Human and Cow milk

Human and Cow milk

Q. 1

All of the following are signs of inadequate breast milk intake in a neonate, EXCEPT:

 A

Weight loss of 5% from birth

 B

Less than six noticeably wet diapers per 24 h by day 3–4

 C

Less than four stools per day by day 3–4

 D

Nursing less than eight times per 24 h

Q. 1

All of the following are signs of inadequate breast milk intake in a neonate, EXCEPT:

 A

Weight loss of 5% from birth

 B

Less than six noticeably wet diapers per 24 h by day 3–4

 C

Less than four stools per day by day 3–4

 D

Nursing less than eight times per 24 h

Ans. A

Explanation:

In a neonate with inadequate breast milk intake the weight loss is more than 8-10%. Other signs of inadequate breast milk intake are: 

 

  • Less than six noticeably wet diapers per 24 h by day 3–4
  • Less than four stools per day by day 3–4
  • Nursing less than eight times per 24 h

 

Breast milk jaundice: refers to presence of unconjugated hyperbilirubinemia lasting until 2–3 months of age. This diagnosis is strongly suspected in the presence of moderate unconjugated hyperbilirubinemia lasting for 6–12 weeks in a thriving breast-fed infant without evidence of hemolysis, hypothyroidism, or other disease.

 

 

 

Ref: Thilo E.H., Rosenberg A.A. (2012). Chapter 2. The Newborn Infant. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds),CURRENT Diagnosis & Treatment: Pediatrics, 21e.

 


Q. 2

The protective effects of breast milk are known to be associated with:

 A

IgM antibodies

 B

Lysozyme

 C

Mast cells

 D

IgA antibodies

Q. 2

The protective effects of breast milk are known to be associated with:

 A

IgM antibodies

 B

Lysozyme

 C

Mast cells

 D

IgA antibodies

Ans. D

Explanation:

Breast milk is especially rich in secretory IgA, that prevents microorganisms from adhering to intestinal mucosa.

Immunoglobulin A (IgA) ingested in colostrum provides mucosal protection against enteric infections.

This may also explain the small amount of fetal secretory IgA found in amnionic fluid.

 

 

 

Ref:Kligman, Behrman, Jenson, Stanton (2008), Chapter 42, “The Feeding of Infants and Children”, In the book, “Nelson’s Textbook of Pediatrics”, Volume 2, 18th Edition, New Delhi, Page 2364

 


Q. 3

Which of the following statement about Recommended Dietary Allowances (RDA) is TRUE?

 A

RDA is statistically defined as two standard deviations (SD) above Estimated Average Requirement (EAR)

 B

RDA is defined as being equal to the Estimated Average Requirement (EAR)

 C

RDA is defined as being equal to Adequate Intake CAT)

 D

RDA is defined as the recommended minimum requirement

Q. 3

Which of the following statement about Recommended Dietary Allowances (RDA) is TRUE?

 A

RDA is statistically defined as two standard deviations (SD) above Estimated Average Requirement (EAR)

 B

RDA is defined as being equal to the Estimated Average Requirement (EAR)

 C

RDA is defined as being equal to Adequate Intake CAT)

 D

RDA is defined as the recommended minimum requirement

Ans. A

Explanation:

EAR forms the basis for setting the RDA. RDA is set at 2 standard deviations above estimated average requirement.

Estimated average requirement (EAR) is the daily intake value that is estimated to meet the requirement in 50% of individuals in a life stage or gender group.

Recommended daily allowance (RDA) is the average daily dietary intake level that is sufficient to meet the nutrient requirement in nearly 97-98% healthy individual in a specific life stage and gender group.

Ref: Harrison’s Principle of Internal Medicine, 18th Edition, Chapter 73 ; Dietary Reference Intakes: For Calcium, Phosphorus, Magnesium, Vitamin D By Institute of Medicine (U.S.). Standing Committee on The Scientific Evaluation of Dietary Reference Intakes, Page 23


Q. 4

Which of the following statement is true about colostrum?

 
1. Secreted after 11 days of childbirth
2. Rich in Immunoglobulin
3. Contains more protein than milk
4. Contains less fat than milk
5. Daily secretion is about 10ml/day
 A

1,2,3 False & 4,5 True

 B

2,3,4 True & 1,5 False

 C

2,3,4 False & 1,5 True

 D

1,2,4 True & 3,5 False

Q. 4

Which of the following statement is true about colostrum?

 
1. Secreted after 11 days of childbirth
2. Rich in Immunoglobulin
3. Contains more protein than milk
4. Contains less fat than milk
5. Daily secretion is about 10ml/day
 A

1,2,3 False & 4,5 True

 B

2,3,4 True & 1,5 False

 C

2,3,4 False & 1,5 True

 D

1,2,4 True & 3,5 False

Ans. B

Explanation:

Colostrum is very rich in proteins, vitamin A and sodium chloride, but contains lower amounts of carbohydrates, lipids, and potassium than normal milk.

Colostrum contains immunoglobulins such as IgA, IgG, and IgM.


Q. 5

Following delivery when does maximal milk output occur in the mother?

 A

3 months

 B

5 months

 C

9 months

 D

12 months

Q. 5

Following delivery when does maximal milk output occur in the mother?

 A

3 months

 B

5 months

 C

9 months

 D

12 months

Ans. B

Explanation:

Under normal conditions breast milk production reaches a maximum when the baby is around 4 – 6 months.


Q. 6

Colostrum contains all of the following in excess of milk, EXCEPT:

 A

Protein

 B

Fat

 C

Minerals

 D

Immunoglobulins

Q. 6

Colostrum contains all of the following in excess of milk, EXCEPT:

 A

Protein

 B

Fat

 C

Minerals

 D

Immunoglobulins

Ans. B

Explanation:

Compared with mature milk, colostrum contains more minerals and amino acids. It also has more protein, much of which is globulin, but less sugar and fat. It also contains antibodies, and its content of immunoglobulin A (IgA) offers the newborn protection against enteric pathogens. Other host resistance factors found in colostrum and milk include complement, macrophages, lymphocytes, lactoferrin, lactoperoxidase, and lysozymes.
 
Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 22. Reproductive Development & Function of the Female Reproductive System. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong’s Review of Medical Physiology, 24e.

Q. 7

Which of the following hormone is essential for breast milk ejection?

 A

Oxytocin

 B

Prolactin

 C

Galactogen

 D

GH

Q. 7

Which of the following hormone is essential for breast milk ejection?

 A

Oxytocin

 B

Prolactin

 C

Galactogen

 D

GH

Ans. A

Explanation:

Milk ejection occurs in response to a surge of oxytocin, which induces a contractile response in the smooth muscle surrounding the gland ductules. Oxytocin release is occasioned by stimuli of a visual, psychologic, or physical nature that prepare the mother for breast-feeding; whereas prolactin (PRL) release is limited to the suckling reflex arc. PRL is essential to milk production.
 
