Maternal Nutrition During Lactation Lecture 4 PDF

Maternal Nutrition during Lactation (Part 1) Lecture 4 17/09/2024 Dr. Reham Shawky Metwally  DEFINITION OF LACTATION PROCESS  Lactation...

Maternal Nutrition during Lactation (Part 1) Lecture 4 17/09/2024 Dr. Reham Shawky Metwally  DEFINITION OF LACTATION PROCESS  Lactation  Lactation: A physiological process naturally follows pregnancy, as the mother’s body continues to nourish the infant.  Lactation: is the process by which milk is synthesized and secreted from the mammary glands of the postpartum female breast in A woman who decides to breastfeed response to an infant sucking the nipple. provides her infant with a full array of nutrients and protective factors to support optimal health and development. 9/16/2024 Dr.Reham Shawky Metwally 5 STRUCTURE OF THE LACTATING BREAST 9/16/2024 Dr.Reham Shawky Metwally 7  STRUCTURE OF the LACTATING BREAST  The breast : is composed of a glandular and ductal system.  Areola: is the pigmented area at the center of the breast.  Lobules (alveoli): is the mammary gland that produces and secrets milk.  Duct: it carries the milk secreted by the lobules through the breast tissue to open at the nipple.  The glandular tissue: develops during puberty, but it is only during pregnancy that the development of the glandular tissue is complete and can produce milk. 9/16/2024 Dr.Reham Shawky Metwally 8  STRUCTURE OF the LACTATING BREAST  The mammary gland is composed of milk transporting lactiferous ducts, which expand and branch extensively during pregnancy in response to: Estrogen: This hormone stimulates the growth and development of the ductal system, preparing the breast for milk production. Growth hormone: This hormone promotes the growth and development of breast tissue, including the ducts and alveoli. Prolactin: This hormone is responsible for initiating and maintaining milk production. It stimulates the alveoli to produce milk. Cortisol: While not directly involved in milk production, cortisol can influence the overall metabolic environment that supports lactation. 9/16/2024 Dr.Reham Shawky Metwally 9  Physiological &Hormonal changes during lactation period.  Metabolic and Physiologic Changes during Lactation  Breast enlargement being early in pregnancy due to:-  The hormones generated by the pituitary gland and the corpus luteum*.  The lacteal cells also, differentiate in preparation for milk production that being when the infant is born.  As the breast undergoes these preparatory changes :  Glandular tissue (alveoli) are grown and increase in size  The areola ( the pigmented area surrounding the nipple ) becomes darker and more prominent  The skin over the nipple becomes more elastic and more erect to facilitate suckling. 9/16/2024 Dr.Reham Shawky Metwally 11 THE PROCESS OF LACTATION  The complex physiology of breastfeeding includes a delicate balance of hormones. ( Explain?)  There are four hormones that help breasts make milk: 1. Estrogen 2. Progesterone 3. Prolactin 4. Oxytocin. 9/16/2024 Dr.Reham Shawky Metwally 12  How Will Breasts This video will illustrate: Know How “ How Will Breasts Know How Much Milk To Make?” Enjoy with this content Much Milk https://www.youtube.com/watch?v=uJdM6U6O6oQ To Make? 9/16/2024 Dr.Reham Shawky Metwally 13  HORMONES OF LACTATION Estrogen and progesterone prepare the breasts to make milk. These hormones are released by the placenta during pregnancy. They have two major roles. They increase the size and number of milk ducts in breasts. They also keep the body from making large amounts of breast milk until after baby is born. Once baby is born and the placenta is delivered, these hormones decrease. This decrease signals the body that it is time to make milk. 9/16/2024 Dr.Reham Shawky Metwally 14  Lactation in Response to Sucking Milk Ejection Reflex (MER), a physiological