing of Breast-milk Substitutes?
What is the aim of the International Code of Marketing of Breast-milk Substitutes?
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Which of these is NOT a benefit of breastfeeding for the infant, as stated in the content?
Which of these is NOT a benefit of breastfeeding for the infant, as stated in the content?
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According to the content, what are some of the potential long-term benefits of breastfeeding that are still under research?
According to the content, what are some of the potential long-term benefits of breastfeeding that are still under research?
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Which of the following is a reason mentioned in the content for choosing formula feeding over breastfeeding?
Which of the following is a reason mentioned in the content for choosing formula feeding over breastfeeding?
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Which of the following is NOT a source of longer chain fatty acids in breast milk?
Which of the following is NOT a source of longer chain fatty acids in breast milk?
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What is the role of lactalbumin in lactose synthesis?
What is the role of lactalbumin in lactose synthesis?
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Which of the following is NOT a function of lactose in breast milk?
Which of the following is NOT a function of lactose in breast milk?
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What is the primary source of amino acids for protein synthesis in breast milk?
What is the primary source of amino acids for protein synthesis in breast milk?
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What is the function of β-D-galactosyltransferase in lactose synthesis?
What is the function of β-D-galactosyltransferase in lactose synthesis?
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What is the mechanism by which milk fat globules are released into the alveolus?
What is the mechanism by which milk fat globules are released into the alveolus?
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Which of the following proteins is NOT typically found in breast milk?
Which of the following proteins is NOT typically found in breast milk?
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How is the glycerol backbone for triglyceride synthesis in breast milk obtained?
How is the glycerol backbone for triglyceride synthesis in breast milk obtained?
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Which hormone is responsible for milk ejection?
Which hormone is responsible for milk ejection?
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Which of the following statements accurately describes the relationship between prolactin and progesterone during pregnancy?
Which of the following statements accurately describes the relationship between prolactin and progesterone during pregnancy?
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What is the primary function of the myoepithelial cells in breast tissue?
What is the primary function of the myoepithelial cells in breast tissue?
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How does suckling influence prolactin levels?
How does suckling influence prolactin levels?
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What is the significance of the "Milk Ejection Reflex" in relation to breastfeeding?
What is the significance of the "Milk Ejection Reflex" in relation to breastfeeding?
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What distinguishes fore milk from hind milk composition?
What distinguishes fore milk from hind milk composition?
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Why is lactation considered an unreliable contraceptive method?
Why is lactation considered an unreliable contraceptive method?
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Which of the following hormones contributes to general breast development and enlargement during pregnancy?
Which of the following hormones contributes to general breast development and enlargement during pregnancy?
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What is the primary function of alpha-lactalbumin in breast milk synthesis?
What is the primary function of alpha-lactalbumin in breast milk synthesis?
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Which of the following is NOT a component found in breast milk?
Which of the following is NOT a component found in breast milk?
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How does the fat content of breast milk affect the infant's feeding behavior?
How does the fat content of breast milk affect the infant's feeding behavior?
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What is the primary distinction between colostrum and mature milk?
What is the primary distinction between colostrum and mature milk?
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How does the hormonal balance of a breastfeeding mother influence the composition of her breast milk?
How does the hormonal balance of a breastfeeding mother influence the composition of her breast milk?
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Why is it important that alveolar epithelial cells are able to synthesize milk components?
Why is it important that alveolar epithelial cells are able to synthesize milk components?
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What is the primary energy source for breast milk?
What is the primary energy source for breast milk?
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What is the primary difference between human and bovine milk composition?
What is the primary difference between human and bovine milk composition?
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What is the primary component of milk that helps protect infants from bacterial infections?
What is the primary component of milk that helps protect infants from bacterial infections?
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Which of the following components in milk is responsible for sequestering iron, making it unavailable to harmful bacteria?
Which of the following components in milk is responsible for sequestering iron, making it unavailable to harmful bacteria?