Ref: Taylor R.N., Badell M.L. (2011). Chapter 16. The Endocrinology of Pregnancy. In D.G. Gardner, D. Shoback (Eds), Greenspan’s Basic & Clinical Endocrinology, 9e.

Q. 8

Most common immunoglobulin secreted by mother in milk and colostrum is :

 A

IgA

 B

IgG

 C

IgE

 D

IgD

Q. 8

Most common immunoglobulin secreted by mother in milk and colostrum is :

 A

IgA

 B

IgG

 C

IgE

 D

IgD

Ans. A

Explanation:

Ans. is a i.e. IgA

Composition of Breast Milk :

Carbohydrate – Lactose is present in high concentration in breast milk.

Protein content is low, as the baby cannot metabolise a high protein diet. The proteins are mainly lactalbumin and lactoglobulin, which are easily digestible. It is also rich in the aminoacids taurine and cysteine, which are necessary for neurotransmission and neuromodulation.

Fats – Breast milk is rich in polyunsaturated fatty acids (PUFA) needed for myelination. Water and electrolytes – The water content is 86 – 87%.

Immunological superiority – Breast milk contains immunoglobulins, especially IgA and IgM, iysozyme, lactoferrin (which protects against enterobacteria), bifidus factor (to protect against E.coli), PABA (which protects from malaria).

“Breast milk has a high concentration of secretory IgA, 1gM”. ‘Colostrum –Contains antibody (1gA) produce locally”.

Therefore, IgA is the option of choice.


Q. 9

Which of these fatty acids is found exclusively in breast milk:

 A

Linolaete

 B

Linolenic

 C

Palmitic

 D

Docosahexanoic acid

Q. 9

Which of these fatty acids is found exclusively in breast milk:

 A

Linolaete

 B

Linolenic

 C

Palmitic

 D

Docosahexanoic acid

Ans. D

Explanation:

D i.e. Docosahexanoic Acid

 

Most of the naturally occurring unsaturated fatty acids are cis-isomers. Trans-FA do not occur naturally in plants and occurs only in small amounts in animals as ruminant fat (eg butter fat) arising from the action of micro organisms in rumen. Cis isomers are less stable than trans FA.

– Trans fatty acids formed during partial hydrogenation or hardening (saturation /deep frying)Q of vegetable oils – a procedure to improve stability or shelf life. Trans – FA increase incidence of coronary heart disease by increasing LDL and decreasing HDLQ.

– Linoelic acid is the most important essential fatty acid because it serves as the basis for production of other EFAs like arachidonic acid & docosahexanoic acid. Arachidonic acid, a w-6 PUFA is essential as it is a precursor of prostaglandins & leukotrienes.

Linoleic acid is the most important essential fatty acid, maximally found in Safflower oilQ>Corn oilQ> Sunflower oilQ

–  Docosahexanoic Acid (DHA; tai, 22:6) which is synthesized from a-linolenic acid or obtained directly from fish oils, is present in high concentrations in retina, cerebral cortex, testis & sperm. DHA is particularly needed for development of brain & retina and is supplied via the placenta and milk. Milk is the constant and continuous source of DHA as placenta is not present at all time. Patients with Retinitis pigmentosa are reported to have low levels of DHA.

Plasma membrane contains both saturated & mono or poly unsaturated FA.


Q. 10

Benifits of breast milk are –

 A

Better nutrition

 B

Less infection

 C

More diarrhea

 D

a and b

Q. 10

Benifits of breast milk are –

 A

Better nutrition

 B

Less infection

 C

More diarrhea

 D

a and b

Ans. D

Explanation:

Ans. is ‘a’ i.e., Better nutrition; ‘b’ i.e., Less infection

Breast feeding

o Breast feeding is feeding an infant or young child with breast milk directly from breast and not from a baby bottle or other container.

o Under any circumstances, breast milk is the ideal food for the infant —> Human breast milk is the best source of nourishment for human infants.

o No other food is required by the baby until the age of 6 months after birth.

o So, exclusive breast feeding should be given to infant for first 6 months of life.

Benefits of breast feeding

o Among the benefits of breast feeding are the following ‑

1. Superior nutrition

A. Carbohydrates

  • Lactose is in a high concentration in breast milk which helps in the absorption of calcium and enhances the growth of lactobacilli in the intestine.

B. Proteins

  • The protein content of breast milk is low which causes lower solute load on the kidney.
  • Most of the protein is whey proteins (lactalbumin and lactoglobulin), which can be digested easily (In contrast cow milk contains more casein).
  • Breast milk contains the ideal ratio of the amino acids cystine, taurine and methionine to support development of central and peripheral nervous system.

C. Fats

  • Breast milk is rich in polyunsaturated fatty acids, necessary for the myelination of the nervous system and brain growth.
  • Active lipase in the breast milk promotes digestion of fats and provides FFA.
  • The pattern of fats facilitates absorption of calcium.

D. Minerals

  • Breast milk protects against neonatal hypocalcemia and tetany due to ideal calcium phosphorus ratio (2:1) and better calcium absorption.
  • Iron of breast milk is very well absorbed —> breast feeding prevents against iron deficiency anemia.
  • Breast milk also prevents deficiencies of vitamin A, C, D, E and zinc.
  • Breast milk has a water content of 88% and hence a breastfed baby does not require additional water in the first 6 months of life even in summer months.
  • Breast milk has a low mineral and sodium content —> low osmolality presents a low solute load to the kidney.

2. Lower risk of infection

  • The breast milk is clean and uncontaminated with several anti-infective factors protect the baby from infection and diarrhea.

3. Protection from allergy (atopy)

  • Low protein contents of breast milk along with a higher concentration of secretory IgA decreases the absorption of protein macromolecules                                                       less chances of allergy and asthma.

4. Emotional bonding

  • Breast feeding promotes close physical and emotional bonds between the mother and the baby.

5. Others

  •   Breast feeding lowers the risk of ovarian and breast cancer in mother.
  •  Breastfed babies have a higher IQ and have less chances of developing hypertension, obesity, coronary artery disease and diabetes in their adulthood.
  •  The other diseases which are less common in breastfed babies include inflammatory bowel disease, Hodgkin’s lymphoma, necrotizing enterocolitis and sudden infant death syndrome.

Q. 11

The protective effects of breast milk are known to be associated with –

 A

IgM antibodies

 B

Lysozyme

 C

Mast cells

 D

IgA antibodies

Q. 11

The protective effects of breast milk are known to be associated with –

 A

IgM antibodies

 B

Lysozyme

 C

Mast cells

 D

IgA antibodies

Ans. D

Explanation:

Ans. is `d’ i.e., IgA antibodies

  1. Although antibodies and Lysozyme, both are important for protective effects of breast milk, antibodies play the major role. Out of IgM and IgA antibodies, breast milk is especially rich in secretory IgA which is the single best answer here.