process that occurs in breastfeeding mothers to release milk from the breasts. This reflex is triggered by the infant's sucking on the nipple. PRH: Prolactin-releasing hormone PIH: prolactin-inhibiting hormone 9/16/2024 Dr.Reham Shawky Metwally 15  Let-Down Reflex Release of milk from the alveoli triggered by infant suckling 9/16/2024 Dr.Reham Shawky Metwally 16  Role of hormones during lactation Prolactin Stimulates milk production in the breast from the alveoli. Oxytocin Stimulates myoepithelial cells around ducts to contract and ejects milk from the alveolus. Both secretion of milk and myoepithelial contraction are responsible for milk ejection. 9/16/2024 Dr.Reham Shawky Metwally 17  Lactation Specialist  Is an expert on breastfeeding and helps new mothers who may be having problems.  Since the best first food for babies is breast milk, a lactation specialist can teach the proper techniques for successful breastfeeding.  In rare cases, women produce too little milk to nourish their infants adequately.  Early warning signs of insufficient milk are:  Dry diapers (a well-fed infant wets about six diapers a day).  Infrequent bowel movements. 9/16/2024 Dr.Reham Shawky Metwally 18 Types of breast milk  Types of breast milk Colostrum milk Transitional milk Mature milk 9/16/2024 Dr.Reham Shawky Metwally 20  1. Colostrum Milk  Colostrum milk is the thick, yellowish secretion that is the first feeding for the infant.  It is rich in protein , immunoglobins , beta- carotene, fat soluble vitamins , minerals (Na , K , Cl) , hormones, and antibodies that help protect the newborn from infection.  It is lower in fat and carbohydrate (lactose)  It also contains a factor that:  Promotes the growth of bifidus flora and maturation of the GIT.  Has a laxative effect that helps the newborn to expel the sticky first stool ( Meconium Passage).  Colostrum milk is produced during the later stages of pregnancy and is present in highest concentration during the first few days of lactation. 9/16/2024 Dr.Reham Shawky Metwally 21  2. Transitional Milk  Transitional milk is a white, creamy milk, produced in much greater quantities than colostrum, and breasts become larger and firmer.  It is produced 1 to 2 weeks postpartum.  It is higher in fat and lactose  It is lower in protein and minerals than colostrum. 9/16/2024 Dr.Reham Shawky Metwally 22  3. Mature milk  Mature milk is produced by the fifteenth day of lactation.  It is composed of emulsified fat and lactose.  It provides 20-22 calories/ounce.  It is nutritionally optimal.. 9/16/2024 23 Dr.Reham Shawky Metwally  Types of Mature milk Fore milk: Hind milk: 1.Watery, translucent breast 1. Creamy breast milk milk that is secreted first during delivered toward the end of a a feeding and is rich in lactose, feeding; rich in fat , fat soluble water soluble vitamins and vitamins and other nutrients; protein; but low in calories. satisfies the infant’s appetite. https://www.ncbi.nlm.nih.gov/books/N 2. It satisfies the newborn’s 2. It provides satiety and the BK539790/#:~:text=The%20foremilk%2 thirst and meet the baby’s calories to ensure growth in 0satisfies%20the%20baby's,due%20to% hydration needs. the baby. 20its%20high%20content. 9/16/2024 Dr.Reham Shawky Metwally 24  Types of Mature milk Foremilk is the milk available when your Hindmilk is the milk baby starts feeding. your baby gets at the end of a feed. https://www.ncbi.nlm.nih.gov/books/NBK539790/#:~:text=The%20foremilk%20sat isfies%20the%20baby's,due%20to%20its%20high%20content. Dr.Reham Shawky Metwally 9/16/2 25 024 Composition of Mature milk  Breast Milk Composition  The amounts and types of protein , fat , and Carbohydrate in breast milk are ideally suited to the human infant.  The composition of breast milk includes:- 1- Fat. 2- Protein. 3- Carbohydrate. 4- Vitamin D. 5- Vitamin K. 9/16/2024 Dr.Reham Shawky Metwally 28