Life Cycle Nutrition Study Guide
Life Cycle Nutrition Study Guide NUTR 650
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This 6 page Study Guide was uploaded by Valerie Nesom on Sunday February 21, 2016. The Study Guide belongs to NUTR 650 at University of New Hampshire taught by Dr. Rielly in Spring 2016. Since its upload, it has received 49 views. For similar materials see Lifecycle Nutrition in Nutrition and Food Sciences at University of New Hampshire.
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Date Created: 02/21/16
Module 2: PreExam Homework (Lactation & Breastfeeding) Spring 2016 Go to the content area (PreExam Homework) and open PreExam Homework Module 2 Folder. Open file entitled: PreExam HomeworkWord Document (Module 2) and download onto your own computer. Do not open the PreExam Homework Assignment until you have answered all the questions in the word document. Answer all the questions in the word document before you submit your assignment into Blackboard. This is an openbook format. You may use any sources you would like to answer these questions; text, lecture notes, other books, etc. I would advise against using the Internet as the information there is not always reliable and it will result in lost points. In order to receive credit all answers to the definitions must apply directly to the module being covered. Please use your own words when answering the questions. After you have answered all the questions go back onto Blackboard. Open Lactation: PreExam Homework Assignment and either type in or cut/paste in your answers from a word document on your computer. You can submit your answers only once. After you submit you cannot go back in and change your answers, as you will be locked out of the assignment. If you have technical difficulties and get locked out of the assignment you need to email Dr. Reilly and Sarah Jacobson immediately as we are the only ones who can unlock the assignment for you. Please be sure to save all your answers. Unlocking the assignment will result in lost answers. Good Practice: Please do not wait until the hour before the assignment is due to submit your essays. At that point technical difficulties may be impossible to fix and the result will be a zero on this assignment. These essays are to be completed on your own with no communication with others. Any violation of the academic contract will result in a zero in the course. This assignment is due no later than Thursday, March 3, 2016 at 9 pm. After this date and time the assignment will be removed from Blackboard. Questions 1. Discuss how breastfeeding functions as a contraceptive. Is it effective? Why or why not? Be sure you include the hormones involved in your answer. (9 points) When the infant feeds from its mother the mother’s body produces prolactin. Prolactin stops FSH, LH and ovulation; estrogen isn’t completely inhibited but is at low levels. 1 Since estrogen is so low and FSH and LH are inhibited, this prevents ovulation from occurring to help the mother build up her iron and other nutrient stores again. Even though the mother isn’t menstruating, this isn’t an effective form of a contraceptive. Around six months when the baby may be eating solid foods the baby will also be feeding less from the mother. As milk feedings decrease, there is less of a stimulus for the mother to produce prolactin. When prolactin levels decrease, FSH and LH levels increase. The increase in these hormones causes the mother to ovulate and if the mother is developing a follicle her estrogen levels will also increase. This can lead to possible pregnancy if not on a prescription contraceptive. Therefore, breastfeeding isn’t an effective contraceptive. 2. HMBANA (16 points) a. What is HMBANA? i. HMBANA is the Human Milk Banking Association of North America. b. What services does this organization provide for breastfeeding women? i. The organization provides breastfeeding women a place to donate their milk if they are producing a lot of milk. The milk is donated for babies who are sick, who have allergies, chronic diseases and mostly to babies that are preterm. c. What is the screening process used for women who are interested in participating in this this program? i. The women who donate are very carefully screened and HMBANA follows national guidelines. They are interviewed over the phone, must give HMBANA health and lifestyle history information, must provide health status from their physician to make sure that the woman is healthy and have a blood test to test for anything that compromises the woman’s immunity, such as HIV. A woman cannot donate if she has had a blood transfusion in the past year, consume more than two ounces of alcohol per day, uses drugs, smokes, or if the mother is on medication and or takes herbal supplements. The woman must be taking a B12 vitamin if she doesn’t consume meat. d. How is the collected breast milk processed and packaged before delivery? i. The donated breast milk is pasteurized to make sure no harmful bacteria are in the milk. The milk is stored in plastic containers that ensure no loss of nutrients and no loss of immune factor and the milk is then frozen. 