Protective role of breastfeeding against infection

o Breast milk provides protection against infection because of the following facts ‑

1. The breast milk is clean and uncontaminated

2. Breast milk contains several antiinfective factors –

i)      Antibodies secretory IgA, IgM

ii)         Lysozyme

iii)    Antistaphylococcal factor

iv)     Specific inhibitory substances against viral infections.

v)     Lactoferrin —> Inhibits growth of E. coli.

vi)    Bile stimulated lipase —> kills entamoeba histolytica and Giardia lamblia.

vii)   Bifidus factor -4 Inhibits growth of E. coli

viii)  Para-amino-benzoic acid (PABA) -3 Provides protection against malaria

ix)    Phagocytic macrophages and lymphoid cells

3. Lower pH of the stool of breastfed infants contributes to the favorable intestinal flora —> more bifidobacteri a and lactobacilli, fewer E. coli.


Q. 12

The important fatty acid present in breast milk which is important for growth is –

 A

Docosahexaenoeic acid

 B

Palmitic acid

 C

Linoleic acid

 D

Linolenic acid

Q. 12

The important fatty acid present in breast milk which is important for growth is –

 A

Docosahexaenoeic acid

 B

Palmitic acid

 C

Linoleic acid

 D

Linolenic acid

Ans. A

Explanation:

Ans. is ‘a’ i.e. Docosahexaenoeis acid

o Up to 5-10% of fatty acids in human milk are polyunsaturated. Most of these are linoleic acid with smaller amounts of linolenic acid.

o Linoleic acid —> gives rise to Arachdonic acid

o Linolenic acid —> gives rise to Docosahexaenoeic acid

o Docosahexaenoeic acid is found in human milk and brain lipids and is required for the development of our nervous system and visual abilities during the first six months of life.

o Lack of sufficient Docosahexaenoeic acid may be associated with impaired mental and visual functioning as well as attention deficit hyperactivity disorder.


Q. 13

True about cow’s milk are all except ‑

 A

Cow’s milk contains 80% whey protein not casein

 B

Cow milk has less carbohydrate than mothers milk          

 C

Has more K+ and Na’ than infant formula feeds

 D

Has more protein than breast milk

Q. 13

True about cow’s milk are all except ‑

 A

Cow’s milk contains 80% whey protein not casein

 B

Cow milk has less carbohydrate than mothers milk          

 C

Has more K+ and Na’ than infant formula feeds

 D

Has more protein than breast milk

Ans. A

Explanation:

Ans. is ‘a’ i.e., Cow’s milk contain 80% whey protein not casein

o Whey protein constitutes 80% of the protein in human milk, while the main protein in cow’s milk is casein.


Q. 14

Percentage of lactose in human milk is ‑

 A

7.2gm

 B

4.5gm

 C

8.0gm

 D

6.7gm

Q. 14

Percentage of lactose in human milk is ‑

 A

7.2gm

 B

4.5gm

 C

8.0gm

 D

6.7gm

Ans. A

Explanation:

Ans. is ‘a’ i.e., 7.2%

o It is not exactly 7.2% but it is the closest choice.

Nutrient                                             Content / 100 ml

Macronutrients

o Calories                                                    67 kcal

o Proteins                                                   1.1 g

o Fat                                                          3.5 g

o Lactose                                                   7.0 g Minerals / Micronutrients

o Sodium                                                    0.9 mEq

o Potassium                                                1.4 mEq

o Calcium                                                  35 mg

o Phosphorus                                             15 mg

o Iron                                                       30-50 g

o Zinc                                                       120 g Vitamins

o Vitamin A                                                60 g

o ‘Vitamin C                                               5.2 mg


Q. 15

Compared with Cow’s milk, mothers milk has more-

 A

Lactose

 B

Vit D

 C

Proteins

 D

Fats

Q. 15

Compared with Cow’s milk, mothers milk has more-

 A

Lactose

 B

Vit D

 C

Proteins

 D

Fats

Ans. A

Explanation:

Ans. is ‘a’ i.e., Lactose


Q. 16

Hind milk is richer in –

 A

Carbohydrate

 B

Protein

 C

Fat

 D

Minerals

Q. 16

Hind milk is richer in –

 A

Carbohydrate

 B

Protein

 C

Fat

 D

Minerals

Ans. C

Explanation:

Ans. is ‘c’ i.e., Fat

o The composition of breastmilk varies at different stages after birth to suit the needs of the baby.

o According to the postnatal period the breast milk is divided into –

1. Clostrum

          Is the milk secreted during the first three days after delivery.

          It is yellow and thick.

          It contains more antibodies and cells and high amounts of vitamins A,D,E and K.

2. Transitional milk

          Is secreted during the following two weeks (after clostrum).

          The immunoglobulin and protein content decreases while the fat and sugar content increases.

3. Mature milk

          Follows transitional milk.

          It is thin and watery but contains all the nutrients essential for optimal growth of the body.

o According to feed the breast milk is divided into ‑

1. Fore milk

           It is watery and is rich in protein, sugar, vitamins, minerals and water that satisfy the baby’s thirst.

2. Hind milk

         Comes towards the end of feed

           Rich in fat content and provides more energy, and satisfies the baby’s hunger.

o The milk of mother who delivers prematurely differs from the milk of a mother who delivers at term –

Preterm milk

Contains more protein S, sodium, iron, immunoglobins and calories as they are needed by the preterm baby.


Q. 17

Human colostrum contains more of the following nutrients than mature human milk, except –

 A

Lactose

 B

Minerals

 C

Proteins

 D

Vitamin A

Q. 17

Human colostrum contains more of the following nutrients than mature human milk, except –

 A

Lactose

 B

Minerals

 C

Proteins

 D

Vitamin A

Ans. A

Explanation:

Ans. is ‘a’ i.e., Lactose

o Sugar is less in clostrum.


