CLC Exam Correct Questions & Answers(GRADED A+)

What are Montgomery glands? - ANSWER Sebaceous glands on areola that are a result of pregnancy hormones What do Montgomery glands do? - ANSWER Allow milk to mix with sebum, makes milk sticky and anti-microbial Function of prolactin? - ANSWER Pro-lactation. Makes milk. What stimulates prolactin? - ANSWER Baby suckles/nipple stimulation stimulates brain to secrete prolactin into blood and that triggers body to respond Do all humans have prolactin? - ANSWER Yes, everyone has prolactin all the time but it is a matter of ramping it up for lactation. Function of oxytocin? - ANSWER Myoepithelial cells to contract, and uterus to contract. Also milk letdown. What stimulates oxytocin? - ANSWER Nipple stretching (proper lactch), baby hand massage, its is a conditioned response of milk ejection too. How does the body make milk? - ANSWER Messages from the breast travel in nervous system to brain and then hormones travel in blood back to breast. How are milk composition and feed frequency related? - ANSWER High fat, protein, water milk producers will nurse less often. General composition of human milk? - ANSWER High in lactose, water. Low in protein, fat. Very dilute -- Due to this composition nursing should be frequent. What are the 3 stages of lactogenesis? - ANSWER Lactogenesis I: colostrum (placental hormone influence) Lactogenesis II: transitional milk (birth of placenta causes drop in progesterone) Lactogenesis III: mature milk (occurs at same time as stage II due to continual nipple stimulation) How is milk composition different with pre-term babies? - ANSWER For first 5-7 weeks milk is generally higher in protein, fat and every content. Milk volume is not any greater. After one year of nursing how does milk composition change? - ANSWER It becomes higher in fat and energy but volume does not increase. How does milk composition change at 24 months? - ANSWER Carbs drop significantly, fat increases significantly, slight protein increase. Overall more energy content (~30 kcal/oz vs ~18 kcal/oz for 1st year) How much energy does fat provide from milk? - ANSWER About 49% Hind milk vs foremilk? - ANSWER More complex than we originally thought, no firm consensus if there is more fat in hind milk, it is possible that both have equal amounts. What are three times when breast milk composition can change? - ANSWER Within a day, during a feeding, over the course of lactation. Is baby fat intake affected by specific practices during a feed? - ANSWER There is no difference in net fat intake according to # of breasts suckled per feed or breastfeeding frequency. How can milk composition vary within a feed? - ANSWER Degree of breast emptying, amount available to begin with, breast storage capacity, faster removal (faster removal = higher fat content) What are some benefits of exclusive breastfeeding? - ANSWER - less diarrhea - better iron amount - presence of bifidus factor - provides hormones and growth hormone - white blood cells/immunity -SIgA antibodies -B12 binding factor -lactorferrin -cell wall disrupters -microbes from mom -absence of exposure from contaminants -HMOs How does breast milk protect against diarrhea? - ANSWER it is more acidic than formula and leads to a more favorable gut pH, also breastfeeding during diarrhea helps to maintain a baby's gut microbiota How does the relatively low iron content in milk help baby? - ANSWER Excess amounts of iron can feed the bad microbes in a baby's gut, leading to diarrhea What is bifidus factor? - ANSWER Bifidus factor is a factor secreted in breast milk that helps promote growth of Lactobacillis bifidus. This helps to provide the newborn with a positive balance of beneficial intestinal flora. How does SIgA antibodies protect baby? - ANSWER Having these present in baby's intestinal tract from breastfeeding prevents them from being absorbed into the rest of the body, provides protective effect against necrotizing enterocolitis in premies and beyond. How does B12 binding factor from breast milk help baby? - ANSWER The binding factor binds B12 found in the intestines, reducing the amount available to microbes. What benefit does lactoferrin from breast milk provide to baby? - ANSWER Deprives bacteria of iron, disrupts the integrity of the outer membrane of bacteria, assists in intestinal maturation and in recovery time of intestine from injury. What do gastrin and CCK do? - ANSWER Promote glucose induced insulin release and growth promoting effects in the gut What does somatostatin? - ANSWER Inhibits GI secretions, inhibits GI motility, and release of GI hormones. What increases gastrin and decreases somatostatin in babies? - ANSWER Suckling, species own milk, decreased stress, wellness, touch How much weight is normal for a newborn to lose in the first few days? - ANSWER No more than 7% and no further wt loss by day 5 At what point should baby have regained the weight it lost after birth? - ANSWER By 2 weeks at the latest baby should have reached birth wt again What factors cause baby to lose more wt in first few days? - ANSWER Labor meds were used, intrapartum fluids have been given, no laboring prior to cesarean Progression of infant poops when exclusive breast feeding? - ANSWER 1st: meconium (dark, sticky) 2nd: greenish 3rd: yellowish What is the expected weight gain per day in an infants early months? - ANSWER About 1 oz or 30 grams per day Does stress effect breastfeeding? - ANSWER Increased worry/stress does not seem directly related to diminished milk supply What causes breast feeding associated hypernatremia? - ANSWER Dehydration from inadequate milk transfer How many feeds per day is expected in early months? - ANSWER 10-12 feeds/day How many more kcals does a breastfeeding mother need daily? - ANSWER Roughly 500 extra kcal/day Qualities of an engorged breast? - ANSWER Hard, temp is hot to touch AND shiny, discomfort, nipple is difficult to grasp and baby cant latch How to help relieve engorgment? - ANSWER Lukewarm water on breasts can help myoepithelial cells to cont