Deck 6: Nutrition During Lactation

Question 1

Lactose is a component of milk that is made in the _____ cells and secreted into ducts by the process of _____.

A) secretory; transcytosis
B) myoepithelial; diffusion
C) secretory; exocytosis
D) myoepithelial; exocytosis
E) secretory; diffusion

Answer 1

C

Question 2

In pregnancy, the luteal and placental hormones assist in preparing the mother's body for breastfeeding.

Answer 2

True

Question 3

Which stimulus would be least likely to trigger the letdown reflex?

A) release of oxytocin due to suckling
B) hearing a baby cry
C) sexual arousal
D) release of prolactin-inhibiting factor from the hypothalamus
E) thinking about nursing

Answer 3

D

Question 4

Infants appear to be interested in their mother's milk when flavors are new to them.

Question 5

Which stage of lactogenesis is marked as the onset of copious milk secretion?

A) lactogenesis I
B) lactogenesis II
C) lactogenesis III
D) lactogenesis IV
E) lactogenesis V

Question 6

Because human infants grow at a relatively slow rate, the mineral content of human milk is higher than that of cow's milk and the milk of other animals that grow faster.

Question 7

The size of a woman's breast does not determine the amount of milk production.

Question 8

The composition of human milk can change over the course of a single day.

Question 9

The cyclic release of the two hormones _____ and _____  governs breast development during puberty.

A) prolactin; oxytocin
B) progesterone; estrogen
C) prolactin; estrogen
D) progesterone; oxytocin
E) testosterone; progesterone

Question 10

Human milk is needed by the majority of healthy infants for approximately the first _____ months.

A) 6
B) 8
C) 10
D) 12
E) 18

Question 11

What hormone is produced during letdown and causes the ejection of milk from the milk glands into the milk ducts?

A) oxytocin
B) prolactin
C) estrogen
D) progesterone
E) lactogen

Question 12

The functional units of the mammary gland are the _____.

A) alveoli
B) nipples
C) myoepithelial cells
D) lobes
E) areolas

Question 13

Milk fat comes from _____.

A) proteins from the mother's blood
B) new milk sugars produced in the breast
C) triglycerides produced by the placenta
D) triglycerides produced by the placenta and new fatty acids produced in the breast
E) triglycerides from the mother's blood and new fatty acids produced in the breast

Question 14

Breastfeeding women who follow a vegetarian diet tend to get plenty of protein as long as their energy intakes are adequate.

Question 15

Prolactin is secreted from the _____ and causes _____.

A) hypothalamus; milk secretion by alveolar epithelial cells
B) posterior pituitary; milk secretion by alveolar epithelial cells
C) anterior pituitary; milk secretion by alveolar epithelial cells
D) posterior pituitary; relaxation of myoepithelial cells surrounding alveoli
E) anterior pituitary; relaxation of myoepithelial cells surrounding alveoli

Question 16

Prolactin is a hormone that _____.

A) stimulates the breast tissue to release oxytocin
B) stimulates mammary gland development
C) decreases estrogen production
D) stimulates milk production
E) stimulates development of breast tissue

Question 17

The composition of breast milk becomes stable during lactogenesis III.

Question 18

Individual fatty acids and other milk components that result from the digestion of human milk are antimicrobial.

Question 19

Breastfeeding has been found to be just as effective as other methods of birth control, such as birth control pills.

Question 20

Letdown occurs only when the infant suckles the breast.

Question 21

Amira is a 25-year-old breastfeeding mom who is trying to lose weight. Her OB/GYN has suggested that she should go on a very low-fat diet (≤15% of calories) to lose weight. How will her dietary changes and weight loss affect the fat composition of her breast milk?

A) It will not change the fat composition at all.
B) Her breast milk will contain more very long-chain fatty acids.
C) Her breast milk will contain more saturated fatty acids.
D) Her breast milk will contain more medium-chain fatty acids.
E) Her breast milk will contain more cholesterol.

Question 22

The level of _____ in human milk can be altered by the mother's diet.

A) manganese
B) molybdenum
C) nickel
D) selenium
E) fluoride

Question 23

Which component of human milk forms a soft, easily digestible curd?

A) copper
B) vitamin K
C) whey protein
D) casein
E) iron

Question 24

Colostrum is higher in _____ and lower in _____ than mature milk.

A) protein; water
B) fat; protein
C) water; protein
D) carbohydrate and fat; protein
E) protein; carbohydrate and fat

Question 25

Which benefit is least likely to occur as a result of breastfeeding?

