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Questions and Answers
What triggers the contraction of muscles around the alveoli to allow milk to flow?
What triggers the contraction of muscles around the alveoli to allow milk to flow?
Which components of human milk are particularly high in colostrum during the first days postpartum?
Which components of human milk are particularly high in colostrum during the first days postpartum?
What is the recommended primary food for infants during the first six months of life?
What is the recommended primary food for infants during the first six months of life?
Which of the following factors influences the composition of human milk?
Which of the following factors influences the composition of human milk?
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During which stage of lactation is colostrum produced?
During which stage of lactation is colostrum produced?
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What is the typical volume of colostrum that infants may consume per feeding in the first few days?
What is the typical volume of colostrum that infants may consume per feeding in the first few days?
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What is one of the characteristics of mature milk compared to colostrum?
What is one of the characteristics of mature milk compared to colostrum?
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Which nutrient is colostrum specifically low in during the first few days after birth?
Which nutrient is colostrum specifically low in during the first few days after birth?
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What is the dominant carbohydrate in human milk?
What is the dominant carbohydrate in human milk?
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Which vitamin is present in colostrum at twice the concentration compared to mature milk?
Which vitamin is present in colostrum at twice the concentration compared to mature milk?
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Which vitamin's content in human milk is reflective of maternal exposure to sunlight?
Which vitamin's content in human milk is reflective of maternal exposure to sunlight?
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What role do oligosaccharides in human milk serve?
What role do oligosaccharides in human milk serve?
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Which vitamin is essential for the formation of clotting factors in infants?
Which vitamin is essential for the formation of clotting factors in infants?
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What is a characteristic of whey protein in human milk during lactation?
What is a characteristic of whey protein in human milk during lactation?
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Which water-soluble vitamin's content is impacted by the mother’s dietary intake?
Which water-soluble vitamin's content is impacted by the mother’s dietary intake?
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What condition may affect about 5% of breastfed infants?
What condition may affect about 5% of breastfed infants?
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What is the primary role of Immunoglobulin A in human milk?
What is the primary role of Immunoglobulin A in human milk?
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What is a major component of human milk that influences hydration in infants?
What is a major component of human milk that influences hydration in infants?
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How does the lipid composition of human milk vary during feeding?
How does the lipid composition of human milk vary during feeding?
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Which of the following statements about energy provision in human milk is accurate?
Which of the following statements about energy provision in human milk is accurate?
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Which protein in mature human milk is known for its antiviral and antimicrobial effects?
Which protein in mature human milk is known for its antiviral and antimicrobial effects?
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What nutrient is essential for retinal development found in human milk?
What nutrient is essential for retinal development found in human milk?
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At what age are breastfed infants typically thinner than those who consume human milk substitutes?
At what age are breastfed infants typically thinner than those who consume human milk substitutes?
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What is the effect of maternal diet on the composition of human milk?
What is the effect of maternal diet on the composition of human milk?
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What is the primary function of prolactin in lactation?
What is the primary function of prolactin in lactation?
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What initiates the release of oxytocin during breastfeeding?
What initiates the release of oxytocin during breastfeeding?
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Which stage of lactogenesis occurs about ten days after birth?
Which stage of lactogenesis occurs about ten days after birth?
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What structural component surrounds the secretory cells in the mammary gland?
What structural component surrounds the secretory cells in the mammary gland?
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What is the main source of lactose in human milk?
What is the main source of lactose in human milk?
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What happens to prolactin levels if the breast is not stimulated?
What happens to prolactin levels if the breast is not stimulated?
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Which of the following is NOT a benefit of breastfeeding for infants?
Which of the following is NOT a benefit of breastfeeding for infants?
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During which phase of lactation is milk stored in the lobules?
During which phase of lactation is milk stored in the lobules?
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What are the main factors affecting breastfeeding?
What are the main factors affecting breastfeeding?
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How does oxytocin affect the uterus during lactation?
How does oxytocin affect the uterus during lactation?
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Which component of milk is actively transported from the cells into milk?
Which component of milk is actively transported from the cells into milk?
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What is the functional role of alveoli in the mammary gland?
What is the functional role of alveoli in the mammary gland?
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What key hormonal change occurs during pregnancy related to lactation?
What key hormonal change occurs during pregnancy related to lactation?
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What is a primary barrier to breastfeeding?
What is a primary barrier to breastfeeding?
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Study Notes
Nutrition During Lactation (Part 1)
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General Outcome:
- Understand physiological changes during lactation and their relation to nutrition.
- Summarize the benefits of breastfeeding.
- Understand factors affecting breastfeeding.
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Specific Outcomes:
- Describe the development, structure, and functional components of the mammary gland.
- Describe key hormonal influences on development and function.
- Describe the benefits of breastfeeding for mother and infant.
- Describe barriers to breastfeeding and ways to overcome them.
Development of Mammary Gland
- Estrogen and progesterone increase during puberty, influencing pubertal breast development.
