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67 Cards in this Set
- Front
- Back
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Blood is supplied to the breast by what two arteries? |
Internal mammary (60%) and Lateral Thoracic (30%l |
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Nipple growth is related to which hormone? |
Serum prolactin |
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Areola growth is related to which hormone in pregnancy? |
Serum placental lactogen |
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Which hormone helps the ductal system proliferate and differentiate in pregnancy? |
Estrogen |
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Which hormone promotes an increase in size of the lobes, lobules and alveoli in pregnancy? |
Progesterone |
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During lactogenesis 2, which breast milk levels decline? Name three. Which levels rise? Name 2. |
Decline: sodium, chloride, and protein Rise: lactose and milk lipid levels |
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Which hormone stimulates mammary secretory epithelial cells to produce milk? |
Prolactin |
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Lactogenesis stage 2 is characterized by a switch from what type to what type of control? |
Endocrine to autocrine control |
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Where is Prolactin released from? |
Anterior pituitary gland |
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Where is oxytocin released? |
Posterior pituitary gland |
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Compared with mature milk, how is colostrum different in regards to protein and minerals? How is it different in regards to carbohydrates, fat, and some vitamins? |
It is richer in protein and minerals. It is lower in carbohydrates, fat, and some vitamins. |
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The neonates intestine at Birth is? |
Sterile |
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What two bacteria are prevalent in the breastfed infants gut? |
Bifidobacteria and lactobacilli |
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Human milk contains what percent solids and what percent water? |
10% solids 90% water |
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What is the general considered caloric content of human milk? |
65 kcal/dL |
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How much does infant gain first 4 weeks (per day)? |
About 5-7 oz per week, 10g/kg/d |
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How much does the infant gain 4 weeks post birth through the first year of life? |
1 g/kg/d or 3 oz per week |
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What percentage of milks calories come from fat? |
About half. |
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What is the main constituent of milk fat? |
Triglycerides at 98 to 99% |
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What enzymes helps the infant breakdown breast milk fat? And what does it break it down to? |
Lipase. It breaks it down into free fatty acids and glycerol. |
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What are the five components of whey protein? |
Alpha-lactalbumin Serum albumin Lactoferrin Immunoglobulins Lysozyme |
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What are the five types of immunoglobulins? |
IGG, IGA, IGM, ige, and igd |
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Which immunoglobulin is the major immunoglobulin in human secretions? |
Secretory IGA |
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Is secretory IGA absorbed from the intestine? Why or why not? |
Only minimally absorbed. Because it is bound to the human milk fat globule membrane |
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Do lysosomes decline or increase as lactation progresses? Why? |
Increase progressively, beginning about 6 months after delivery. High levels of lysozyme May be a safeguard against the risk from pathogens and diarrheal disease |
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Which four maternal factors most affect the rate of drug transfer into human milk? |
Maternal plasma levels of the drug, molecular weight of the medication, oral bioavailability of the medication in mother and infant, and protein binding of the medication |
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Explain briefly passive diffusion of drugs into milk |
Normally, drugs transfer from areas of high concentration to areas of low concentration via passive diffusion. |
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How should we view milk and maternal plasma as related to each other? |
Two distinct and separate compartments |
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The _____ the molecular weight of the medication, the ______ the rate of diffusion across the bilayer lipid membrane. |
Smaller, greater. |
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At what molecular weight of medication is it increasingly difficult to diffuse through the layer membranes and enter the milk? |
500 to 800 Dalton's. |
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The _____ lipid-soluble the medication, the _____likely it will transfer into human milk |
More, more. |
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For an infant that is failing to thrive, or behind on weight for age, what is the daily supplement minimum to offer? |
100 ml per kg per day |
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What is the general rule of thumb for normal total intake of breastmilk or formula? |
150 to 200 mL per kilogram per day |
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The ph of a medication will likely increase/decrease absorption if it is weakly acidic |
Decrease |
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The ph of a medication given to an infant will likely increase/decrease absorption if it is weakly basic |
Increase |
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Dopamine receptors are in what part of brain? |
Hypothalamus |
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______ release from the (what part of brain??)___ is inhibited by dopamine from the hypothalamus? |
Prolactin, pituitary |