Q. 18

Breast milk storage in a refrigerator is upto ‑

 A

4 hrs

 B

8 hrs

 C

12 hours

 D

24 hrs

Q. 18

Breast milk storage in a refrigerator is upto ‑

 A

4 hrs

 B

8 hrs

 C

12 hours

 D

24 hrs

Ans. D

Explanation:

Ans. is ‘d’ i.e., 24 hrs

Breast milk

o Can be stored at room temperature     —>        For 8-10 hours

o In a refrigerator                             —>        For 24 hours

o In a freezer                                  —>       -20°c for 3 months


Q. 19

Breast milk at room temperature stored for‑

 A

4 hrs

 B

8 hrs

 C

12 hrs

 D

24 hrs

Q. 19

Breast milk at room temperature stored for‑

 A

4 hrs

 B

8 hrs

 C

12 hrs

 D

24 hrs

Ans. B

Explanation:

Ans. is ‘b’ i.e., 8 hrs


Q. 20

Para amino benzoic acid of breast milk prevent the infection of-

 A

Plasmodium vivax

 B

Kleibsella-pneumonia

 C

Giardia

 D

E.coli

Q. 20

Para amino benzoic acid of breast milk prevent the infection of-

 A

Plasmodium vivax

 B

Kleibsella-pneumonia

 C

Giardia

 D

E.coli

Ans. A

Explanation:

Ans. is ‘a’ i.e., Plasmodium vivax


Q. 21

The substance that has anti infective property directly or indirectly in milk is all except-

 A

Lactoferin

 B

Lactalbumin

 C

Lysozyme

 D

All

Q. 21

The substance that has anti infective property directly or indirectly in milk is all except-

 A

Lactoferin

 B

Lactalbumin

 C

Lysozyme

 D

All

Ans. B

Explanation:

Ans. is ‘b’ i.e., Lactalbumin


Q. 22

Breast milk is maximum at –

 A

1-2 months

 B

3-4 months

 C

5-6 months

 D

7-8 months

Q. 22

Breast milk is maximum at –

 A

1-2 months

 B

3-4 months

 C

5-6 months

 D

7-8 months

Ans. C

Explanation:

Ans. is ‘c’ i.e., 5-6 months

o Breast milk is maximum at 5-6 months of lactation —> 730 ml/day.

o It is minimum at 37-38 months of lactation  —> 345 ml/day.


Q. 23

Breast milk is known to transmit –

 A

Tuberculosis

 B

CMV

 C

Varicella

 D

Rubel la

Q. 23

Breast milk is known to transmit –

 A

Tuberculosis

 B

CMV

 C

Varicella

 D

Rubel la

Ans. B

Explanation:

Ans. is ‘b’ i.e., CMV

o Breast milk transmits (with definitive evidence) —> 1) HIV            

2) CMV

o Breast milk can rarely transmit —> 1) HTLV – type 1 

2) Rubella virus   

3)HBV   4) HSV


Q. 24

After premature delivery, mother’s milk is low in

 A

Lactose

 B

Fat

 C

Protein

 D

Sodium

Q. 24

After premature delivery, mother’s milk is low in

 A

Lactose

 B

Fat

 C

Protein

 D

Sodium

Ans. A

Explanation:

Ans.is ‘a’ i.e., Lactose

Premature milk contains less lactose in comparison to term milk


Q. 25

Lactose content of breast milk per 100 ml is –

 A

3.5 gm

 B

4. 5 gm

 C

6 gm

 D

7 gm

Q. 25

Lactose content of breast milk per 100 ml is –

 A

3.5 gm

 B

4. 5 gm

 C

6 gm

 D

7 gm

Ans. D

Explanation:

Ans is ‘d’ i.e., 7 gm


Q. 26

Benifits of breast milk are –

 A

Better nutrition

 B

Less infection

 C

More diarrhea

 D

a and b

Q. 26

Benifits of breast milk are –

 A

Better nutrition

 B

Less infection

 C

More diarrhea

 D

a and b

Ans. D

Explanation:

Ans. is ‘a’ i.e., Better nutrition; ‘b’ i.e., Less infection

Breast feeding

o Breast feeding is feeding an infant or young child with breast milk directly from breast and not from a baby bottle or other container.

o Under any circumstances, breast milk is the ideal food for the infant Human breast milk is the best source of nourishment for human infants.

o No other food is required by the baby until the age of 6 months after birth.

o So, exclusive breast feeding should be given to infant for first 6 months of life.

Benefits of breast feeding

o Among the benefits of breast feeding are the following ‑

1. Superior nutrition

A. Carbohydrates

            Lactose is in a high concentration in breast milk which helps in the absorption of calcium and enhances the growth of lactobacilli in the intestine.

B. Proteins

             The protein content of breast milk is low which causes lower solute load on the kidney.

            Most of the protein is whey proteins (lactalbumin and lactoglobulin), which can be digested easily (In contrast cow milk contains more casein).

            Breast milk contains the ideal ratio of the amino acids cystine, taurine and methionine to support development of central and peripheral nervous system.

C. Fats

            Breast milk is rich in polyunsaturated fatty acids, necessary for the myelination of the nervous system and brain growth.

              Active lipase in the breast milk promotes digestion of fats and provides FFA.

                The pattern of fats facilitates absorption of calcium.

D. Minerals

            Breast milk protects against neonatal hypocalcemia and tetany due to ideal calcium phosphorus ratio (2:1) and better calcium absorption.

              Iron of breast milk is very well absorbed —> breast feeding prevents against iron deficiency anemia.

                Breast milk also prevents deficiencies of vitamin A, C, D, E and zinc.

Breast milk has a water content of 88% and hence a breastfed baby does not require additional water in the first 6 months of life even in summer months.

            Breast milk has a low mineral and sodium content —> low osmolality presents a low solute load to the kidney.

2. Lower risk of infection

           The breast milk is clean and uncontaminated with several anti-infective factors —> protect the baby from infection and diarrhea.

3. Protection from allergy (atopy)

           Low protein contents of breast milk along with a higher concentration of secretory IgA decreases the absorption of protein macromolecules —> less chances of allergy and asthma.

4. Emotional bonding

           Breast feeding promotes close physical and emotional bonds between the mother and the baby.

5. Others

           Breast feeding lowers the risk of ovarian and breast cancer in mother.

           Breastfed babies have a higher IQ and have less chances of developing hypertension, obesity, coronary artery disease and diabetes in their adulthood.

The other diseases which are less common in breastfed babies include inflammatory bowel disease, Hodgkin’s lymphoma, necrotizing enterocolitis and sudden infant death syndrome.


Q. 27

Fatty acid characterstically present in breast milk and essential for baby growth –

 A

Linoliec acid

 B

Palmitic acid

 C

Arachidonic acid

 D

Docosahexaenoic acid

Q. 27

Fatty acid characterstically present in breast milk and essential for baby growth –

 A

Linoliec acid

 B

Palmitic acid

 C

Arachidonic acid

 D

Docosahexaenoic acid

Ans. D

Explanation:

Ans. is ‘d’ i.e., Docosahexaenoic acid 

o Up to 5-10% of fatty acids in human milk are polyunsaturated. Most of these are linoleic acid with smaller amounts of linolenic acid.

o Linoleic acid —> gives rise to Arachidonic acid

o Linolenic acid —> gives rise to Docosahexaenoic acid

o Docosahexaenoic acid is found in human milk and brain lipids and is required for the development of our nervous system and visual abilities during the first six months of life.

o Lack of sufficient Docosahexaenoic acid may be associated with impaired mental and visual functioning as well as attention deficit hyperactivity disorder.