A) minimized postpartum blood loss
B) return of uterus to nonpregnant size
C) decreased risk of breast and ovarian cancer in young nursing mothers
D) increased self-confidence in mothers
E) increased fertility

Question 26

Which of the following nutrients is present in more quantity in colostrum than mature milk?

A) protein
B) fat
C) lactose
D) calcium
E) vitamin B₂

Question 27

One of the nutritional benefits of breastfeeding is that _____.

A) human milk contains few protein-bound minerals, making it more digestible for the infant
B) the balance of nutrients in human milk matches requirements needed for the growth of infants
C) infants need no additional fluids other than water when breastfeeding
D) human milk provides very low amounts of lipids
E) the high protein content in human milk provides immature kidneys with nitrogen

Question 28

What nutrient is predominant in human milk?

A) water
B) fat
C) protein
D) fiber
E) carbohydrate

Question 29

Breast milk is isosmotic, which means breast milk _____.

A) contains milk proteins
B) has ion concentration similar to plasma
C) has the same ion concentration as human milk substitutes
D) has a greater ion concentration than human milk substitutes
E) contains high amounts of minerals

Question 30

The hormone responsible for uterine contractions and the minimization of maternal postpartum blood loss is _____.

A) prolactin
B) oxytocin
C) estrogen
D) progesterone
E) testosterone

Question 31

Breastfeeding to any duration and to any extent reduces the risk of _____.

A) vitamin D deficiency
B) phenylketonuria
C) adult obesity
D) sudden infant death syndrome (SIDS)
E) weight gain in the mother

Question 32

Which component of human milk is responsible for the phagocytosis of bacteria and the production of complement proteins?

A) whey proteins
B) epithelial cells
C) macrophages
D) B-lymphocytes
E) immunoglobins

Question 33

Which statement explains the difference between morbidity rates and mortality rates?

A) Morbidity is the rate of death in a population; mortality is the rate of illness.
B) Morbidity is the rate of illness in a population; mortality is the rate of death.
C) Morbidity is the obesity rate in a population; morality is the rate of illness.
D) Morbidity is the obesity rate in a population; mortality is the rate of death.
E) Morbidity is the rate of infant deaths in a population; mortality is the rate of adult deaths.

Question 34

The predominant secretory immunoglobin in human milk is _____.

A) sIgA
B) sIgE
C) sIgG
D) sIgM
E) sIgD

Question 35

Which component of human milk prevents the binding of pathogenic microorganisms to the surface receptors of their target cell, thereby preventing infection?

A) nucleic acids
B) oligosaccharides
C) whey proteins
D) DHA
E) cholesterol

Question 36

Women who pump milk _____.

A) are only able to pump one breast at a time
B) may increase prolactin expression by hand pumping rather than electric pumping
C) on average require 3 pumping sessions per day to stimulate adequate milk production
D) are encouraged to pump early and often to obtain an adequate milk supply
E) are less likely to experience insufficient milk production than women who breastfeed

Question 37

The dominant carbohydrate in human milk is _____.

A) galactose
B) glucose
C) lactose
D) sucrose
E) maltose

Question 38

Which statement correctly describes milk production?

A) The amount of milk produced is the same regardless of the number of infants being nursed.
B) Milk production is triggered only when the breast is empty of milk.
C) Women with smaller breasts have a reduced capacity for milk production.
D) Milk production is highest in the days following birth and decreases thereafter.
E) Milk production is triggered by the removal of milk from the breast.

Question 39

The major class of protein found in mature human milk is _____.

A) whey
B) casein
C) lactose
D) maltose
E) colostrum

Question 40

A woman was not planning to breastfeed because she felt her breasts were small and they would not produce enough milk. Which of the following statements contradicts her assumption?

A) Inadequate food intake by the mother decreases the quantity of milk, not the quality.
B) A woman with small breasts can produce the same amount of milk as a woman with large breasts.
C) Eating a diet rich in refined grains would best support adequate milk production.
D) Drinking more water and milk products would make up for the smaller breast tissue.
E) If she chooses to breastfeed, she must also use a human milk supplement to ensure her infant receives enough milk.

Question 41

Identify the mineral whose rare deficiency causes dermatitis or intractable diaper rash in infants.

A) copper
B) iron
C) selenium
D) calcium
E) zinc

Question 42

Exclusively breastfed infants should receive  _____ supplements.