- During pregnancy, estrogen stimulates the development of milk-producing mammary glands.
- Breasts produce milk from water and nutrients.
- Milk is stored in lobules until oxytocin signals muscles to contract and push milk through ducts.
Functional Units of the Mammary Gland
- Alveoli are the functional units of the mammary gland.
- Each alveolus contains secretory cells and a duct.
- Ducts are arranged like branches of a tree.
- Myoepithelial cells surround secretory cells and contract under oxytocin influence, ejecting milk into the ducts.
Lactogenesis
- Lactogenesis is another term for human milk production.
- Lactogenesis has three stages:
- Stage I: Begins at the end of the last trimester (12 weeks before delivery), milk begins to form, and lactose & protein in milk increase.
- Stage II: Occurs 2-5 days after birth with increased blood flow to the mammary gland. Delayed stage II is associated with breastfeeding failure.
- Stage III: Occurs about ten days after birth, also called galactopoiesis, where milk composition becomes stable.
Hormonal Control of Lactation
- Prolactin: Stimulates milk production, stimulated by suckling, and influenced by stress, sleep, and exercise. Prolactin level in the blood isn't directly related to the amount of milk produced. If breasts aren't stimulated, prolactin levels can drop.
- Oxytocin: Involves in the ejection of milk from the milk glands, stimulated by suckling, also acts on the uterus during and after delivery – causing it to contract, seal blood vessels and shrink.
Secretion of Milk
- Lactose: Made in the secretory cells.
- Milk fat: Comes from maternal triglycerides and fatty acids produced in the breast. Actively transported from the cell into milk.
- Sodium, potassium & water: Actively transported from the cell into milk.
- Proteins: Captured from the mother's bloodstream through transcytosis.
- Leukocytes: Pass directly between cells (paracellular pathway)
- Milk components are secreted into ducts through exocytosis.
Letdown Reflex
- Also called the milk ejection reflex.
- A natural response during breastfeeding when the body releases milk from the breasts.
- Stimulation: Baby sucking on the breast stimulates sensory nerve endings in the nipple and areola.
- Hormonal response: Signals are sent to the brain to release oxytocin. Oxytocin causes the muscles around the alveoli to contract.
- Milk release: Muscle contractions push milk through the milk ducts and out of the nipple.
Human Milk Composition (Summary)
- Human milk: the only food needed by infants for the first six months
- Composition: changeable over a feeding, dependent on infant age, maternal nutritional status, and location.
- Variations: colostrum and mature milk have different compositions.
Human Milk Composition - Colostrum
- A thick, yellow fluid produced during lactogenesis II (days 1–3 after birth).
- Infants may drink only 2-20 mL (0.5–4 tsp) per feeding.
- High in protein and immunoglobulin A (provides antibodies). High in lactoferrin (regulates iron absorption).
Human Milk Composition - Water & Energy
- Human milk is isotonic with maternal plasma.
- Provides 0.65–0.75 kcal/mL. Fewer calories than milk substitutes. Enhanced growth in the first 3-4 months in exclusively breastfed infants.
- At 8-11 months, breastfed infants are thinner than infants who consume human milk substitutes.
Human Milk Composition - Lipid, Protein, Carbohydrate, and Fat-soluble Vitamins
- Lipid: Contributes half of the calories in human milk, with variations in foremilk and hindmilk. Contains DHA, trans fatty acids, and cholesterol.
- Protein: Protein content is relatively low, and influenced by infant age. Contains casein and whey proteins.
- Carbohydrate: Dominant carbohydrate is lactose, which enhances calcium absorption. Other carbohydrates include oligosaccharides, which stimulate the growth of beneficial bacteria, and inhibit harmful ones.
- Fat-soluble Vitamins:
- Vitamin A: Higher concentration in colostrum, often in beta-carotene form. Important for calcium absorption and bone metabolism.
- Vitamin D: Content reflects maternal exposure to sunlight.
- Vitamin E: Protects cells, crucial for neurological and muscle function.
- Vitamin K: Used in blood clotting, with some newborns at risk of deficiency and needing intramuscular supplementation.
Human Milk Composition - Water-soluble Vitamins
- Content reflects maternal diet and supplements.
- Well-nourished mothers provide infants with appropriate amounts of nutrients – minerals like magnesium, calcium, iron, and zinc are highly available.
- Vitamins like vitamin C and lactose promote iron absorption.
Taste of Human Milk
- Human milk taste is important to newborns.
- The taste is slightly sweet, carrying flavors of ingested compounds (e.g., mint, garlic, vanilla).
- Transfer of flavors is selective.
- Variation in flavor can influence infant interest in consumption.
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Description
This quiz explores the physiological changes during lactation and their nutritional implications. Understand key developmental aspects of the mammary gland and the benefits of breastfeeding for both mother and infant. Additionally, it covers the barriers to breastfeeding and strategies to overcome them.