Q. 28

The following statements about breast milk are true except-

 A

The maximum milk output is seen at 12 months

 B

The coefficient of uptake of iron in breast milk is 70%

 C

Calcium absorption of human milk is better that that of cow’s milk

 D

It provides about 65 k cals per 100 ml

Q. 28

The following statements about breast milk are true except-

 A

The maximum milk output is seen at 12 months

 B

The coefficient of uptake of iron in breast milk is 70%

 C

Calcium absorption of human milk is better that that of cow’s milk

 D

It provides about 65 k cals per 100 ml

Ans. A

Explanation:

Ans. is ‘a’ i.e., The maximum milk output is seen at 12 months 

o Under normal conditions, Indian mothers secrete 450 – 600 ml of milk daily

Maximum output of milk is at 5 – 6 months (730 ml/ day) after which the output constantly declines. At 12 months the output is 525 ml/day -Park p. 455

o Iron was supposed to be deficient in breast milk, but recent work has shown that iron contained in human milk has a high level of bioavailiability thanks to complex phenomena.

The coefficient of uptake of iron in breast milk may be as high as 70% where as it is only 30 percent for cow’s milk and infant formulas’ Park p. 463

  • The calcium phosphorus ratio is high so that uptake of calcium is better than cow’s milk’ – Park p. 374
  • Energy value of human milk is 64 to 72 kcal per 100 ml. -Park 463

Q. 29

Not true about breast milk is ?

 A

Maximum output is seen at 12 month

 B

Breast milk protein is a reference protein

 C

Calcium utilization from breast milk is more than cow’s milk

 D

Coefficient of absorption of iron is 70%

Q. 29

Not true about breast milk is ?

 A

Maximum output is seen at 12 month

 B

Breast milk protein is a reference protein

 C

Calcium utilization from breast milk is more than cow’s milk

 D

Coefficient of absorption of iron is 70%

Ans. A

Explanation:

Ans. is ‘a’ i.e., Maximum output is seen at 12 months 

o Under normal conditions, Indian mothers secrete about 400 to 600 ml of milk daily. Maximum milk output is 730 ml per day at 5-6 months after which the milk output constantly declines.

o At 12 months, milk output is around 525 ml per day.

o Iron was supposed to be deficient in breast milk but recent work has shown that iron contained in human milk has a high level of bioavailability due to action of lactoferrin, acidity of digestive track and presence of appropriate zinc and copper.

o Coefficient of absorption of iron in breast milk may be as high as 70% whereas it is only 30% for cow’s milk and infant formulas. o Calcium phosphorus ratio is high in breast milk, so that the uptake of calcium is better than cow’s milk.

o Egg protein is considered as reference protein but in the given internet site, I found that for infants, the amino acid composition of breast milk is used as reference. So, this option also seems to be right.

Had it been PGI question, we would have marked both (a) and (b) as the answers but as we have choose only one answer, I will go with (a).


Q. 30

Calcium in human milk in mg/dl –

 A

28

 B

45

 C

35

 D

55

Q. 30

Calcium in human milk in mg/dl –

 A

28

 B

45

 C

35

 D

55

Ans. C

Explanation:

Ans. is ‘c’ i.e., 35 mg/di 

Nutrient                                                           Content / 100 ml

Macronutrients

o Calories                                                    67 kcal

o Proteins                                                    1.1 g

o Fat                                                            3.5 g

o Lactose                                                    7.0 g Minerals / Mic onutrients

o Sodium                                                    0.9 mEq

o Potassium                                                1.4 mEq

o Calcium                                                   35 mg

° Phosphorus                                              15 mg

o Iron                                                       30-50 g

o Zinc                                                      120 g Vitamins

o Vitamin A                                               60 g

o Vitamin C                                             5.2 mg


Q. 31

Compared with cow’s milk, mother’s milk has more-

 A

Lactose

 B

Vitamin D

 C

Proteins

 D

Fat

Q. 31

Compared with cow’s milk, mother’s milk has more-

 A

Lactose

 B

Vitamin D

 C

Proteins

 D

Fat

Ans. A

Explanation:

Ans. is ‘a’ i.e., Lactose 


Lactose (g)

Cow’s milk

4.4

Human milk

7.4

Proteins (g)

3.2

1.1

Fat (g)

4.1

3.4

Calcium (mg)

120

28                  

Iron (mg)

0.2

1.0

Water (g)

87

 

Energy (Kcal)

67

65                  


Q. 32

Human milk with respect to cow milk has –

 A

Less fat

 B

Less protein

 C

Less carbohydrate 

 D

a and b

Q. 32

Human milk with respect to cow milk has –

 A

Less fat

 B

Less protein

 C

Less carbohydrate 

 D

a and b

Ans. D

Explanation:

Ans. is ‘a’ i.e., Less fat; `b’ Less protein

o Human milk has less fat, less protein, more carbohydrates and less calcium, in comparison to cow milk.

o Human milk has less sodium, potassium and chloride. However, these substances are in correct amount (though less) in

human milk.

Salts (meq/L)                        Cow’s milk                            Human milk

Sodium                                   25 (too much)                       6.5 (correct amount)

Chloride                                 29 (too much)                      12 (correct amount)

Potassium                              35 (too much)                      14 (correct amount)


Q. 33

What is absent in breast milk ?

 A

Vit K

 B

Vit C

 C

Lactose

 D

Vit A

Q. 33

What is absent in breast milk ?

 A

Vit K

 B

Vit C

 C

Lactose

 D

Vit A

Ans. A

Explanation:

Ans. is ‘a’ i.e., Vitamin K 

o Milks from the mother whose diet is sufficient and properly balanced will supply all the necessary nutrients except fluoride and Vitamin D.

o The iron content of human milk is low, but most normal term infants have sufficient iron stores for the first 4-6 months. Human milk iron is well absorbed. Nonetheless, by 6 months the breast-fed infant’s diet should be supplemented with iron fortified complementary foods.

o The Vitamin K content of human milk is low and may cause hemorrhagic disease of newborn.


Q. 34

Colostrum is rich in the following constituents as compared to breast milk –

 A

Minerals

 B

Proteins

 C

Fats

 D

Carbohydrates

Q. 34

Colostrum is rich in the following constituents as compared to breast milk –

 A

Minerals

 B

Proteins

 C

Fats

 D

Carbohydrates

Ans. B

Explanation:

Ans. is ‘b’ i.e., Protein 

o The composition of breastmilk varies at different stages after birth to suit the needs of the baby. o According to the postnatal period the breast milk is divided into ‑

1. Clostrum

          Is the milk secreted during the first three days after delivery.