A) vitamin K
B) fluoride
C) iron
D) fluoride and vitamin D
E) vitamin D

Question 43

Ria is a breastfeeding mother. She does not have exposure to sunlight. Her doctor warned that her infant may develop hypocalcemia or rickets. Identify the nutrient that is deficient in her breast milk.

A) vitamin D
B) vitamin A
C) whey proteins
D) oligosaccharides
E) cholesterol

Question 44

What is the appropriate daily water intake recommendation for a nursing mother?

A) 6-8 glasses
B) 8-10 glasses
C) 10-12 glasses
D) more than 12 glasses
E) Drink enough fluids to keep your urine pale yellow.

Question 45

Which of the following reflexes help an infant to position herself to breastfeed?

A) gagging reflex and rooting reflex
B) oral search reflex and rooting reflex
C) oral search reflex and feeding reflex
D) gagging reflex and rooting reflex
E) feeding reflex and rooting reflex

Question 46

Hindmilk has a _____ content than foremilk.

A) lower calorie and higher lactose
B) higher lactose and higher fat
C) higher fat and higher calorie
D) higher calorie and higher lactose
E) lower fat and higher calorie

Question 47

Which of the following is an iron carrier protein in human milk that provides immunological benefits?

A) casein
B) immunoglobulin
C) isozyme
D) lactoferrin
E) myoglobin

Question 48

An infant should be allowed to nurse at one breast of her mother as long as she wants so that _____.

A) she gets more foremilk
B) she gets both foremilk and hindmilk
C) she does not drink too much milk
D) the formation of excess gas is prevented
E) allow the mother to store more milk in the second breast for later feedings

Question 49

When infants are hungry, they will often _____.

A) spit up
B) bring their hands near their mouth and suck on them
C) move their heads from side to side with their mouths closed
D) reach for their mother
E) burp

Question 50

Which of the following cells manage monovalent ion secretion to maintain the isosmotic composition of human milk?

A) alveolar cells
B) epithelial cells
C) white blood cells
D) myoepithelial cells
E) adipose cells

Question 51

With regard to onsite childcare, current federal law _____.

A) prohibits a woman from being fired if she breastfeeds while on a break
B) protects a woman's right to breastfeed anywhere on federal property that she is authorized to be
C) prohibits a woman from being fired if she breastfeeds while at lunch
D) provides tax credits to employers who provide lactation services
E) establishes minimum standards for breast pump safety

Question 52

The mother should hear _____ sounds when the infant is breastfeeding and in the proper position.

A) swallowing
B) coughing
C) smacking
D) clicking
E) little or no

Question 53

To avoid damage to the ductal system, which incision would you recommend for a woman undergoing breast reduction surgery?

A) an incision around the lower part of the breast
B) an incision in the middle of the breast
C) an incision around the nipple (periareolar incision)
D) an incision around the lower part of the breast and around the nipple
E) an incision between the breasts

Question 54

Which statement correctly describes maternal energy balance and milk composition?

A) Protein-calorie malnutrition usually compromises the composition of milk.
B) Milk production stops whenever there is a negative calorie balance.
C) Milk production can occur regardless of the calorie balance of the mother.
D) Protein-calorie malnutrition results in an energy deficit that reduces the volume of milk.
E) A high-fat diet greatly changes the protein and carbohydrate content of milk compared with a normal diet.

Question 55

Which of the following vitamins' content in human milk is least influenced by maternal diet?

A) riboflavin
B) thiamin
C) folate
D) vitamin B₆
E) vitamin B₁₂

Question 56

Which of the following statements is true of acinus?

A) It is a hormone that stimulates lactogenesis.
B) It is a hormone that is necessary for milk production.
C) It is a circular structure in the mammary gland.
D) It is a small sac that is lined by milk-secreting cells.
E) It is made up of fibrous and fatty tissues present in the breast.

Question 57

Healthy People 2020 has breastfeeding objectives focusing on _____.

A) increasing the proportion of breastfed infants only
B) increasing the duration of breastfeeding only
C) decreasing the duration of breastfeeding
D) increasing the proportion of breastfed infants and increasing the duration of breastfeeding
E) increasing the proportion of breastfed infants but decreasing the duration of breastfeeding

Question 58

Latching on refers to the _____.

A) infant grasping the mother's breast with her hand before beginning to suckle
B) mother holding her nipple in her hand to increase the production of milk
C) smacking and slurping sound made by an infant while feeding
D) absorption of minerals present in the human milk during digestion
E) process of helping the infant attach onto the breast for an optimal feeding position

Question 59

Which of the following hormones is responsible for the ductal growth of the mammary glands?

