Study Guide and Lactation College-isms

November 5, 2024

Hi everyone,

For our test takers, as this Semester progresses I will be sending out an updated Study Guide which includes the “Lactation College-isms.” These are tricks for remembering facts. I used to post this Study Guide as a complete document at the end of the Semester but I am going to change that this Semester and post updates periodically. If something doesn’t make sense, please go back and look at the post on the topic.

This study guide is for Topics #1-14. Topic 14 will be posted tomorrow.

Also, we are now posting lactation facts related to these posts several times a week over on Instagram. Follow along: @lactationcollege

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 https://www.who.int/nutrition/topics/infantfeeding_recommendation/en/

• 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.

Milk line ridges develop in utero at 4-5 weeks

Colostrum

During pregnancy, the production of colostrum begins at 16 weeks.

What’s in colostrum? LLAMAS Pee Gold

• L-Living cells

• L-Lactoferrin

• A – Vitamin A

• M-Microbiome

• A – secretory IGA

• S-Sugars (HMOs)

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

• G-Growth factors

Colostrum, compared to mature milk, has:

• Higher concentrations of protein

• Lower concentrations of lactose and fat

Calories in human milk

• Mature milk has about 20 calories per ounce (1 ounce is 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 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 Fats

• #3 HMOs

Macronutrients in human milk

Carbohydrates

• Lactose - made up of glucose and galactose, provides 40% of energy content

• HMOs (human milk oligosaccharides)

  • What do HMOs? Remember 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

Proteins

• Little Miss Muffet sat on a tuffet eating her curds and whey.

• Whey

  • What’s in whey? ALLI: alpha-lactalbumin, lactoferrin, lysozyme, immunoglobulins (antibodies)

  • HAMLET = Human Alpha-lactalbumin Made LEthal to Tumors. HAMLET is found in whey, and it kills cancer cells

• Human milk whey: casein ratio

  • Colostrum 90:10

  • Mature milk 60:40

  • Late milk 50:50

Fats

• Provide 50% of the total energy content

• Play an important role in the development of the central nervous system (BRAIN)

• 98% of the fat is in the form of triglycerides

• Remember the Fork: triglycerides —— handle of fork-glycerol, prongs of fork-fatty acids

• MFGM - triple layer milk-fat globule membrane surrounds the fat globule

• Essential fatty acids, omega-3 and omega-6, linoleic acid, linolenic acid, ARA and DHA