What are the differences among colostrum, transitional breast milk, and mature breast milk?

a thick, yellowish &fluid—colostrum—is secreted as early as 16 weeks of gestation (Records & Tanaka,
2016

102 PART II The Family Before Birth

Colostrum is higher in protein and some vitamins and minerals than mature milk (Pletsch, Ulrich,
Angelini, Fernandes, & Lee, 2013)

CHAPTER 22 Infant Feeding 607

Transitional milk appears between colostrum and mature milk. Mature milk continues to provide
immunoglobulins and antibacterial component

630 PART IV The Family Following Birth

Colostrum is rich in protein, vitamins, minerals, and immunoglobulins. Transitional milk has less protein
and immunoglobulins but more lactose, fat, and calories than colostrum. Mature milk appears less rich
than colostrum and transitional milk, but it supplies all nutrients needed

802 APPENDIX A Answers to Knowledge Check

. Mature milk replaces transitional milk during lactogenesis III. Lawrence & Lawrence, 2016).

CHAPTER 22 Infant Feeding 607

. How does breast milk compare with commercial formulas?

Breast milk is species specific (made for human infants) and is the reference point on which to compare
necessary infant nutrition. The nutrients in breast milk are proportioned appropriately for the neonate
and vary to meet the newborn’s changeling needs. Breast milk provides protection against infection and
is easily digested. Maternal immunoglobulins, leukocytes, antioxidants, enzymes, and hormones
important for growth are present in breast milk but are not available in formula. (Pletsch, Ulrich,
Angelini, Fernandes, & Lee, 2013)

CHAPTER 22 Infant Feeding 607

Continuation

Formulas Commercial formulas are produced to replace or supplement breast milk. They are sometimes
called “breast milk substitutes” or “artificial breast milk” because manufacturers must adapt them to
correspond to the components in breast milk as much as possible. However, an exact match is impossible
and although formula provides adequate nutrition, it cannot provide the important immunologic
components of breastmilk. A variety of formulas, which differ in price and ingredients, are available

608 PART IV The Family Following Birth

(AAP & ACOG, 2012).

3. What factors that help prevent infection are present in breast milk?

Other factors present in human milk help prevent infection in the newborn. Bifidus factor promotes the
growth of Lactobacillus bifidus, an important part of the intestinal flora that helps produce an acidic
environment in the GI tract. Thiis protects the infant against infection from common intestinal
pathogens. Leukocytes present in breast milk also help protect against infection. Macrophages are the
most abundant and secrete lysozyme and lactoferrin. Lysozyme is a bacteriolytic enzyme that acts
against gram-positive and enteric bacteria. (Riordan, 2016).

Breast milk contains factors that help establish the normal intestinal flora and prevent infection. !ese
includes bifidus factor, leukocytes, lysozymes, lactoferrin, and immunoglobulins.

608 PART IV The Family Following Birth

4. What are the factors that influence a woman's choice of feeding method?

Many factors influence a woman’s choice of feeding method. These factors must be considered when
educating women about their choices, because breastfeeding education is an important health
promotion activity and not just a lifestyle choice.

Support from Others , family members and friends may share in the decision-making process. Women
with a support system are more likely to begin breastfeeding and continue longer than those without a
perceived support system. (Haroon, Das, Salam, Imdad, & Bhutta, 2013)

culture - Cultural influences may dictate decisions about how a mother feeds her infant. Women who are
most likely to breastfeed are Asian, Pacific Islander, or Hispanic. Those with the lowest breastfeeding
rates include women who are non-Hispanic black (Callister, 2014; CDC, 2016b).

, employment - the need to return to roles outside the home soon after giving birth may cause concern
about feeding methods

Staff Knowledge- It is important that all birth facility staff members have Education about how to help
women breastfeed and not provide inaccurate or conflicting information to new mothers. (Siggia &
Rosenburg, 2014).

Other Factors- Other factors also may influence a woman’s decision. Her knowledge and past experience
with infant feeding are important. Modesty may be an issue for some women who are concerned about
breastfeeding in public situations. ) (Whipps, 2017).

610 – 611 PART IV The Family Following Birt

5. What is the effect of suckling on the let-down reflex and milk production?

Suckling causes the posterior pituitary to secrete oxytocin, producing the let-down reflex, which releases
milk from the breast. Oxytocin also causes the uterus to contract, which aids in involution.

612 PART IV The Family Following Birth

6. What preparation of the breasts is needed during pregnancy

Preparation of Breasts for Breastfeeding

Little preparation is needed during pregnancy for breastfeeding. The mother should avoid applying soap
on her nipples because it removes the natural protective oils secreted by the Montgomery tubercles of
the breasts. The use of creams and nipple rolling, pulling, and rubbing to “toughen” nipples does not
decrease nipple pain after birth and may cause irritation or uterine contractions from release of
oxytocin. (Wambach & Genna, 2016)

612 -613 PART IV The Family Following Birth

7. What should the nurse teach the mother about frequency and length of feedings?

Frequency of Feedings. Breastfeeding is most successful when babies are not subjected to scheduled
feedings, but are instead allowed to feed as frequently and for as long as they show feeding cues. Most
babies need to feed 8 to 12 times per day, but these feedings may not be evenly spaced. Frequent
feedings are especially important in the early days after birth, while lactation is being established and
the infant’s stomach capacity is small. Explaining that the hormone prolactin, which is responsible for
milk production, is released in increased amounts while the infant is suckling helps the mother
understand the relationship between frequent feeding and milk supply. Long periods between feedings
increase the likelihood of breast engorgement. [ABM], 2009).

Length of Feedings. Early feedings were once limited to only a few minutes per breast to prevent sore
nipples; however, improper positioning, rather than time at breast, is the usual cause of nipple trauma.
When feedings are too short, infants receive little or no colostrum or milk. It may take as long as 5
minutes for the milk-ejection (let-down) reflex to occur during the early days after birth. (Hoover, 2016)

CHAPTER 22 Infant Feeding 617

8. How does sucking from a bottle differ from suckling from the breast?

Suckling at the breast causes release of oxytocin, which triggers the let-down reflex. It also causes the
release of prolactin, which increases milk production. 630 PART IV The Family Following Birth

Sucking from a bottle requires pushing the tongue against the nipple to slow the flow of milk. Suckling
from the breast requires drawing the nipple far into the mouth so that the gums compress the areola.