          It is yellow and thick.

          It contains more antibodies and cells and high amounts of vitamins A, D, E, K, & “Protein”.

2. Transitional milk

          Is secreted during the following two weeks (after clostrum).

          The immunoglobulin and protein content decreases while the fat and sugar content increases.

3. Mature milk

          Follows transitional milk.

      It is thin and watery but contains all the nutrients essential for optimal growth of the body. o According to feed the breast milk is divided into –

4. Fore milk

       It is watery and is rich in protein, sugar, vitamins, minerals and water that satisfy the baby’s thirst. 2. Hind milk

       Comes towards the end of feed

       Rich in fat content and provides more energy, and satisfies the baby’s hunger.

o The milk of mother who delivers prematurely differs from the milk of a mother who delivers at term – Preterm milk

Contains more protein S, sodium, iron, immunoglobins and calories as they are needed by the preterm baby.


Q. 35

Colostrums has in compared to normal milk ‑

 A

Decreased K

 B

Decreased Na

 C

Increased proteins

 D

Increased calories

Q. 35

Colostrums has in compared to normal milk ‑

 A

Decreased K

 B

Decreased Na

 C

Increased proteins

 D

Increased calories

Ans. C

Explanation:

Ans. is ‘c’ i.e., Increased proteins 


Q. 36

According to WHO, exclusive breast milk is given upto –

 A

6 months

 B

4 months

 C

8 months

 D

10 months

Q. 36

According to WHO, exclusive breast milk is given upto –

 A

6 months

 B

4 months

 C

8 months

 D

10 months

Ans. A

Explanation:

Ans. is ‘a’ i.e., 6 months 

Exclusive breast feeding :The baby should be given only breast milk and nothing else (not even water) for first 6 months of life. Weaning should be started by 6 months of age with semisolid food, in addition to continuing breast feeding.

o The WHO recommends exclusive breast feeding for the first six months of life and then breast feeding up to two years or more.                                                                   

Internet Complementary feeding means giving the child other nutritious foods in addition to breast milk. Breast feeding

is sufficient food for first 6 months. Thereafter, concentrated energy dense complementary foods are essential in order to maintain an adequate velocity of growth for the infant.


Q. 37

The milk of which of the following contains the least amount of calcium ?

 A

Human

 B

Cow

 C

Buffalo

 D

Goat

Q. 37

The milk of which of the following contains the least amount of calcium ?

 A

Human

 B

Cow

 C

Buffalo

 D

Goat

Ans. A

Explanation:

Ans. is ‘a’ i.e., Human 

Nutritive value of milks compared (value per 100 grams)

 

 

Buffalo

Cow

Goat

Human

Fat

(g)

6.5

4.1

4.5

3.4

Protein

(g)

4.3

3.2

3.3

1.1

Lactose

(g)

5.1

4.4

4.6

7.4

Calcium

(mg)

210

120

170

28

Iron

(mg)

02

0.2

0.3

 

Vitamin C

(mg)

1

2

1

3

Minerals

(g)

0.8

0.8

0.8

0.1

Water

(g)

81.0

87

86.8

88

Energy

(kcal)

117

67

72

65


Q. 38

Which one is wrong about human milk‑

 A

Gives energy of 67 K cal/1

 B

Carbohydrate forms 40% of total energy

 C

Fats forms > 50% of total energy

 D

All

Q. 38

Which one is wrong about human milk‑

 A

Gives energy of 67 K cal/1

 B

Carbohydrate forms 40% of total energy

 C

Fats forms > 50% of total energy

 D

All

Ans. A

Explanation:

Ans. is ‘a’ i.e., Gives energy of 67 K cal/1 

o Human milk gives 67 kcal per 100 ml (not per litre).

o Protein forms 8-10% of total energy.

o Carbohydrate forms 3 8-40% of total energy.

o Fat forms 50-52% of total energy.


Q. 39

Cow’s milk contains what % proteins – 

 A

1.1

 B

3.2

 C

3.5

 D

4.1

Q. 39

Cow’s milk contains what % proteins – 

 A

1.1

 B

3.2

 C

3.5

 D

4.1

Ans. B

Explanation:

Ans. is ‘b’ i.e., 3.2 


Q. 40

Which one of the following nutrient is more in the human milk as compared to cow’s milk –

 A

Protein 

 B

Calcium 

 C

Cabohydrate 

 D

Fat

Q. 40

Which one of the following nutrient is more in the human milk as compared to cow’s milk –

 A

Protein 

 B

Calcium 

 C

Cabohydrate 

 D

Fat

Ans. C

Explanation:

Ans. is ‘c’ i.e., Carbohydrate 


Q. 41

Among the following milk sources, which one is the correct sequence with decreasing fat content ‑

 A

Buffalo, Cow, Goat, Human

 B

Buffalo, Goat, Cow, Human

 C

Buffalo, Human, Cow, Goat

 D

Buffalo, Goat, Human, Cow

Q. 41

Among the following milk sources, which one is the correct sequence with decreasing fat content ‑

 A

Buffalo, Cow, Goat, Human

 B

Buffalo, Goat, Cow, Human

 C

Buffalo, Human, Cow, Goat

 D

Buffalo, Goat, Human, Cow

Ans. B

Explanation:

Ans. is ‘b’ i.e., Buffalo, Goat, Cow, Human 

o Fat content of milk: Buffalo > Goat > Cow > Human

o Protein content of milk: Buffalo > Goat > Cow > Human

o Lactose content of milk: Human > Buffalo > Goat > Cow

o Energy content of milk: Buffalo > Goat > Cow > Human


Q. 42

Milk is a poor source of which of the following ?

 A

Essential fatty acids 

 B

Iron

 C

Vitamin C

 D

Vitamin A

Q. 42

Milk is a poor source of which of the following ?

 A

Essential fatty acids 

 B

Iron

 C

Vitamin C

 D

Vitamin A

Ans. C

Explanation:

Ans. is ‘c’ i.e., Vitamin C 


Q. 43

In which one of the following is the calcium content of milk lowest –

 A

Human milk

 B

Goat milk

 C

Cow milk

 D

Buffalo milk

Q. 43

In which one of the following is the calcium content of milk lowest –

 A

Human milk

 B

Goat milk

 C

Cow milk

 D

Buffalo milk

Ans. A

Explanation:

Ans. is ‘a’ i.e., Human milk 

o Human milk has low calcium content, but availability of calcium is high.


Q. 44

Which immunoglobulin is present in the breast milk:

September 2005

 A

Ig A

 B

Ig E

 C

Ig D

 D

Ig M

Q. 44

Which immunoglobulin is present in the breast milk:

September 2005

 A

Ig A

 B

Ig E

 C

Ig D

 D

Ig M

Ans. A

Explanation:

Ans. A: Ig A

Secretory IgA is the principal immunoglobulin of breast milk/colostrum.

