Lactation

Prolactin

Ans is a, b and c Prolactin; HPL; and Progesterone

Lactation can be divided into 3 stages :

Stage I : Mammogenesis – Mammary growth and development

Hormones responsible :

Growth                        Main hormone                                          Supporting hormones

Ductal growth             Oestrogen                                        Growth hormone and glucocorticoids

Alveolar growth          Progesterone                                   Prolactin, prednisolone and other

(in the oestrogen primed breast)                                       growth promoting factors

Stage ii :                 Lactogenesis : Initiation of milk secretion

Main hormone responsible : Prolactin

Although prolactin levels continue to rise as pregnancy advances, placental sex steroids block prolactin induced secretory activity of-the glandular epithelium. Therefore, lactation is not initiated until plasma estrogens progesterone, and human placental lactogen (hPL) level fall after delivery.”

Supporting hormones : • Estrogens

• Progestins
• Human placental Lactogen

Stage

Galactopoiesis or Maintenance of established milk secretion is mainly by suckling°. Hormones responsible :

• Prolactin°                                   • Oxytocin°
• Growth hormone°                       • Thyroxine/Parathyroid hormone°
• Cortisol°                                     • Insulin°

Suckling

Ejection of milk

Maternal plasma levels of prolactin increase markedly during normal pregnancy and concentrations are usually 10-fold greater at term—about 150 ng/mL—compared with nonpregnant women. Paradoxically, plasma concentrations decrease after delivery even in women who are breast feeding.

During early lactation, there are pulsatile bursts of prolactin secretion in response to suckling. 

Ans. is a i.e. IgA

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

Therefore, IgA is the option of choice.

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.

Ans. is ‘a’ 25 gm 

Ans. is ‘c’ i.e., 600 mg

Ans. B: 150 microgram/day

The dietary intake values of folate as recommended by ICMR are:

• Healthy adults: 100mcg per day
• In pregnancy: 400mcg per day
• During lactation: 150mcg per day
• Children: 100 mcg per day

Ans. is ‘a’ i.e., Iron

• Required more during lactation as compared to pregnancy : Energy, Vitamin A, thiamin, riboflavin, Vitamin C, niacin, and Vitamin B12.
• Required more during pregnancy : Iron, protein, and folate.
• Same requirment in pregnancy and lactation : Fat, calcium, zinc, magnesium, and vitamin B6.