A) prolactin
B) oxytocin
C) human placental lactogen
D) progesterone
E) estrogen

Question 60

Which agency or organization monitors maternity practices and policies related to breastfeeding support in hospitals and birthing centers with the Maternity Practices in Infant Nutrition and Care survey?

A) U.S. Surgeon General
B) Health Resources and Services Administration
C) UCLA Center for Healthier Children
D) The Centers for Disease Control and Prevention
E) Wellstart International

Question 62

A young woman comes to your office for a lactation consultation complaining that her 1-month-old baby has colic and slow weight gain. Her baby requires 6 to 7 diaper changes each day and suffers from diarrhea. She tells you that she allows the baby to nurse equally on each breast; she is desperate for help and asks your advice on what to do. A 24-hour diet history provides the following information about her eating habits.
Breakfast:        cereal, milk, banana, and walnut pieces; sometimes she has eggs
Lunch:             peanut butter sandwich, salad, and grapes with a glass of milk
Dinner:            fish or chicken, vegetables, potato or rice, applesauce, and milk
Snacks:            change daily but she likes trail mix because it is easy to eat when nursing
 
What is likely happening to this baby and causing the diarrhea?

A) The baby is not latched on properly.
B) The mother is not producing enough breast milk.
C) The baby is getting too much foremilk and not enough hindmilk.
D) The baby has a poor suckle.
E) The baby is lactose intolerant.

Question 63

Describe how infant suckling leads to milk secretion from the mammary glands.

Question 64

A young woman comes to your office for a lactation consultation complaining that her 1-month-old baby has colic and slow weight gain. Her baby requires 6 to 7 diaper changes each day and suffers from diarrhea. She tells you that she allows the baby to nurse equally on each breast; she is desperate for help and asks your advice on what to do. A 24-hour diet history provides the following information about her eating habits.
Breakfast:        cereal, milk, banana, and walnut pieces; sometimes she has eggs
Lunch:             peanut butter sandwich, salad, and grapes with a glass of milk
Dinner:            fish or chicken, vegetables, potato or rice, applesauce, and milk
Snacks:            change daily but she likes trail mix because it is easy to eat when nursing
 
After looking at her diet, what changes could you suggest to help with the baby's colic?

A) Eliminate all fruit except canned fruit and include nuts.
B) Eliminate only nuts, not dairy products.
C) Eliminate dairy products, not nuts.
D) Eliminate nuts and dairy products.
E) Eliminate all fruit except canned fruit, nuts, and dairy products.

Question 65

A young woman comes to your office for a lactation consultation complaining that her 1-month-old baby has colic and slow weight gain. Her baby requires 6 to 7 diaper changes each day and suffers from diarrhea. She tells you that she allows the baby to nurse equally on each breast; she is desperate for help and asks your advice on what to do. A 24-hour diet history provides the following information about her eating habits.
Breakfast:        cereal, milk, banana, and walnut pieces; sometimes she has eggs
Lunch:             peanut butter sandwich, salad, and grapes with a glass of milk
Dinner:            fish or chicken, vegetables, potato or rice, applesauce, and milk
Snacks:            change daily but she likes trail mix because it is easy to eat when nursing
 
What would the best advice be for this woman?

A) Allow your baby to nurse on one breast until it is completely empty.
B) Increase your intake of fats; this will increase fat content in the milk and help the baby gain weight.
C) Stop nursing immediately and use an infant formula so your baby starts growing.
D) Use supplemental infant formula after each feeding because the baby is not getting enough to eat.
E) Increase your intake of nuts because the baby is not receiving enough protein.

Question 66

Define the term infant colic and explain what can be done to alleviate the condition.

Question 67

Identify three reflexes of healthy-term infants. Discuss how these reflexes help infants nourish themselves.

Question 68

Which of the following is a bioavailable source of vitamin B₁₂ for breastfeeding women who consume no animal products?

A) oranges
B) tomatoes
C) yeasts
D) chocolates
E) rice

Question 69

Which statement is part of the policy established by UNICEF regarding the marketing of breast milk substitutes?

A) Breast milk substitutes should not be advertised.
B) Breast milk substitutes should not have food labels.
C) Free samples of breast milk substitutes should be provided to breastfeeding mothers.
D) Promotion of products is important through health care facilities.
E) Companies' sales representatives must advise mothers about the products.

Question 70

Describe how the WIC program supports breastfeeding.