Breastfeeding

True or false: males have mammary glands

True, males and females have mammary glands in their breasts, but they usually only develop in females during puberty

What is the function of the oxytocin neuron?

It secretes oxytocin from the posterior pituitary gland

What is the function of the prolactin cell?

It secretes prolactin from the anterior pituitary gland

What two stimuli can trigger milk production and ejection?

1. Baby suckling 2. Baby crying

What are the connective tissues that support the breast structures?

1. Collagen 2. Elastin 3. Adipose tissue

What are the AAP recommendations regarding breastfeeding?

1. Exclusively breastfeed for first 6 months with supplemental vitamin K and vitamin D 2. Avoid pacifiers until breastfeeding established 3. Keep mother and baby in close proximity 4. Do 8-12 feedings per day 5. Introduce solids at 6 months and continue breastfeeding for at least a year

When should you not breastfeed?

1. Galactosemia in the infant (infant can't metabolize galactose) 2. Maternal infections (untreated TB, herpes lesions on breast, HIV in developed world) 3. Some maternal medications 4. Maternal drug abuse 5. Maternal refusal for any rea

What are the benefits of breastfeeding for the infant?

1. Ideal nutritional composition at all stages of early development (early milk is colostrum packed with antibodies and protein; as child grows milk changes from high sugar to high fat; even in a single feed milk goes from sugary to fatty) 2. Protection from infection (passive immunity) 3. Reduced risk of SIDS 4. Reduced risk of diabetes (Type 1 and Type 2) 5. Marginally improved cognitive development for child

What did the International Code of Marketing of Breast Milk Substitutes require?

1. Labels on formula need to have languages understood by mothers 2. Prominent health warning on each label 3. No giving free samples to hospitals and new mother

What challenges occur during the newborn period (first six weeks of age) that make breastfeeding a challenge?

1. Maternal exhaustion 2. Breastfeeding complications and pain 3. Dramatic shift in roles for new parents 4. Physical recovery from childbirth, including hormonal shift 5. Fear about baby's growth and the amount of milk being transferred

What are the benefits of breastfeeding for the mother?

1. Mother-child bonding 2. Child spacing due to lactational amenorrhea 3. Reduced risk of breast and ovarian cancer 4. Reduced risk of osteoporosis 5. Economic benefits (formula can be expensive)

What are the three reasons why breastfeeding is best in developing countries?

1. Passive immunity from breast milk 2. Doesn't require use of contaminated water 3. It is free, so no risk of dilution to save on resources

What three things resulted from the "infant holocaust" in the early 1900s?

1. Pediatrics and Food Science emerge as specialties in the US 2. First infant formula developed in Europe 3. Formula manufacturers begin aggressively marketing products

What reflexes does that baby have to help it breastfeed?

1. Rooting reflex 2. Ability to swallow 3. Ability to suck

What two things does the hypothalamus do when it receives the signal from the breast mechanoreceptors to start producing milk?

1. Sends "go" message to oxytocin neuron 2. Sends "off" message to prolactin inhibitory neuron

What factors may contribute to women stopping breastfeeding early than recommended?

1. Sexualization of breasts 2. Stigma of breastfeeding in public 3. Maternal exhaustion 4. Pain associated with breastfeeding 5. Fear about baby's growth and amount of milk being transferred

Why are newborns relatively deficient in vitamin K?

1. Vitamin K doesn't pass through placenta well 2. Breast milk is relatively low in vitamin K 3. The infant doesn't yet have the gut flora to produce vitamin K

How many babies die every year because they aren't being breastfed?

1.5 million, most in low-income countries

How great is the risk of dying due to GI infection in the developing world for bottle-fed babies?

25x greater risk

How does passive immunity from breast milk save infant lives?

Breast milk contains passive immunity, so antibodies specific to the area in which the mother and child are living will be passed on the the baby. This can help prevent infection, which could lead to diarrhea, dehydration, and death

What evidence supports the idea that breastfeeding may be overhyped in terms of benefits for child?

Breastfeeding studies often show huge benefits and advantages for breastfed children, but when you control for within-family differences by looking at outcomes for siblings where one was breastfed and the other was bottle-fed, those differences are no longer statistically significant, suggesting family and environmental factors are more important

What is the function of oxytocin?