3. Sara is breastfeeding her 6monthold son and is concerned that she is not getting enough fluids. What are four tips you would give Sara concerning consumption of fluids while breastfeeding? (9 points) 2 I would tell Sara: 1) to make sure she is consuming 34 liters of fluid each day, 2) to look at her urine after she goes to the bathroom and if it’s a pale yellow color she is most likely consuming enough fluids, 3) to drink fluid before, during and after nursing her son and 4) to drink to thirst and to make sure she understands that the amount of fluid she intakes doesn’t effect the amount of milk she produces. 4. Judy is currently breastfeeding her 2monthold son, Joseph. Judy wakes up one morning and starts to experience flulike symptoms and has a temperature of 103°. She also notices a reddish, hard spot on her right breast that feels hot and painful to the touch. (16 points) a. What do you think these symptoms indicate? i. These symptoms indicate that she has mastitis. b. What is the most likely cause of Judy’s condition? i. The most likely cause is unresolved plugged ducts. c. What steps should Judy take to remedy these symptoms? i. First, Jody should continue breastfeeding to remove the milk from her breasts or use a pump if nursing is too painful. Removal of the breast milk may be enough to resolve the mastitis. Second, should take an antiinflammatory, such as Ibuprofen, for pain and inflammation. Third, Jody should rest and drink enough fluid. d. Do you think it is advisable for Judy to stop breastfeeding Joseph? Why or why not? i. No, Jody should continue to nurse through mastitis. By her son nursing and removing the milk, this will help to minimize the engorgement. If it’s too painful for Jody to breastfeed she should pump her milk out of her breasts using a pump. 5. Lactation: Describe the process of lactation and breastfeeding. Please include the following points in your essay: (12 points) a. Describe breast anatomy and the role each of these structures play in lactation and breastfeeding. b. How is human milk produced and delivered to the infant? Be sure to include the three hormones involved and how they facilitate the process of lactation and breastfeeding. The breast is made up of the following structures: mammary gland, areola, sebaceous glands, alveoli, myoepithelial cells, lactiferous ducts, lactiferous sinuses and Montgomery’s tubercles. The mammary gland is the actual breast that is made up of the alveoli, where milk is produced, the duct system and the areola, where the sebaceous glands are located. The alveoli have cavities where milk is made. They also have secretory cells and myoepithelial cells that cause the milk to secrete into the duct system through contraction. The duct system consists of the lactiferous ducts, which send the milk from the alveoli to areas that store and release the milk within the breast. The duct system also consists of the lactiferous sinuses, which store the milk. The sebaceous 3 glands and Montgomery’s tubercles coincide together. The sebaceous glands help the baby to suck on the nipple by stiffening the nipple and lubricating it. The lubricant is secreted by Montgomery’s tubercles, which are the little bumps around the nipple. The human milk is produced in the alveoli and is then secreted into the duct system by the myoepithelial cells. The milk first travels down into small ducts to larger ducts. From there, the milk is transmitted into the lactiferous sinuses where it is stored until the infant is nursed and latched onto the nipple. Three hormones involved in this process are prolactin, oxytocin and prolactin inhibiting hormone (PIH). When the infant is suckling, this action stimulates prolactin secretion and milk production. The nerves in the nipple send a signal to the hypothalamus to signal the anterior pituitary gland when the baby is suckling. The anterior pituitary gland then secretes prolactin. Prolactin works by developing the alveolar and secretion of milk. Without prolactin, milk production wouldn’t be possible. Oxytocin is released by the posterior pituitary gland from a signal from the hypothalamus from the action of the infant suckling. Oxytocin is the letdown hormone that is stimulated by suckling as well. It letdowns the milk from the myoepithelial cells in the alveoli by causing them to contract and releasing the milk through the ducts. From the ducts, the milk is sent to the lactiferous sinuses to be available to the infant to feed from. PIH functions by preventing over production of milk. It is released from the hypothalamus during the last three months of pregnancy to inhibit prolactin levels. PIH helps to prepare the mother’s body for milk production when pregnant. 