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What is the primary reason why untreated cow's milk is not recommended for infants under the age of 12 months?
What is the primary reason why untreated cow's milk is not recommended for infants under the age of 12 months?
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What is the main objective of the International Code on Marketing of Breast-milk Substitutes?
What is the main objective of the International Code on Marketing of Breast-milk Substitutes?
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Which of the following is NOT a component of the WHO's recommendations for infant feeding?
Which of the following is NOT a component of the WHO's recommendations for infant feeding?
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What is the main reason why infant formula is considered nutritionally inferior to breast milk?
What is the main reason why infant formula is considered nutritionally inferior to breast milk?
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What is the primary reason why infant formula is modified to resemble human milk?
What is the primary reason why infant formula is modified to resemble human milk?
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What is the primary function of lysozyme in breast milk?
What is the primary function of lysozyme in breast milk?
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Which of these factors contributes to a more effective weight loss for breastfeeding mothers compared to formula feeding mothers?
Which of these factors contributes to a more effective weight loss for breastfeeding mothers compared to formula feeding mothers?
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A breastfeeding mother's milk composition can be influenced by a number of factors. Which of these factors is LEAST likely to directly influence the milk's composition?
A breastfeeding mother's milk composition can be influenced by a number of factors. Which of these factors is LEAST likely to directly influence the milk's composition?
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While breastfeeding is considered the ideal feeding method, certain circumstances can lead to the use of formula feeding. Identify the reason MOST likely to prompt a decision for formula feeding.
While breastfeeding is considered the ideal feeding method, certain circumstances can lead to the use of formula feeding. Identify the reason MOST likely to prompt a decision for formula feeding.
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What is the primary reason why untreated cow's milk is NOT recommended for infants under 12 months?
What is the primary reason why untreated cow's milk is NOT recommended for infants under 12 months?
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The International Code on Marketing of Breast-milk Substitutes aims to promote breastfeeding. Which of the following is NOT a direct objective of this code?
The International Code on Marketing of Breast-milk Substitutes aims to promote breastfeeding. Which of the following is NOT a direct objective of this code?
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Which of the following accurately describes the relationship between prolactin and progesterone during pregnancy?
Which of the following accurately describes the relationship between prolactin and progesterone during pregnancy?
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Which of the following statements is TRUE regarding the hormonal control of milk 'letdown'?
Which of the following statements is TRUE regarding the hormonal control of milk 'letdown'?
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Which of the following accurately describes the composition of colostrum?
Which of the following accurately describes the composition of colostrum?
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Which of the following BEST explains the difference between fore milk and hind milk?
Which of the following BEST explains the difference between fore milk and hind milk?
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Which of the following is TRUE about the relationship between prolactin and fertility during lactation?
Which of the following is TRUE about the relationship between prolactin and fertility during lactation?
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Which of the following hormones, besides prolactin and oxytocin, plays a role in breast development and milk production?
Which of the following hormones, besides prolactin and oxytocin, plays a role in breast development and milk production?
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Which of the following accurately describes the role of alpha-lactalbumin in milk production?
Which of the following accurately describes the role of alpha-lactalbumin in milk production?
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Which of the following accurately portrays the process of milk fat globule release into the alveolus?
Which of the following accurately portrays the process of milk fat globule release into the alveolus?
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Which of the following is most likely to contribute to the diurnal changes in breast milk composition?
Which of the following is most likely to contribute to the diurnal changes in breast milk composition?
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Which of the following is TRUE regarding the relationship between breastfeeding and menstruation?
Which of the following is TRUE regarding the relationship between breastfeeding and menstruation?
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Which of the following explains why untreated cow's milk is not recommended for infants under 12 months?
Which of the following explains why untreated cow's milk is not recommended for infants under 12 months?
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Why is infant formula considered nutritionally inferior to breast milk?
Why is infant formula considered nutritionally inferior to breast milk?
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What type of fatty acids are primarily synthesized in the mammary gland from blood glucose and ketone bodies?