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Which infants would be classified as low risk in regards to medications? |
Generally older infants 6-18 mos |
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Which infants are considered moderate risk in regards to medications? |
Infants younger than 6 mos w metabolic problems |
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Which infants are considered high risk in regards to medications? (4 types) |
Premature, newborns, unstable infants, and infants w poor renal output |
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Nonspecific early symptoms of congenital hypothyroidism may include? (2) |
Feeding difficulties and hyperbilirubinemia |
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Late preterm brain vs full term infant: brain increases by at least ______ in the final 6 to 8 weeks |
1/3 |
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Milk storage capacity of mothers fully breastfeeding their own infant ranges from about _______ mL |
100 to 600 ml per breast |
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On average, breast make milk at a rate of blank per breast per hour? |
1 oz 30 ml |
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During pregnancy high/low? Blood concentrations of estrogen act to ____ Maternal sensitivity to pain? |
High, increase |
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Ten steps to successful breastfeeding? |
1. Written breastfeeding policy. 2. Train all Healthcare staff and skills necessary to implement this policy 3. Inform all pregnant women about the benefits of management of breastfeeding 4. Help mothers initiate breastfeeding within 30 minutes after birth 5. Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants. 6. Give newborn infants no food or drink other than breast milk last medically indicated 7. Practice rooming in 8. Encourage breastfeeding on demand 9. Give no artificial teeth or pacifiers to breastfeeding infants 10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge. |
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What was innocenti declaration? |
Restated the importance of breastfeeding for maternal and child health. Four goals. |
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What were four goals of innocenti Declaration? |
1. Establishment of national breastfeeding coordinators, 2. practice of 10 steps, 3. implementation of the who international code of marketing of breast-milk substitutes and 4. enactment of enforceable laws for protecting the breastfeeding rights of employed women |
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Describe the infant's hard palate |
Short, wide and only slightly arched |
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Milk output typically greater from what breast? |
Right |
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Describe the amount of milk infants take per feeding in first one to two days after birth |
7014 Mel |
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By day 5, what is volume of milk per day for infants? How much milk do full breastfeeding infants take on average during months 1 to 6? |
500 ml per day. 800 ml per day |
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What are the two types of white blood cells in human milk? What do each of them do? |
Phagocytes engulf and absorb pathogens and release IGA Lymphocytes (83% t cells) protect an infant by destroying the cell walls of viruses in a process called cell mediated immunity |
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At hospital discharge 2 to 3 days postpartum the average weight loss of exclusively breastfed neonates is about ______Compared to formula-fed neonates? |
Twice |
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ACE inhibitors: use caution in what group? |
Premature infants; compatible thereafter |
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Amiodarone: avoid what? High risk of accumulation due to? |
Long-term use. Brief use okay. Long Half-Life and high volume of distribution. |
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Is aspirin use ok? |
81 milligram dose probably okay. Avoid higher doses. |
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Clinical significance of Doxepin? |
Dangerous sedation and respiratory arrest reported. Hazardous |
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Clinical significance of iodine in breastfeeding mothers? |
High levels and milk. May inhibit thyroid function in the unit. Possibly hazardous. |
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Clinical significance of lithium in breastfeeding mothers? |
Levels high in milk. Risk High to infant unless monitored closely. Probably safe with close observation. |
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Clinical significance of Ribavirin in breastfeeding mothers? |
No reported milk levels, but following chronic use may lead to hemolytic anemia. Caution is recommended. |
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Clinical significance of sulfonamide in breastfeeding mothers? |
Avoid early postnatally. Displaces bilirubin from its binding site. Do not use in G6PD deficiency. |
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Clinical significance of tetracycline in breastfeeding mothers? |
Brief use okay less than three weeks. Chronic use not recommended. |
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What have phenothiazines been associated with? |
Neonatal apnea and sudden infant death syndrome. Poor choices for use in breastfeeding mothers. Older phenothiazines and thiozanthines should probably be avoided in breastfeeding women |
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Which antipsychotics may be the best choice of therapy for breastfeeding mothers? Name four. |
Newer atypical antipsychotics. Olanzapine risperidone Quetiapine and aripiprazole |
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Name six breastfeeding assessment tools |
IBFAT Latch Via Christi (combined IBFAT & latch) Mother baby assessment tool (MBA) Preterm infant breastfeeding Behavior scale (PIBBS) Neonatal oral motor assessment scale (NOMAS) (non-nutritive sick assessment) |
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What is the only single Behavior found that predicts milk intake? |
Audible swallowing |
