Lactation part 1

alveoli

rounded or oblong shaped cavity present in breast, contain cells that produce milk

secretory cells

responsible for secreting milk

myoepithelial cells

surround secretory cells and contract to cause milk ejection into ducts

lactgenesis 1

1st few days after birth, milk formation begins

lactgenesis II

2-5 days after birth, increased blood flow to breast, milk comes in

lactgenesis III

10 days after birth, milk composition is stable

prolactin

hormone that promotes milk production, stimulated by suckling

oxytocin

hormone responsible for ejection of milk from the milk gland, stimulated by suckling or nipple stimulation

human milk

the only food needed by most healthy infants for first 6 months, protects from infectious diseases, composition changes over single feeding

pathways of secretion of milk

made by secretory cells and secreted into the ducts; water, sodium, potassium, and chloride pass through alveolar cell membranes; triglycerides in mother’s blood and fatty acids made in the breast

colostrum

first milk secreted during 1st few days after birth, rich in proteins like secretory IgA and lactoferrin, lower in calories, prevention of infection, rich in vitamin A like beta-keratin

water

babies don’t need water/other fluids to maintain hydration, major component in human milk

energy

calories may vary with fat, carbohydrate, and protein composition

lipids

provide half the calories in human milk, higher in hind-milk, profile reflects dietary intake of mother, DHA essential for retinal development

proteins

have antiviral and antimicrobial effects, casein main protein, facilitates calcium absorption

lactose

major form of carbohydrate, disaccharide- glucose and galactose

oligosaccharides

difficult to digest, medium length carbohydrate, prevents binding of pathogenic microorganisms which prevent infections

vitamin A

colostrum has twice the concentration of mature milk, deficiency can increase risk of eye problems, infection and growth failure

vitamin D

role in calcium absorption and bone metabolism, maternal vitamin D status mirrors content of human milk

vitamin E

antioxidant that protects cells from oxidative damage

vitamin K

needed to support development of clotting factors, 5% of infants at risk for deficiency, infants receive one time injection at birth

water soluble vitamins

reflective of mother’s diet or supplements, well nourished women provide nutrients in quantities meeting infant needs

minerals

bioavailability, minerals usually in low concentrations but well absorbed

hormonal benefits for breastfeeding mother

oxytocin stimulates uterus to return to pre-pregnancy status and minimizes postpartum blood loss

psychological benefits for breastfeeding mother

increased self-confidence and bonding with infant

long-term benefits for breastfeeding mother

lower risk of breast, endometrium, ovarian cancer, diabetes and cardiovascular disease, cost

benefits for breastfeeding infant

optimal nutrition, balanced nutrient, provides proteins, lipids, and minerals, leaner infants, increased cognitive abilities, reduction in pain, flavor experience

identifying hunger and satiety

hunger is signaled by infant brining hands to mouth, sucking on them and moving head from side to side, crying is late sign of hunger, allow infant to nurse on one breast as long as they want to ensure they get hind-milk with its high fat content that provides satiety

feeding frequency

10-12 feedings a day are normal for newborns, stomach emptying occurs about 1 ½ hours

normal weight loss for newborns

up to 7% of birthweight in first 5 days

signs for malnourished infants

become sleepy, non-responsive, have a weak cry and wet few diapers

most common reason for mother’s to stop breastfeeding

fear of malnutrition they’re unable to see how much baby is consuming

vitamin supplements for breastfeeding

vitamin K- injection at birth, vitamin D- exclusively breastfed infants need supplements at 2 months

maternal energy needs

vary by activity level, 500 more calories for milk production in 1st 6 months, individualized

maternal protein-calorie malnutrition

still enough for infant, reduction in milk volume but not composition

vitamin and mineral supplements

not needed in well-nourished women, vegan moms that don’t consume easts or fortified soy products may need B12 supplements

optimal breastfeeding duration

health of mother-child should be primary criteria, human milk feeding for ~6 months with continued breastfeeding for a year or longer

WIC and breastfeeding

WIC staff are trained to promote breastfeeding and provide support to mothers, provide assistance with purchasing breast pumps, different food packages for moms fully breastfeeding