What type of fatty acids are primarily synthesized in the mammary gland from blood glucose and ketone bodies?
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What component of milk is predominantly formed in the Golgi apparatus before being exocytosed into the alveolus?
What component of milk is predominantly formed in the Golgi apparatus before being exocytosed into the alveolus?
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Which protein modifies the substrate specificity of galactosyltransferase in lactose synthesis?
Which protein modifies the substrate specificity of galactosyltransferase in lactose synthesis?
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What is the primary structural characteristic of casein proteins in breast milk?
What is the primary structural characteristic of casein proteins in breast milk?
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Which process in milk fat globule formation involves the membrane closing behind the globule?
Which process in milk fat globule formation involves the membrane closing behind the globule?
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What role does UDP-Galactose play in lactose synthesis?
What role does UDP-Galactose play in lactose synthesis?
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Which milk protein is associated with the transport of iron and may influence the absorption of minerals?
Which milk protein is associated with the transport of iron and may influence the absorption of minerals?
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From which sources are longer chain fatty acids in breast milk primarily derived?
From which sources are longer chain fatty acids in breast milk primarily derived?
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What is the primary immunological benefit of lactoferrin found in breast milk?
What is the primary immunological benefit of lactoferrin found in breast milk?
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Which of the following steps is involved in the processing of cow's milk for infant formula?
Which of the following steps is involved in the processing of cow's milk for infant formula?
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According to WHO recommendations, what is the recommended duration for exclusive breastfeeding?
According to WHO recommendations, what is the recommended duration for exclusive breastfeeding?
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What role do leukocytes, specifically macrophages, primarily serve in breast milk?
What role do leukocytes, specifically macrophages, primarily serve in breast milk?
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What is a key reason why the International Code on Marketing of Breast-milk Substitutes was created?
What is a key reason why the International Code on Marketing of Breast-milk Substitutes was created?
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What is the primary nutritional disadvantage of infant formula compared to breast milk?
What is the primary nutritional disadvantage of infant formula compared to breast milk?
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Which component of breast milk is primarily responsible for promoting beneficial bacteria?
Which component of breast milk is primarily responsible for promoting beneficial bacteria?
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What is the main reason untreated cow's milk is not recommended for infants under 12 months?
What is the main reason untreated cow's milk is not recommended for infants under 12 months?
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Which of the following is NOT a potential reason for a woman to feel hesitant about breastfeeding?
Which of the following is NOT a potential reason for a woman to feel hesitant about breastfeeding?
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Which of the following is NOT a contributing factor to breast development during puberty?
Which of the following is NOT a contributing factor to breast development during puberty?
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Which statement accurately describes the role of estrogen and progesterone in breast development?
Which statement accurately describes the role of estrogen and progesterone in breast development?
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The content indicates that the breast reaches its full functional capacity for milk production once a woman is fully developed. What is the primary reason for this?
The content indicates that the breast reaches its full functional capacity for milk production once a woman is fully developed. What is the primary reason for this?
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Why might it be difficult to determine a woman's capacity for breastfeeding based solely on the size or appearance of her breasts?
Why might it be difficult to determine a woman's capacity for breastfeeding based solely on the size or appearance of her breasts?
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Flashcards
Key Hormones in Milk Production
Key Hormones in Milk Production
Hormones like prolactin and oxytocin control milk synthesis and release.
Lactose Biosynthesis
Lactose Biosynthesis
Lactose is synthesized in the mammary gland from glucose and galactose.
Composition of Human vs Bovine Milk
Composition of Human vs Bovine Milk
Human milk has more antibodies; bovine milk has more protein.
