What is the role of the pituitary glade in milk making? - ✔✔Messages from certain
stimulation travels through the breast to the pituitary gland which triggers it to produce
prolactin and oxytocin which are two hormones needed to make milk.
How in prolactin produced? - ✔✔Breast stimulation
Nipple stimulation (makes the most)
What is the first way oxytocin can be triggered? - ✔✔Conditioned response/Conditioned
Milk Ejection Reflex (Let down). Automatic response that comes with the association of smell,
touch, sounds of baby at the breast. Also occurs on babies end with knowing what to do when
placed at the breast.
What is the second way oxytocin can be triggered? - ✔✔Nipple stretching that occurs with a
proper latch
What is a third way oxytocin can be triggered? - ✔✔Baby hand massage
What does prolactin do? - ✔✔Enters receptor sites in the milk making cells and helps
produce breastmilk
What does oxytocin do? - ✔✔Allows for the milk to move from the milk making cells and
through the nipple with "contractions" that squeeze the cells and the ducts.
Preterm milk - ✔✔Appears to have different composition for the first 5-7 weeks after
delivery independent of gestational age
Preterm milk appears to be higher in protein, fat, and electrolytes than mature milk
,This is determined by being preterm not just having a small baby therefor it does not matter if
the baby is SGA or LGA only dependent of gestational age
1+ year of lactation - ✔✔After one year of lactation the milk expressed has significantly
increased fat and energy contents, compared with milk expressed by women who have been
lactation for a shorter time.
The volume of milk does not have to change as the baby gets older/bigger because the
composition of the milk changes
Breast milk composition changes... - ✔✔Over the course of lactation
Within the day there are variations on the composition of milk
Within a feeding
By the way it is taken during a feeding
and also between feedings
Fat content in breast milk - ✔✔Longer times in between feedings made for a lower fat
content but faster feedings made for a higher fat content where as feedings lasting longer than
30 mins made for a lower fat content
Breastfed babies can regulate fat intake quickly and thus mothers should be encouraged to
practice baby led feeding
Maximum fat levels were obtained 30 mins post-feed
1 breast or 2? - ✔✔There is no difference in baby's net fat intake according to the number of
breasts suckled per feeding or the breastfeeding frequency
Offer the 1st breast 1st and the 2nd breast 2nd it really doesn't matter 1 breast or 2 whatever
they want
Lactogenesis 1/Secretory Differentiation - ✔✔Production of colostrum from the placental
hormones (progesterone)
, When placenta delivers the progesterone levels drop to allow for prolactin to take its place in
the milk making cells
Lactogenesis 2/Secretory Activation - ✔✔Begins when progesterone leaves the cells and
prolactin enters the receptor sites
Milk will be a mix of colostrum and mature milk
Lactogenesis 3/Galactopoesis - ✔✔Long term production of mature milk
Need frequent removal of milk and frequent nipple stimulation to continuously produce milk
How does pH of the gut effect babies - ✔✔Gut pH of breastfed babies is higher than those
who are formula fed or even mixed fed. Higher pH means less harmful bacteria is able to grow
which helps have less issues with diarrhea
How does iron effect baby's gut - ✔✔Low iron in the gut is good, breastmilk has relativly low
iron content
Tons of different bacteria thrives on excess iron so having to much can cause issues
How does the presence of lactobacillus bifidus affect baby's gut - ✔✔Presence of bifidus
factor in breast milk promotes the growth of lactobacillus bifidus which helps maintain the low
pH and crowd out the harmful bacteria
How does the presence of SIgA antibodies effect baby's gut - ✔✔Antibodies such as SIgA
bind to microbes in the baby's intestinal tract and prevent them from being absorbed into the
rest of the body. Mothers IgA has been found to protect against the development of necrotizing
enterocolitis in preterm infants
Weight loss in breastfed infant - ✔✔No more than 7% weight loss from with birth weight
and no more weight loss by day 5 and should be back to birth weight by 2 weeks
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