Which milk is higher in calories - hand expressed milk or pumped milk? - ANS Hand
expressed milk
Define: Exclusive breastfeeding - ANS Infant receives only mother's milk as its food
source, from 0-6 months
What is the only absolute infant contraindication to breastfeeding? - ANS galactosemia
Can infants with PKU breastfeed? - ANS Yes, but they need formula supplementation
Define: Complementary feeding - ANS Receiving both human milk and
solids/semisolids. From 6-23 months
9 stages of the first hour after birth - ANS 1. Birth cry
2. Relaxation
3. Awakening
4. Activity
5. Rest (interspersed throughout)
6. Crawling
7. Familiarization
8. Suckling
9. Sleeping
Is crying an early or late feeding cute? - ANS Late
Clenched hands are a sign that baby... - ANS ... is hungry!
When is the fastest drop-off point when people stop breastfeeding? - ANS In the first 10
days after discharge from hospital
What triggers oxytocin pathway to milk production? - ANS 1. Conditioned let-down
reflex (smell, touch, sound)
2. Nipple stretching
3. Baby hand massage
What are the two hormone pathways for milk production? - ANS Oxytocin and Prolactin
, How does fat, protein and water content affect the frequency of feedings between
different mammal species? - ANS High fat, high protein, low water = infrequent feeds
High water = more frequent feeds
When does Lactogenesis II start? - ANS complete delivery of the placenta
How does preterm milk differ from term milk? - ANS Generally higher in protein, fat and
electrolytes
How long does preterm milk production last? - ANS 5-7 weeks
Which has higher fat content: hindmilk or foremilk? - ANS Neither. Some say hindmilk is
highest in fat - but this is not supported by research and shouldn't be a part of
counseling
Which hormone(s) drive the production of colostrum and where do they come from? -
ANS Progesterone from the placenta
Which hormone(s) drive the production of transitional milk and where do they come
from? - ANS Progesterone - left from the placenta and is rapidly dropping
Prolactin - generally already circulating, not yet being released by nipple stimulation
Which hormone(s) drive the production of mature milk and where do they come from? -
ANS Prolactin - comes from nipple stimulation in feeding
Describe paracellular vs transcellular pathways - ANS Paracellular: during
progesterone-driven lactogenesis, there is free flow of blood/nutrients/etc between milk
cells, increased permeability to some drugs
Transcellular pathway: during prolactin-driven lactogenesis, milk cells are larger with no
pathways between them, which yields more safety from substances
Name 5 instances when breastmilk composition changes - ANS 1. over the course of
entire lactation experience
2. time of day (higher caloric concentration at night)
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