WHO Breastfeeding Recommendations
WHO Breastfeeding Recommendations
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Benefits of Breastfeeding
Benefits of Breastfeeding
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Breastfeeding aversion
Breastfeeding aversion
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Mammary gland
Mammary gland
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Breast development stages
Breast development stages
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Role of estrogens
Role of estrogens
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Milk production readiness
Milk production readiness
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Short and medium chain FA
Short and medium chain FA
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Long chain FA
Long chain FA
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Triglyceride synthesis
Triglyceride synthesis
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Milk fats production
Milk fats production
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Lactose
Lactose
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Lactose Synthase
Lactose Synthase
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Casein vs. Whey
Casein vs. Whey
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Lactose functions
Lactose functions
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Passive Immunity from Milk
Passive Immunity from Milk
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IgA Antibodies
IgA Antibodies
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Role of Lactoferrin
Role of Lactoferrin
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Importance of Leukocytes
Importance of Leukocytes
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Infant Formula Composition
Infant Formula Composition
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Risks of Untreated Cow Milk
Risks of Untreated Cow Milk
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International Code on Breastfeeding
International Code on Breastfeeding
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WHO Feeding Recommendation
WHO Feeding Recommendation
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Hypertrophy in Pregnancy
Hypertrophy in Pregnancy
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Prolactin Function
Prolactin Function
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Hormonal Regulation During Pregnancy
Hormonal Regulation During Pregnancy
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Milk Production Trigger
Milk Production Trigger
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Oxytocin Function
Oxytocin Function
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Milk Ejection Reflex
Milk Ejection Reflex
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Reduced Fertility During Lactation
Reduced Fertility During Lactation
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Milk Composition
Milk Composition
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Colostrum Characteristics
Colostrum Characteristics
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Fore Milk vs. Hind Milk
Fore Milk vs. Hind Milk
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Mature Milk Production
Mature Milk Production
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Role of Lipids in Milk
Role of Lipids in Milk
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Hormones Affecting Milk
Hormones Affecting Milk
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Pregnancy & Breast Cancer
Pregnancy & Breast Cancer
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Hormonal Sources in Lactation
Hormonal Sources in Lactation
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Nutritional Factors in Breastfeeding
Nutritional Factors in Breastfeeding
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Immunity Factors in Breastfeeding
Immunity Factors in Breastfeeding
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Breastfeeding Benefits for Mothers
Breastfeeding Benefits for Mothers
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Breastfeeding vs. Formula Feeding
Breastfeeding vs. Formula Feeding
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WHO Breastfeeding Aim
WHO Breastfeeding Aim
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Mammary gland development
Mammary gland development
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Breast size increase
Breast size increase
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Milk production ability
Milk production ability
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Latching difficulties
Latching difficulties
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Fatty Acid Sources in Breast
Fatty Acid Sources in Breast
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Long Chain Fatty Acids
Long Chain Fatty Acids
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IgA Antibodies in Milk
IgA Antibodies in Milk
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Triglyceride Formation
Triglyceride Formation
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Lactoferrin Function
Lactoferrin Function
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Lactose Structure
Lactose Structure
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Lactose Synthase Components
Lactose Synthase Components
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Leukocytes in Milk
Leukocytes in Milk
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Infant Formula Processing
Infant Formula Processing
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Casein Function
Casein Function
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Whey Characteristics
Whey Characteristics
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Lactose Benefits
Lactose Benefits
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WHO Infant Feeding Recommendation
WHO Infant Feeding Recommendation
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Breast Tissue Differentiation
Breast Tissue Differentiation
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Pregnancy and Cancer Risk
Pregnancy and Cancer Risk
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Prolactin Overview
Prolactin Overview
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Role of Progesterone
Role of Progesterone
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Oxytocin Role
Oxytocin Role
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Effects of Suckling
Effects of Suckling
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Lactation and Fertility
Lactation and Fertility
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Mature Milk Composition
Mature Milk Composition
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Lipids in Milk
Lipids in Milk
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Milk Composition Variability
Milk Composition Variability
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Breast Development Hormones
Breast Development Hormones
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Nutritional Value of Milk
Nutritional Value of Milk
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Study Notes
Mammary Gland and Lactation
- Module: Endocrine
- Class: MedYear 1, semester 2
- Date: February 7, 2024
- Lecturer: Paul O'Farrell
Learning Objectives
- Identify the hormones involved in milk synthesis and release
- Outline lactose biosynthesis in lactating mammary glands
- Compare and contrast human and bovine milk composition
- State current WHO recommendations for infant breastfeeding
- Outline the aim of the International Code of Marketing of Breast-milk Substitutes
Why Breastfeed?