6. Human Milk (8 points) a. Describe how and why human milk changes during lactation? i. Human milk changes during lactation from colostrum to transitional milk to mature milk. The changes occur in order for the milk to be completely customized for the needs of the infant. For instance, if an infant is born preterm the mother’s milk will adjust to the higher nutrient need of the infant. Preterm milk is very high in protein and lower in volume as apposed to mature milk to accommodate all of the nutrient needs of the preterm infant. Colostrum is premilk that is produced throughout Lactogenesis II one to three days after childbirth. It is rich in antibodies, white blood cells, protein, electrolytes and nutrients as opposed to mature milk. Transitional milk is also produced during Lactogenesis II three to six days after childbirth. During this stage of milk change, the milk is adapting and customizing its composition in order to meet the changing needs of the infant. After transitional milk it is now called mature milk. It is completely isomotic with the mother’s plasma and has a watery consistency. At one month after childbirth, the milk now has consistent protein levels and fat and carbohydrate levels are higher than colostrum. 4 b. Describe how and why human milk changes during each breastfeeding session? i. During the nursing session there are two types of milk released. Foremilk is released first because of its high nutrient density and low fat content. When the infant firsts starts to suckle, the baby is hungry and is more aggressive. The composition of the foremilk ensures that the baby is consuming all of the necessary nutrients it needs. During the end of the nursing session hindmilk is released and its composition is much higher in fat. Toward the end of the session the baby is becoming more full and isn’t suckling as aggressively. The high fat content makes the baby sleepy and relaxed. Definitions: In one or two sentences define the following term. (Please make sure your answers apply to Lactation and Breastfeeding). (3 points each) 7. Nipple Confusion: is when the infant is feeding from both the breast and a bottle too early in infancy. Since it’s easier for the infant to feed from the bottle, he/she may prefer the bottle instead of the breast. 8. Meconium is the infant’s first stool promoted by the colostrum. It is composed of what the infant consumed in the uterus and usually green in color. 9. Lactogenesis II is the second stage of milk production beginning two to five days after birth. During this stage there is an increase in blood flow to the mammary gland, changes in milk composition and quantity and colostrum is produced. 10. M/P Ratio: stands for milk and plasma ratio, which is a ratio of how much drug concentrate is in the breast milk as opposed to how much of that is in the mother’s plasma over time. This ratio helps to determine how much of a drug is in the mother’s bloodstream and helps to determine the level of exposure to the infant. 11. Parturition: is childbirth, where the PIH, estrogen and progesterone decrease dramatically and prolactin increases. Prolactin stimulates production of milk, where the first milk is called colostrum right when the infant is born. 12. Galactactorrhea: is when milk is secreted randomly from the mother’s breast during a nonphysiological state. This can happen during the first month after childbirth before breastfeeding has been established when the mother is away 5 from her infant. 13. Engorgement: is a complication that can happen especially to first time moms who haven’t connected completely their infant. The breasts accumulate with milk and become very painful and can lead to infection. To prevent this, make sure the infant is latched on correctly and is receiving milk. 14. Galactopoiesis: is when there is a consistent production of milk during lactogenesis III. 15. Rooting Relex: is a reflex that the infant has, which is stimulated by stroking the infant’s cheek. The infant will turn towards the stroking and latch onto the breast. 16. Lactoferrin: is a primary protein found in colostrum. It helps the infant bind to iron found in the GI tract in order to prevent bacteria that feed off of iron there from growing. 6
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