BMS 407 Exam 2 Ch. 6-13 (GVSU)

What do myoepithelial cells do?

Contract to push milk into the ducts

Mammary gland development is usually complete how long after menarche?

12 to 18 months.

Lactogenesis I

First few days after birth; milk formation begins.

Lactogenesis II happens when, and what occurs?

2 to 5 days after birth; increased blood flow to the breast, milk 'comes in'.

Lactogenesis III is when:

Milk composition is stable.

Which hormone promotes milk production and is stimulated by suckling?

Prolactin.

Which hormone causes letdown (milk ejection)?

Oxytocin.

Match the hormone to its role: estrogen

Ductal growth.

Human growth hormone's role in breast development is:

Development of terminal end buds.

Colostrum is high in which proteins?

Secretory IgA and lactoferrin.

Compared with mature milk, colostrum has more:

Total protein.

Human milk provides about how much energy?

About 0.65 kcal/mL.

Lipids provide what share of calories in human milk, and where are they highest?

Half; hindmilk.

DHA in human milk is essential for:

Retinal development.

The main protein in mature human milk, which facilitates calcium absorption, is:

Casein.

What do oligosaccharides in human milk do?

Prevent pathogens from binding, which prevents infection.

Nonprotein nitrogen in milk accounts for what, and is used for what?

20-25% of nitrogen; non-essential amino acids.

Vitamin A in colostrum compared with mature milk:

About twice as much.

The vitamin D content of breast milk reflects:

The mother's sun exposure.

Which fat-soluble vitamin is a concern for about 5% of breastfed infants, especially those who did not get an injection at birth?

Vitamin K.

Which water-soluble vitamin is bound to whey proteins and less influenced by maternal intake?

Folate.

How can maternal diet affect breast milk taste, and why does it matter?

Flavors pass into milk; variety may increase acceptance of new solid-food flavors.

Which is a hormonal benefit of breastfeeding for the mother?

Oxytocin helps the uterus return to its pre-pregnancy state.

Breastfeeding lowers an infant's risk of which conditions listed in the chapter?

Celiac disease, IBS, and leukemia.

Does breast size limit a woman's ability to breastfeed?

No, breast size does not limit it.

How many expressions per day may be needed to stimulate adequate milk when pumping?

8 to 12 or more.

Newborn feeding frequency is normally:

10 to 12 per day.

What is a LATE sign of infant hunger?

Crying.

Why let the infant nurse on one breast as long as they want?

To get high-fat hindmilk that provides satiety.

Normal newborn weight loss is up to:

7% of birth-weight in the first five days.

The main risk factor for tooth decay in breastfed children is:

Frequent nursing at night after one year.

When do exclusively breastfed infants need vitamin D supplements?

At two months.

Extra energy for milk production in the first six months is about:

500 cal/day.

Maternal protein-calorie malnutrition reduces:

Milk volume but not composition.

Infant colic is defined as:

Crying more than 3 hours a day with no medical cause.

WHO and the U.S. Surgeon General recommend exclusive breastfeeding for:

The first 6 months.

Which are workplace barriers to breastfeeding?

No on-site day career, insufficiently paid leave, rigid schedules, employer knowledge gaps.

Which infant reflex has the baby turn toward a touched cheek?

Rooting.

Sore nipples are the ___ reason mothers list for stopping breastfeeding, and are best prevented by:

Second highest; proper positioning of the baby on the breast.

A mother with flat or inverted nipples has trouble latching her baby. What helps?

Use a breast pump before feeding.

Letdown failure (milk does not eject) may be treated with:

Oxytocin nasal spray and relaxation techniques.

Hyperactive letdown makes the infant cough, choke, or gulp. Management is:

Express milk until flow slows, then let the infant nurse.

Hyperlactation means:

Milk volume produced exceeds infant intake.

How is hyperlactation managed?

Nurse on one side only, express for comfort on the other, use cold compresses.

The best prevention for engorgement is:

Nurse frequently.

A plugged duct is caused by ___ and treated with ___.

Milk stasis; massage and warm compress.

Mastitis is:

Inflammation of the breast, infective or non-infective, most common 2-3 weeks after birth.

The most common reason for stopping breastfeeding is:

Low milk supply (real or perceived).

Which contraceptive advice applies during lactation?

Avoid combined oral contraceptives from 6 weeks to 6 months postpartum.

Medicinal herbs during lactation should be viewed as:

Drugs.

Which herbs reduce milk flow?

Sage, fresh parsley, jasmine flower, castor bean.

Which teas are generally regarded as safe during lactation?

Rose hips, raspberry, red bush, orange spice, peppermint, chicory.