- Meets baby's nutritional needs, eliminating the need for supplemental vitamins.
- Provides nutritional factors for optimal growth and development.
- Contains immunity factors, reducing infection rates.
- Protects against allergies.
- Supports normal jaw, tooth, and speech development.
- Always available at the correct temperature and amount, even for multiples.
- Enhances bonding.
- Associated with milder baby stools compared to formula-fed infants.
- Promotes maternal postpartum weight loss.
- Improves maternal health by increasing maternal circulating antibodies.
- Important in developing countries due to potential lack of safe water for formula.
- Ongoing research explores the impact on microbiome and epigenetics.
Why Formula Feed?
- Breastfeeding may be perceived as repulsive or embarrassing.
- Breastfeeding may be seen as too complex or restrictive.
- Mothers may experience difficulty in latching.
- Reluctance to breastfeeding due to lifestyle or nervousness.
- Concern about not adequately measuring baby's intake.
- Underlying medical conditions such as reflux or dietary requirements.
- Inability for the baby to gain weight.
- Other issues.
The Breast (Mammary Gland Anatomy)
- An exocrine gland
- Diagram showing lobule, alveoli, myoepithelial cells, milk-secreting epithelial cells, lactiferous ducts, nipple, areola, and pectoralis major. (anatomy)
Breast Development
- At birth, the breast mainly has lactiferous ducts and few alveoli.
- Estrogens and progesterone stimulate further duct growth, branching, and lobule development during puberty.
- Cyclic hormonal changes during the menstrual cycle affect breast size and tissue growth.
- Breast competence for milk production begins during pregnancy.
- Hypertrophy of duct-lobule-alveolus system takes place during early pregnancy.
- Alveolar epithelial cells develop ability to secrete milk during pregnancy, especially in mid-pregnancy.
Clinical Note: Pregnancy and Breast Cancer
- Final breast tissue cell differentiation occurs at the end of pregnancy.
- Less differentiated cells have a higher cancer risk.
- Pregnancy offers protection against breast cancer.
- Later primigravida (first-time pregnant women) shows less protection.
Hormonal Control of Milk Production - Prolactin
- Anterior pituitary hormone.
- Promotes lactation, steadily increasing during pregnancy (10-20 times pre-pregnancy levels).
- Progesterone from the placenta counteracts prolactin's effects.
- Progesterone levels decrease postpartum, allowing milk production.
- Suckling stimulates prolactin release.
- Milk production is proportional to stimulation duration and intensity.
- Twins typically stimulate more milk production.
- (includes graph detailing prolactin levels, mature milk, transitional milk, colostrum)
Hormonal Control of Milk "Letdown" - Oxytocin
- Posterior pituitary hormone.
- Produced within alveoli but needing ejection.
- Suckling triggers nervous signals to the hypothalamus promoting oxytocin release.
- Oxytocin travels to the breast.
- Myoepithelial cells contract, releasing milk from alveoli.
- Suckling on one breast triggers milk flow in the other.
- Emotional response (e.g., fondling, hearing cries) releases oxytocin and promotes milk release.
- (includes graph detailing pathway)
Fertility Reduced During Lactation
- Menstruation and ovulation return slower in lactating women.
- Conception can occur without an intervening menstruation.
- Elevated prolactin suppresses GnRH release, affecting FSH and LH, leading to no cycle.
- Breastfeeding is unreliable as a contraceptive method (Irish twins).
Hormones: Summary Table
- Table listing hormones, their source(s), and function in milk production. (includes prolactin, oxytocin, progesterone, estrogens, hGH, cortisol, parathyroid hormone and insulin)
Milk Composition
- Table comparing human and cow's milk constituent percentages (Water, Fat, Lactose, Casein, Lactalbumin, Other Proteins, Ash).
