HUN 3403 Study guide for Exam 2 Fall 2012 This is a guide to help you to prepare for the exam All topics listed here will be tested in this exam however your notes lecture slides and textbooks are also necessary for exam preparation Prolactin The hormone involved in breastfeeding the function of each a hormone that stimulates milk production The actual level of the hormone in the blood is not related to the amount of milk made but it is necessary for milk synthesis to occur Milk production begins in small amounts 20 weeks after becoming pregnant Stimulation suckling prolactin levels double with suckling stress sleep sexual intercourse Inhibition prolactin inhibiting factor that is released by the hypothalamus Prevents milk production in the last 3 months of pregnancy Inhibition allows mother s body to prepare for milk during pregnancy its main role is letdown or the ejection of milk from the milk gland acinus into the Oxytocin milk ducts and lactiferous sinuses Stimulation suckling nipple stimulation Women may experience tingling or sometimes sharp shooting pain that lasts about a minute and corresponds with contractions in the milk ducts It also acts on the uterus causing it to contract seal blood vessels and shrink its size Maternal benefit of breastfeeding Immediately increases levels of oxytocin a hormone that stimulates uterine contractions minimizes maternal postpartum blood loss and helps the uterus to return to nonpregnant size After the birth the return of fertility through monthly ovulations monthly period is delayed in most women during breastfeeding This delay results in longer intervals between pregnancies Breastfeeding alone is not as effective as other birth control methods Increased self confidence and facilitated bonding with their infants Faster return to prepregnancy weight However women lose and gain weight while nursing Women who nurse at a younger age and for longer duration have lower risk of breast and ovarian cancer and rheumatoid arthritis Common barriers of breastfeeding Embarrassment Time and social constraints Lack of support from family and friends Lack of confidence Concerns about diet and health mom Fear of pain Definitions infant mortality SGA LGA infant toddler preadolescence NSLP adiposity rebound death that occurs within the first year of life small for gestational age newborn weight is 10th percentile for gestational age also Infant mortality SGA called small for date SFD LGA gestational age also defined as birthweight greater than 4500 g 10 lb and referred to as excessively sized for gestational age or macrosomic Infant large for gestational age weight for gestational age exceeds the 90th percentile for a baby up to 1 year NSLP the stage of development immediately preceding adolescence 9 11 years of The National School Lunch Program NSLP is a federally assisted meal program born 37 42 weeks somewhere between 3 4 months born before 37 weeks Full term Preterm Toddler children between the ages of 1 and 3 years Preadolescence age for girls and 10 12 years of age for boys operating in public and nonprofit private schools and residential child care institutions It provides nutritionally balanced low cost or free lunches to children each school day The program was established under the National School Lunch Act signed by President Harry Truman in 1946 Adiposity rebound BMI declines and reaches its lowest point at 4 6 years of age aka BMI rebound a normal increase in body mass index that occurs after Common gastrointestinal problems for infants At birth infants can digest fats proteins and simple sugars With time coordination of peristalsis continues to improve Colic a condition marked by a sudden onset of irritability fussiness or crying in a young infant between 2 weeks and 3 months of age who is otherwise growing and healthy Babies who are not breastfed are twice as likely to have it GER gastroesophageal reflux a type of heartburn for infants Unexplained diarrhea and constipation Could be change of formula some formulas have different key ingredients Know how to calculate gestation adjusted age for pre term infants Instructions Document the infant s gestational age in weeks how many weeks it took for the baby to be born Subtract the child s gestational age in weeks from 40 weeks gestational age of a full term infant to determine the adjustment for prematurity in weeks This is the number of weeks left in the pregnancy Subtract the adjustment for prematurity in weeks from the child s chronological postnatal age in weeks to determine the child s gestation adjusted age Example Randy was born prematurely on March 19 2001 His gestational age at birth was determined to be 30 weeks based on ultrasonographic examination At the time of the June 11 2001 clinic visit his chronological postnatal age is 12 weeks What is his gestation adjusted age 30 gestational age in weeks 40 30 10 weeks adjustment for prematurity Can also convert into months just divide of weeks by 4 weeks 10 weeks 2 5 months preterm 12 10 2 weeks gestation adjusted age Example Ella was born at 28 weeks 40 28 12 weeks early 3 months At 5 months her gestation adjusted age is 8 weeks or 2 months 5 3 2 months Can convert months to weeks 5 months 20 weeks 20 current age 12 weeks early 8 weeks ges adj age Development of motor controls for infants These reflect an infant s ability to control voluntary muscle movement Top down This is the way that muscle development is controlled It starts with the head and the lower legs come last Central to peripheral This is another form of muscle control It simply means that the muscles towards the core of the body are more advanced than the outer ones For example the infant learns to control the shoulder and arm muscles before muscles in the hands It influences the ability of an infant to feed and the amount of calories expended in the activity An example would be sitting in a high chair If baby cannot balance or keep his her head straight he she cannot eat using a spoon With increased motor skills comes higher needs in calories because an increase in activity requires more energy The following picture depicts motor development during the first 15 months boys usually develop a little later than girls What are unsafe food for infants toddler Infants Breastfeeding is constraindicated withheld from the diet breast milk contains harmful medications street drugs viruses or other infective agents or when the infant has a specific type of gastrointestinal tract