Alcohol level in breast milk compared with maternal plasma, and peak timing:

Same level; peaks 30-60 min without food, 60-90 min with food.

Alcohol's impact on lactation includes:

Decreased oxytocin/letdown, altered odor, less milk consumed, disrupted infant sleep.

Nicotine levels in breast milk compared with the mother's blood are:

1.5 to 3 times higher.

Marijuana use during lactation is:

Contraindicated

Caffeine in breast milk is about ___ of maternal plasma level, and may accumulate in infants younger than:

1%; 3-4 months

In 2017 the FDA recommended against which drugs during lactation?

Codeine and tramadol

Neonatal jaundice occurs in about ___ of full-term and ___ of preterm infants.

40%; 80%

Bilirubin is a byproduct of:

Hemoglobin breakdown (neonatal production is double an adult's)

Breast non-feeding jaundice is caused by:

Infrequent or inefficient nursing; usually resolves in 1-2 weeks

Breast-milk jaundice syndrome:

Becomes apparent after day 3; a milk substance increases intestinal bilirubin absorption

Treatment for severe jaundice, per AAP:

Phototherapy with fluorescent lights; continue breastfeeding

The main obstacle to breastfeeding twins, triplets, or quadruplets is:

Mother's time and fatigue

At least ___ of exclusive breastfeeding protects against dermatitis and wheezing.

4 months

Late-preterm infants are born at:

34 to 37 weeks

AAP statement on preterm infants:

All should receive human milk; mother's milk fortified for infants under 1.5 kg

Which is NOT advisable for breastfeeding?

Infant with galactosemia; mother with HIV, untreated active TB, HTLV I/II, illicit drug use, or chemotherapy

HIV transmission through breast milk ranges:

5 to 20%, depending on duration of breastfeeding

Human milk banks mainly serve:

Premature and sick infants; donors are carefully screened

A full-term infant is born at ___ weeks and weighs ___.

37 to 42 weeks; 2500-3800 g

Birthweight cutoffs: low, very low, and extremely low.

LBW under 2500 g; VLBW under 1500 g; ELBW under 1000 g

Infant mortality is death that occurs:

Within the first year

Factors associated with infant mortality include:

Socioeconomic level, access to health care, teen pregnancy, multiple births, racial/ethnic differences

Newborn growth assessment uses which measures?

Gestational age, birthweight, length, and head circumference

The Moro reflex is:

Arms thrown out then inward, as if embracing

The Babinski reflex is:

Toes fan out when the sole of the foot is stroked

The palmar reflex is a precursor to:

Voluntary grasping

Rooting reflex: cheek stroked, baby turns head and opens mouth. Its significance is:

Helps a baby find the nipple

Motor development proceeds:

Top down (head first) and central to peripheral

A critical period is:

A fixed period in which certain behaviors emerge; if missed, there may be difficulty later

Which impact cognitive, motor, and socio-emotional development?

Severe acute malnutrition, chronic undernutrition, iron deficiency anemia, iodine deficiency, environmental interactions

At birth, a healthy newborn can digest:

Fats, protein, and simple sugars

Infant energy needs range from:

80 to 120 kcal/kg

Protein needs: birth-6 months and 7-12 months.

1.52 g/kg; 1.2 g/kg

Fat in infant nutrition:

Provides essential fatty acids and about half of breast milk calories; aids fat-soluble vitamin absorption

Low carbohydrate or energy intake in infants causes:

Protein catabolism, which impacts growth

Growth chart warning signs include:

No increase in weight or length; continued decline or rapid increase in percentile

Feeding recommendation for the first year:

Exclusive breastfeeding for 6 months, continuing to 1 year

Why not give cow's milk in infancy?

Early introduction is linked to iron-deficiency anemia (GI blood loss, lack of iron-rich foods)

Birth to 5 months: mouth and body pattern.

Suck/swallow and tongue thrust reflexes; poor lip closure and head control; pushes solids out

At 4-6 months, an infant can:

Sit with support, have good head control, use palmar grasp, and swallow a spoonful of puree

Pincer grasp and sitting alone appear at about:

5-9 months

Newborn metabolic screening checks for:

PKU, galactosemia, hypothyroidism, sickle-cell disease

Rotary chewing (grinding) develops at:

10-11 months

Cues for feeding readiness:

Watching food, tight fists/reaching for the spoon, playing with food or spoon

First complementary foods at six months:

Small portions of semisoft food on a spoon once or twice a day

Correct feeding position:

Infant seated with back and feet supported; adult in front with eye contact

Cup readiness begins at ___, and weaning to a cup is at ___.

6-8 months; 12-18 months

Vegetarian diets in infancy:

Can support normal growth if well planned; vegan diets increase deficiency risk