Causes contraction of myoepithelial cells to help with milk ejection from breast

What is the function of the lactiferous ducts?

Drain milk from mammary glands to areola

What effect does breastfeeding have on infant mortality in the US?

Early infant mortality reduced by 21% in breastfed infants, probably due to protection from disease

True or false: if a mother gives birth to twins, she must choose which baby to breastfeed because she can't produce enough milk for both

False

True or false: the Nestle formula campaign stopped in the 1980s.

False, it is still going on. It hit South Africa in 2003.

How do formula manufacturers market their product to the developing world?

Give free supplies to hospitals, use pictures of healthy babies, target health workers to promote formula, pay community women to promote formula

What is the rooting reflex?

Helps the baby locate the mother's nipple

How did infant formula development first come about?

In 1900s when 16% of babies in US died before first birthday. Infant formulas were developed in Europe and embraced in the US

How does the fact that breast milk doesn't require mixing with water save infant lives?

In countries with limited access to clean water, mothers who feed their babies formula often mix it with contaminated water, which can lead to infection, diarrhea, dehydration, and death for the baby

Why are HIV+ women in the developing world told to breastfeed their babies, but HIV+ women in the US are told not to?

In the developing world, the risk of death as a result of bottle-feeding is greater than the risk of HIV transmission

How did Nestle respond to the Nestle Boycott?

Promised to comply with International Code of Marketing of Breast Milk Substitutes, but then continued to give out formula as "disaster relief"

What is the function of prolactin?

It causes lactogenesis, or the making of milk inside the mammary gland

What is the function of the prolactin inhibitory neuron?

It inhibits prolactin cells

How does a baby crying trigger a hypothalamus response?

Mother's ear picks up the sound of the crying and sends it to auditory centers in the brain that tell the hypothalamus to initiate the cascade of events. This means any lactating mother in the vicinity could nourish any hungry child

Why does mixed feeding (formula + breast) lead to the highest risk of vertical transmission of HIV?

Mothers mix dirty water with formula so pathogens enter the baby's warm gut and make it inflamed. The baby's body sends white blood cells to fight pathogens so the baby's gut becomes porous. When the mom breastfeeds, the HIV virus can more easily gain access to the baby due to the porous nature of the gut

What is the benefit of vitamin K supplementation?

Must be given by injection within 6 hours of life to prevent hemorrhagic disease of the newborn

What is the benefit of vitamin D supplementation?

Needs to be given orally to all exclusively breastfed babies to prevent ricket

How did the US respond to the Nestle marketing campaigns in the developing world?

Nestle Boycott in 1974. Led to the International Code of Marketing of Breast Milk Substitutes in 1981

Is there an upper age limit to breastfeeding?

No, as long as mother and child are in mutual agreement that breastfeeding should continue

Should you be concerned if your newborn loses 5-7% of his birthweight in the first week of life?

No, this is normal, as long as the baby regains his birthweight by the second week

What percent of babies in the developing world are exclusively breastfed?

Only 38% due to formula marketing, lack of community support, and misinformed community health workers

What changes could support mothers breastfeeding?

Paid maternity leave, nursing rooms, enhanced social support for breastfeeding

How does the fact that breast milk is free save infant lives?

Poverty can lead moms to dilute formula so that it lasts longer, which leads to malnutrition and suppressed immunity in the baby so it is more susceptible to infection, diarrhea, dehydration, and death

What is lactational amenorrhea?

Temporary postnatal infertility that occurs when mother is fully breastfeeding

What are cooper's ligaments?

The ligaments that anchor the breast to the chest wall

What is the problem with a mother using free formula samples from a hospital until they run out and then switching to breastfeeding?

There is a critical period for establishing milk supply, so if you don't start breastfeeding early enough you won't be able to

What is the function of the myoepithelial cells lining mammary glands?

They can contract to eject milk out toward the lactiferous ducts

Why is the areola darkened?

To help infants find the breast since they don't see well when they're first born

What is the main function of mammary glands?

To secrete milk to nourish the human infant

How does the human body know to start producing breast milk?

When the baby suckles at the breast, mechanoreceptors in the breast detect the suckling and send a ascending sensory information to the mother's hypothalamus through the spinal cord

What is the "let down reflex"?

When the mother produces milk in response to the sound of a baby crying