Lactation College-isms

April 30, 2021

Hi everyone.

Our first semester is drawing to a close. This experiment has proven to be a big success. This semester of the Lactation College ran for four months, January 1 - April 30, 2021. Over those 4 months we posted on 61 topics. The Lactation College has 1,730 subscribers and, by the month of April, 2500 views per post.

I plan to take a one-month break and use that time to figure out what is next. I really hope The College will be back June 1st, 2021 for another semester, even bigger and better - to help the candidates testing in September. I will keep the archive of all the college posts up for a while. I thank our two generous donors (who both wish to remain anonymous). As with many things, this is about funding!

It is my sincere hope that this has been helpful. From your emails I think it has been! New moms need your help with breastfeeding - especially now, as we are in such an isolating time. And we need to make this IBCLC credentialing process less expensive!

No messing around! Pass this test so you can help them.

I have collected a few of the pearls along the way - mnemonics and other fun ways to remember facts. Of what is posted below - about 80% are Lactation College-isms and the other 20% are tips from the internet.

This has been fun.

I send you all the best of luck on the exam.

You got this.

Bobbi Philipp, Boston MA, USA

babydoctor53@gmail.com

That’s me on the right and my colleague, Sig, on the left.

Lactation College-isms

Important Definitions

  • Species specific: the milk of each mammal species is perfectly designed to supply its offspring with what is needed for optimal growth and survival

  • Exclusive breastfeeding is defined as no other food or drink, not even water, except breast milk (including milk expressed or from a wet nurse) for 6 months of life, but allows the infant to receive oral rehydration solution (ORS), drops and syrups (vitamins, minerals and medicines). World Health Organization

  • For how long? The World Health Organization recommends that infants start breastfeeding within one hour of life, are exclusively breastfed for six months, with timely introduction of adequate, safe and properly fed complementary foods while continuing breastfeeding for up to two years of age or beyond.

Mnemonics

What’s in colostrum? LLLAMAS Pee Green

  • Living cells

  • Lactoferrin

  • Laxative

  • A – secretory IgA

  • Microbiome

  • A – Vitamin A

  • Sugars (HMOs)

  • Protein - lots of whey (90:10 whey to casein ratio)

  • Growth factors

Colostrum is a salty, protein milkshake. (For this to work, you need to know that salt is composed of sodium and chloride.)

Colostrum, compared to mature milk, has

  • Higher concentrations of protein, sodium, chloride, vitamins A and E

  • Lower concentrations of lactose and fat

What do HMOs do? P-I-D-E-N (kind of like BIDEN)

  • P-I-D-E-N    prebiotic, long term immune health, decoy receptor, Einstein (brain), NEC protect

Vitamins

  • Fat soluble: ADEK

  • Water soluble: 8 B’s and 1 C

Innocenti Declaration — 10LCCs are better than 1

  • 10 Steps

  • Legislation

  • Code

  • National Committee and Coordinator

The main immunoglobulin in human milk —> Sing it! For secretory IgA

MALT = GALT + BALT

  • Mucosal associated lymphoid tissue = gastric + bronchus associated lymphoid tissue

HAMLET = Human Alpha-lactalbumin Made LEthal to Tumors.

  • HAMLET is found in whey, the protein component of human milk, and it kills cancer cells

Research

  • Qualitative research – l- lovely – words

  • Quantitative research – quant - amount

INDE MAN – independent variable is the one that is manipulated

MISfeasance - mistake

MALfeasance – illegal (mal – bad)

Definitions

  • Autonomy – the capacity of a rational individual to make an informed, un-coerced decision

  • Beneficence – the duty to do good

Where is prolactin secreted from?

  • PAP smear

  • Prolactin Anterior Pituitary

Where is oxytocin secreted from?

  • OPP – opposite of PAP

  • Oxytocin Posterior Pituitary

Stroma - supports breast structures /// Parenchyma - functional parts

How to remember the 12 cranial nerves (from the internet)

  • On ole Olympus towering top, a Finn and German viewed a hop.

How to remember the functions of each cranial nerve - Sensory, Motor or Both (from the internet)

  • Some Say Marry Money – But My Brother Says Big Boobs Matter Most

  • 5: Trigeminal – tri means 3, it has 3 branches – sensory of jaw, muscles of mastication (chewing)

  • 7: Facial – Muscles of facial expression, taste anterior 2/3rds of tongue

  • 9: Glossopharyngeal – G gag, taste posterior 1/3 of tongue

  • 10: Vagus - 5 organs and 5 letters in vagus – larynx, pharynx, gallbladder, lungs, heart, gag

  • 11: Accessory - motor movement of neck muscles - you wear accessories on your neck

  • 12: Hypoglossal - motor movement of tongue muscles, glossal means tongue

Classification according to gestational age:

  • Preterm: <37 weeks

  • Late preterm: 34.0 – 36.6 weeks

  • Full term: 37-42 weeks

  • Post term: >42 weeks

Classification according to weight:

  • Average birth weight: 2500-4200 grams

  • Low birth weight (LBW): <2500 grams

  • Very low birth weight (VLBW): <1500 grams

  • Extremely low birth weight (ELBW): <1000 grams

Weight, plotted on the growth curve:

  • Appropriate for gestational age (AGA): 10%-90%

  • Small for gestational age (SGA): <10%

    • At risk for hypothermia, hypoglycemia, feeding difficulties

  • ·   Large for gestational age (LGA): >90%

    • At risk for hypoglycemia

Gross Motor Milestones

  • 4-6-9-12 months

  • Roll – sit- crawl - walk

NUMBERS

Milk line ridges:         4-5 weeks

Colostrum begins:       16 weeks

Calories in human milk: Mature milk has about 20 calories per 30 cc

Milk production

  • DOL                Per feed                       Per 24 hours

  • Day 1              7-14 mL per feed        37 mL

  • Day 3              27 mL per feed           408 mL

  • Day 5              57 mL per feed           705 mL

Composition of human milk

  • 87.5%              Water

  • About 7%        Lactose (Carbohydrate)

  • About .8-1%   Protein

  • About 4%        Fat (but this is highly variable)

In human milk, % of calories (or energy) from

  • Fat: 50%

  • Lactose: 40%

  • Protein: 10%  

Most abundant components in human milk

  • #1 Lactose

  • #2 Lipids

  • #3 HMOs

Mother’s milk comes in:

Range 38-98 hours

Average 50-59 hours

Human milk whey: casein ratio

Colostrum 90:10 (remember that colostrum has way more whey)

Mature milk 60:40