- Details on how fat contributes to caloric value (50% in humans), protein content (human milk has a higher protein content).
- Higher lactose content and higher ash levels in human milk compared to cow's milk.
Compositional Changes During Lactation
- Colostrum is early breast milk (yellowish, sticky); high protein, lower fat, and higher nutrient levels, including vitamins.
- Transitional milk is produced after colostrum, also characterized by lower fat content and higher protein content than mature milk.
- Mature milk is produced after approximately 2-3 weeks and contains lower IgA, lactoferrin, and cell levels.
- Fore milk: low fat content, early in a feeding session.
- Hind milk: higher fat content, later in a feeding session; aids satiation.
- Diurnal changes in milk composition due to maternal diet and hormonal changes.
Synthesis of Milk - Lactose
- Lactose is milk sugar (a disaccharide), composed of galactose and glucose.
- Synthesized from blood glucose; galactose is created and activated through a UTP-coupling process.
- UDP-Galactose is combined with another glucose by lactose synthase.
Lactose Synthase
- Composed of two proteins: beta-D-galactosyltransferase (Protein A) and lactalbumin (Protein B).
- Beta-D-galactosyltransferase is a crucial enzyme for sugar chain formation in various tissues.
- Lactalbumin modifies galactosyltransferase and functions only in the lactating mammary gland.
- Lactose is produced within Golgi, passes to alveolar lumen via exocytosis process.
- Functions include energy source for Lactobacillus bifidus population, colonisation of the gut by good bacteria, and mineral absorption (especially calcium.)
Immunological Properties of Milk
- Supplies passive immunity by supporting infant immune system development.
- Contains antibodies (mostly IgA) protected from digestion by a secretory component.
- Contains lactoferrin (iron sequestering element), lysozyme (bacteria-attacking enzyme) and lactose (facilitates beneficial bacteria growth).
- Leukocytes (especially macrophages) also provide protective mechanisms (10⁴-10⁵/mL milk).
Infant Formula
- Based on cow's milk but processed for better protein balance closer to human milk.
- Contains added essential ingredients and/or partial or total fat replacement using vegetable or marine fats.
- Nutritionally inferior to breast milk but higher quality than unprocessed cow's milk to other substitutes.
- Not recommended under the age of 12 months, untreated cow's milk.
International Code on Marketing of Breast-milk Substitutes
- Adopted by WHO member countries in 2002
- Aims to promote and protect breastfeeding.
- Aims to limit marketing practices of artificial feeding products.
- Aims to give health workers the responsibility to encourage and promote breastfeeding.
WHO Infant Feeding Recommendations
- Breastfeeding is an ideal food for healthy infant growth and development. It is an integral part of reproductive health.
- Exclusive breastfeeding is recommended for the first six months of life to optimize health and development.
- Complementary foods should be introduced to meet evolving nutritional needs up to the age of two years.
- ( Includes recommendations for exclusive breastfeeding levels globally - likely 35% worldwide average).
Other Points
- Vegans, and those with dietary restrictions, require careful consideration.
- Diabetic mothers need special care due to glucose demands for milk production.
- The American Academy of Pediatrics recommends 400IU vitamin D/day supplementation for breastfed infants.
- Infants have low vitamin K reserves. Some mothers have low vit K milk levels due to medication. Supplementing is recommended prophylactically (for example, in haemolytic disease). Vitamin K supplements for babies are also available in an injectable form.
Reading
- Guyton and Hall, chapter 82.
- emedicine lactation
- https://www2.hse.ie/babies-children/breastfeeding/ or alternative links from notes.
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Description
Test your knowledge on breastfeeding, mammary gland development, and related hormonal changes. This quiz covers essential functions, benefits, and considerations regarding breastfeeding and formula feeding. Ideal for students and professionals in health and nutrition fields.