It is synthesized in the mammary epithelial cell by the coupling of two IgA molecules, produced locally by lymphocytes resident in the breast tissue, with two proteins, J-chain and secretory component. The specificity of breast milk secretory IgA antibodies reflects the mother’s exposure to mucosal infection and is independent of the specificity profile of blood-borne IgA.


Q. 45

True regarding comparison values of cow and human milk are all except:

March 2012

 A

Human milk has comparatively less of protein

 B

Human milk has comparatively less of calcium

 C

Human milk has comparatively less of minerals

 D

Human milk has comparatively less of lactose

Q. 45

True regarding comparison values of cow and human milk are all except:

March 2012

 A

Human milk has comparatively less of protein

 B

Human milk has comparatively less of calcium

 C

Human milk has comparatively less of minerals

 D

Human milk has comparatively less of lactose

Ans. D

Explanation:

Ans: D i.e. Human milk has comparatively less of lactose

Comparison of human and cow link

  • Protein in human milk is 1.1 g, whereas in cow milk it is 3.2
  • Calcium in human milk is 28 mg, whereas in cow milk it is 120 mg
  • Minerals in human milk is 0.1 g, whereas in cow milk it is 0.8 g
  • Lactose in human milk is 7.4 g, whereas in cow milk it is 4.4 g

Q. 46

Differences between human milk and cow milk are all of the following except:

September 2005

 A

Cow milk has comparatively more fat

 B

Cow milk has comparatively more protein

 C

Cow milk has comparatively more calcium

 D

Cow milk is iron deficient

Q. 46

Differences between human milk and cow milk are all of the following except:

September 2005

 A

Cow milk has comparatively more fat

 B

Cow milk has comparatively more protein

 C

Cow milk has comparatively more calcium

 D

Cow milk is iron deficient

Ans. D

Explanation:

Ans. D: Cow milk is iron deficient

Cow milk has comparatively more energy, fat, protein, minerals, iron and calcium Human milk has comparatively more of lactose and vitamin C but is deficient of iron.



Q. 47

Number of calories in 100 grams of breast milk is:

September 2007

 A

45 Kcal

 B

65 Kcal

 C

85 Kcal

 D

105 Kcal

Q. 47

Number of calories in 100 grams of breast milk is:

September 2007

 A

45 Kcal

 B

65 Kcal

 C

85 Kcal

 D

105 Kcal

Ans. B

Explanation:

Ans. B: 65 Kcal

Each 100 grams of breast milk yields approximately:

  • 65 Kilocalories
  • 88 g water
  • 7.4 g carbohydrates (primarily lactose)
  • 3.4 g fat
  • 1.1 g protein

Q. 48

Amount of proteins in human milk (in gms):

September 2007

 A

1.1

 B

2.2

 C

3.3

 D

4.4

Q. 48

Amount of proteins in human milk (in gms):

September 2007

 A

1.1

 B

2.2

 C

3.3

 D

4.4

Ans. A

Explanation:

Ans. A: 1.1

Each 100 grams of breast milk yields approximately:

  • 65 Kilocalories
  • 88 g water
  • 7.4 g carbohydrates (primarily lactose)
  • 3.4 g fat
  • 1.1 g protein

Q. 49

Vitamin not present in breast milk:

March 2009, March 2013 (e)

 A

Vitamin A

 B

Vitamin B

 C

Vitamin C

 D

Vitamin D

Q. 49

Vitamin not present in breast milk:

March 2009, March 2013 (e)

 A

Vitamin A

 B

Vitamin B

 C

Vitamin C

 D

Vitamin D

Ans. B

Explanation:

Ans. B: Vitamin B

Park’s PSM, 21st ed., p-570 states “Human milk has recently been shown to contain considerable amounts of water soluble vitamin D sulfate”

p-581 states “The fat content of milk varies from 3.4% in human milk to 8.8 % in buffalo milk. Milk fat is a good source of retinol and vitamin D”

p-582 (table 21) shows “Vitamin C content in human milk is 3 mg”

The essential vitamins present in breast milk are:

  • Vitamin A: This is high in colostrum, then the amount lessens in mature milk
  • Vitamin D: Breast milk has very little.
  • The earlier teaching was that human milk was deficient in vitamin D is no longer accepted. It is present in human milk in water soluble form.
  • Vitamin E: This is high in colostrum; it is a significant vitamin to prevent hemolytic anemia and muscle integrity, and it is also important as an antioxidant. The amount lessens in mature milk.
  • Vitamin C is also present in the human milk (3 mg/100 gram of milk)

Q. 50

Human milk as compared to cow’s milk is:

March 2011,March 2013 (b)

 A

Rich in lactose

 B

Rich in Vitamin D

 C

Rich in minerals

 D

Rich in proteins

Q. 50

Human milk as compared to cow’s milk is:

March 2011,March 2013 (b)

 A

Rich in lactose

 B

Rich in Vitamin D

 C

Rich in minerals

 D

Rich in proteins

Ans. A

Explanation:

Ans. A: Rich in lactose

Lactose content of human milk is 7.4g/100 gm whereas that of cows milk is 4.4 g/100 grams

