Repro 11.1 lactation Flashcards Preview

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Flashcards in Repro 11.1 lactation Deck (31)
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1
Q

Describe the realationship between mammary tissue and breast tissue.

A

Mammary tissue is found WITHIN breast tissue, and in the non lactating female there is much less mammary tissue than breast tissue.

2
Q

What is the mammary gland composed of?

A

around 15-20 lobules, which are divided by fibrous tissue and adipose tissue.

3
Q

Where do the mammary lobules drain?

A

Into the lactiferous ducts.

These combine to form a few lactiferous sinus’, which drain out of the nipple via pores.

4
Q

What are the single units of lactation known as?

A

Alveoli/acini

5
Q

What is the lining of the mammary alveoli?

A

collumnary epithelium which is supported by myoepithlium. (smooth muscle cells able to contract)

6
Q

What is the mammary tissue like at birth?

A

There is very little and it is underdevelopped.

7
Q

What happens to the mammary tissue at puberty?

A

The increase in oestrogens causes sprouting of the ducts and the formation of the alveoli (not yet functional).

More stroma is formed.

8
Q

What happens to the mammary glands during each stage of menstruation?

A
  • follicular phase- dormant lobules
  • luteal phase- cell proliferation and stromal oedema
  • menses- decrease in the size of the lobules
9
Q

What happens to the mammary tissue with increasing age?

A
  • lobular unit number decreases

- stroma is replaced by adipose tissue (which makes mammography easier)

10
Q

When does the majority of mammary gland development occur?

A

During pregnancy

11
Q

What happens to the mammary tissue during early pregnancy?

A

Hypertrophy of the ductular-lobular system

  • lobules become capable of producing milk
  • reduction in stromal levels
12
Q

With regards to mammary tissue and lactation, what are the effects of:

Oestrogen

Progesterone

A

Oestrogen- promotes milk production

Progesterone- promotes mammary tissue growth (As is seen at the beginning of pregnancy)

13
Q

Give some features of the milk produced soon after birth?

A

Colostrum

Yellow in colour, smelly

High levels of protein (particularly antibodies) and less water, fat and sugar than mature milk.

14
Q

How much Colotrum is produced per day after birth?

A

Around 40ml/day.

15
Q

Give some features of mature milk produced after birth of the neonate

A
  • high in sugar (lactose)
  • high water, and fat levels
  • White in colour
16
Q

How long after partuition doe mature milk get produced?

A

2-3 weeks

17
Q

Describe the formation of different components of mature milk produced for the infant

A
  • fats produced by the SER
  • proteins produced and secreted by the golgi via exocytosis
  • sugars- synthesised and exocytosed
18
Q

Which hormone is primarily responsible for lactogenesis?

A

Prolactin

19
Q

Why does milk production increase massively after birth?

A

The relative drop in progesterone compared to oestrogen causes the alveolar cells to become sensitive to prolactin, and the whole process to get switched on.

20
Q

How is prolactin secretion controlled?

A

It is secreted from the anterior pituitary, in respose to the hypothalamus.

It’s secretion is inhibited by dopamine.

21
Q

Describe how suckling promotes lactogenesis.

A

Neuro-endocrine reflex.

Suckling stimulates mechanical receptors in the nipple, which relay back to the hypothalamus.

this reduced dopamine, which means prolactin secretion rises

This allows lactogenesis to occur
(suckling causes milk production for the next feed, not the current one)

22
Q

Why should a baby be encouraged to suckle, even if they dont want to?

A
  • promotes lactogenesis for the next feed
  • without regular releiving, breasts become turgid and full of milk, which can damage surrounding blood vessels and reduce the ability to produce milk.
  • breasts become sore if milk isnt relieved regularly
  • keeps prolactin levels high (reduction of dopamine)
23
Q

Describe the process of milk ‘let down’.

A

Babies do not actively suck milk out of the breast.

sensation of baby suckling is relayed back to the hypothalamus.

There is increased oxytocin secretion (from the posterior pituitary)

Stimulates the myoepithelial cells to contract, releasing the milk into the babies mouth.

24
Q

Why might some mothers ‘leak’ milk when they dont want to, and in what situations might this happen?

A

The milk ‘let down’ reflex becomes conditioned when the mother anticipates suckling.

Eg hearing another baby cry, holding another baby.

25
Q

What is inflammation of the breast called?

A

Mastitis.

26
Q

What protection do the breasts have against infection?

A

They have lubricating glands known as montgomery tubercles, which produce a sebum lubricant. This prevents cracking of the nipple, which would allow infection to move into the breast.

27
Q

How much mature milk is the mother capable of producing each day?

A

800ml.

28
Q

Why is a large amount of milk needed to be produced by the mother during lactation?

A

The energy content of milk is low, so lots needs to get into the neonate.

27 Mjoules per litre,

29
Q

Other than reduced suckling, what factors can cause cessation of lactation?

A
  • suppression of prolactin (eg some diuretics, some mushrooms, retained placenta)
  • painful breasts, due to build up of milk
  • menstrual changes, causes breasts to become lumpy, mother doesnt want to feed baby from these.
30
Q

For what reasons is breast feeding thought to be good?

A
  • reduced infections in the newborn (passive immunity)
  • bonding between mother and child
  • reduced risk of breast/ovarian cancer in later life (due to reduced oestrogen exposure)
  • aids loss of weight induced by pregnancy.
31
Q

When should breast feeding stop?

A
  • around 6 months

- when the baby starts to develop teeth (will hurt mother)

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