Human milk

  • The initial milk produced is often referred to as colostrum, which is high in the immunoglobulin IgA, which coats the gastrointestinal tract.
  • This helps to protect the newborn until its own immune system is functioning properly, and creates a mild laxative effect, expelling meconium and helping to prevent the build up of bilirubin (a contributory factor in jaundice).
  • During the first few days after delivery, the breasts produce colostrum.
  • This is a thin yellowish fluid that is the same fluid that leaks from the breasts during pregnancy.
  • It is rich in protein and antibodies that provide passive immunity to the baby (the baby’s immune system is not fully developed at birth).
  • Colostrum also helps the newborn’s digestive system to grow and function properly.
  • After 3 to 4 days, breasts will begin producing milk that is thin, watery, and sweet.
  • This quenches the baby’s thirst and provides the proteins, sugar, and minerals that the baby needs.
  • Foremilk, the milk released at the beginning of a feed, is watery, low in fat, and high in carbohydrates relative to the creamier hindmilk, which is released as the feed progresses.
  • The breast can never be truly “emptied,” since milk production is a continuous biological process.
  • The level of Immunoglobilin A (IgA) in breast milk remains high from day 10 until at least 7.5 months post-partum.
  • Human milk contains 1.1% protein, 3.4% fat, 7.4% carbohydrates, and 0.1% ash (minerals).
  • Carbohydrates are mainly lactose.
  • The fat fraction contains specific triglycerides of palmitic and oleic acid (0-P-0 triglycerides), and also quite a large quantity of lipids with trans bonds.
  • They are vaccenic acid, and Conjugated linoleic acid (CLA) accounting for up to 6% of the human milk fat.
  • The principal proteins are casein (homologous to bovine beta-casein), alpha-lactalbumin, lactoferrin, IgA, lysozyme, and serum albumin.
  • In an acidic environment such as the stomach, alpha-lactalbumin unfolds into a different form and binds oleic acid to form a complex called HAMLET.
  • Non-protein nitrogen-containing compounds, making up 25% of the milk’s nitrogen, include urea, uric acid, creatine, creatinine, amino acids, and nucleotides.
  • It is now universally recognized that there is no commercial formula that can equal breast milk.
  • In addition to the appropriate amounts of carbohydrate, protein, and fat, breast milk provides vitamins, minerals, digestive enzymes, and hormones – all of the things that a growing infant will require.
  • Breast milk also contains antibodies and lymphocytes from the mother that help the baby resist infections.
  • The immune function of breast milk is individualized, as the mother, through her touching and taking care of the baby, comes into contact with pathogens that colonize the baby, and, as a consequence, her body makes the appropriate antibodies and immune cells.
  • This is the reason why breast milk contains very little iron, as iron is an essential precursor to the activation of micro bacteria and gut flora; providing iron in the milk would lead to infection.
  • However, the internal iron supplies of the infant, held in the hepatic cells of the liver, are exhausted at 4-6 months,
    hence this is the time that complimentary feeding is introduced, as to prevent anemia (recommended by WHO).
  • Whole cow’s milk
  • It does not contain sufficient vitamin E, iron, or essential fatty acids, which can make infants fed on cow’s milk anemic.
  • Whole cow’s milk also contains excessive amounts of protein (3.2 g/ 100 gram), sodium, and potassium, which may put a strain on an infant’s immature kidneys.
  • In addition, the proteins and fats in whole cow’s milk are more difficult for an infant to digest and absorb than the ones in breast milk.
  • A significant minority of infants are allergic to one or more of the constituents of cow’s milk, most often the cow’s milk proteins.
  • These problems can also affect infant formulas derived from cow’s milk.

Q. 51

Expresses breast milk can be stored in refrigerator, for how many hours: 

September 2011

 A

12 hours

 B

24 hours

 C

36 hours

 D

48 hours

Q. 51

Expresses breast milk can be stored in refrigerator, for how many hours: 

September 2011

 A

12 hours

 B

24 hours

 C

36 hours

 D

48 hours

Ans. B

Explanation:

Ans. B: 24 hours

Expressed breast milk can be stored at room temperature for 6-8 hours, in a refrigerator for 24 hours and a freezer at -20 degree C for 3 months


Q. 52

Breast fed baby is protected from some GI infection due to presence of what in mothers milk:

March 2013

 A

IgA

 B

Vitamin D

 C

Long chain omega-3 fatty acids

 D

IgE

Q. 52

Breast fed baby is protected from some GI infection due to presence of what in mothers milk:

March 2013

 A

IgA

 B

Vitamin D

 C

Long chain omega-3 fatty acids

 D

IgE

Ans. A

Explanation:

Ans. A i.e. IgA


Q. 53

Donor Breast milk is known to transmit all EXCEPT:

September 2012

 A

Tuberculosis

 B

CMV

 C

HIV

 D

Rubella

Q. 53

Donor Breast milk is known to transmit all EXCEPT:

September 2012

 A

Tuberculosis

 B

CMV

 C

HIV

 D

Rubella

Ans. D

Explanation:

Ans. D i.e. Rubella


Q. 54

Which antiepileptic drug is least secreted in breast milk ‑

 A

Ethosuximide

 B

Clonazepam

 C

Gabapentin

 D

Carbamazepine

Q. 54

Which antiepileptic drug is least secreted in breast milk ‑

 A

Ethosuximide

 B

Clonazepam

 C

Gabapentin

 D

Carbamazepine

Ans. B

Explanation:

Ans. is ‘b’ i.e., Clonazepam


Q. 55

Protein content in F-75 milk formula ‑

 A

0.5 gm per 100 ml

 B

0.9 gm per 100 ml

 C

1.5 gm per 100 ml

 D

2.0 gm per 100 ml

Q. 55

Protein content in F-75 milk formula ‑

 A

0.5 gm per 100 ml

 B

0.9 gm per 100 ml

 C

1.5 gm per 100 ml

 D

2.0 gm per 100 ml

Ans. B

Explanation:

Ans. is ‘b’ i.e., 0.9 gm per 100 ml


Q. 56

Breast milk is deficient in which vitamin

 A

Vitamin A

 B

Vitamin B1

 C

Vitamin K

 D

Vitamin C

Q. 56

Breast milk is deficient in which vitamin

 A

Vitamin A

 B

Vitamin B1

 C

Vitamin K

 D

Vitamin C

Ans. C

Explanation:

Ans. is ‘c’ i.e., Vitamin K

  • Exclusive breasfed infants may have following deficiencies –
  1. Vit B12 (if mother is strict vegetarian)
  2. Fluoride
  3. Vit D
  4. Vit K

“Breastfed infants are protected as the breastmilk contains adequate amounts of vitamin C, except when the mother is deficient in Vitamin C”.


Q. 57

Average daily breast milk output during first 6 months ‑

 A

100-200 ml

 B

200-300 ml

 C

300-400 ml

 D

500-600 ml

Q. 57

Average daily breast milk output during first 6 months ‑

 A

100-200 ml

 B

200-300 ml

 C

300-400 ml

 D

500-600 ml

Ans. D

Explanation:

Ans. is ‘d’ i.e., 500-600 ml

Under normal conditions, Indian mothers secrete 450 – 600 ml of milk daily

Maximum output of milk is at 5 – 6 months (730 ml/ day) after which the output constantly declines.

At 12 months the output is 525 ml/day -Park p. 455


Q. 58

Protein content in F-75 milk formula ‑

 A

0.5 gm per 100 ml

 B

0-9 gm per 100 ml

 C

1-5 gm per 100 ml

 D

2.0 gm per 100 ml

Q. 58

Protein content in F-75 milk formula ‑

 A

0.5 gm per 100 ml

 B

0-9 gm per 100 ml

 C

1-5 gm per 100 ml

 D

2.0 gm per 100 ml

Ans. B

Explanation:

Ans. is `b’ i.e., 0.9 gm per 100 ml


Q. 59

Protein content in 100 grams of cow milk

 A

4.3

 B

3.2

 C

2.2

 D

1.2

Q. 59

Protein content in 100 grams of cow milk

 A

4.3

 B

3.2

 C

2.2

 D

1.2

Ans. B

Explanation:

Ans. is ‘b’ i.e., 3.2 



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