Certified Breastfeeding Counselor 2023 with verified questions and answerss

Where does breast tissue normally develop? Along the breast line - located from under the arms down to the groin What are the 3 stages of early breast development? 1. In utero 2. First 2 months of life 3. Puberty Breast development during menstruation - Estrogen: Induces Ductal System development - Progesterone: Induces Lobular-Alveolar development What is Lactogenesis? The initiation of milk production How many stages of Lactogensis are there? 4 What stages of Lactogenesis occur during pregnancy? 1 and 2 Lactogenesis 1 Ductal and Lobular-Alveolar systems grow at an accelerated rate (influenced by hormones) - breasts enlarge - high progesterone levels cause an increase in alveoli - colostrum begins to produce in the alveoli When does Lactogenesis 1 occur? around 16 weeks Lactogenesis 2 The placenta is released from the uterus and progesterone levels drop - this causes the alveolar cells to begin to release milk and allows them to continue to produce more milk How long does Lactogenesis 2 last? 2-4 days What are the 5 main areas of the breast? - Upper Inner - Lower Inner - Upper Outer - Lower Outer - Tail of Spence What are the 2 types of breast tissue and what are they composed of? - Parenchyma: ductal and lobular-alveolar structures - Strom: connective tissue (fat, vascular, nerve, lymphatic) What is an Alveolus Small cavity where milk is produced and stored - made of epithelial cells What are Alveoli? multiple alveolus What is the Intra-lobular duct? Connects a lobule to the lactiferous ducts What is a Mammary Lobule? 10-100 alveoli combined together What are Lactiferous Ducts? connects mammary lobules/intra-lobular ducts to the nipple Breast Anatomy What surrounds the breast tissue? Fat Nerves Lymph Tissue Vascular Network Myoepithelial Cells What is the purpose of the Myoepithelial cells? They surround the alveolus and contract (like a muscle) - pushes milk out into the ducts What is the purpose of the Vascular Network surrounding breast tissue? - supplies nutrients, materials, hormones to each alveolus for milk production - supplies hormones to the myoepithelial cells for ejection of milk What is the purpose of fat surrounding breast tissue? protection support provides space for growth What purpose do nerves serve in the breasts? Intercostal nerves 3, 4 and 5 deal with breast tissue - innervation to the nipple tells the brain to produce oxytocin when breast feeding - emptying of the alveolus tells the breast to make more milk What are Montgomery's Tubercles? Glands that secrete an antibacterial-like substance that protects the nipples and areola. - found on the nipple and areola - enlarge during pregnancy Lactogenesis 3 also known as galactopoiesis - the resupply of mature milk that occurs when milk is removed from the breast When does Lactogenesis occur? day 10-14 postpartum - when mature milk is established - lasts until mom is ready to wean from breastfeeding Lactogenesis 4 involution - milk production is decreased by apoptosis of the milk making epithelial cells What are the 2 main hormonal influences of breastfeeding? Prolactin and Oxytocin What is the job of Prolactin? Milk production Where is prolactin released? the anterior pituitary gland into the blood stream to the alveoli What is the main inhibitor of prolactin? progesterone When is prolactin released? When the placenta detaches, progesterone levels decrease and prolactin levels increase What are some other purposes of prolactin? - keeps alveoli glued together - inhibits ovulation Remaining fragments of placenta can cause what problem in breastfeeding? delay/decrease the release of prolactin What is the job of oxytocin? milk release (the let-down reflex) - tells the myoepithelial cells (and the uterus) to contract and move milk to the ducts and out the breast Where is oxytocin released? the posterior pituitary gland via many stimuli Name some of the stimuli used to release both Oxytocin and Prolactin - nipple stretching - massaging the breasts - Seeing/Touching/Smelling/Hearing the infant How often does the let-down reflex occur? several times during a feeding What are some signs of Prolactin/Oxytocin release? cramping thirst leaking pins and needles increased bleeding sleepy sometimes, nothing Does stress play a role in hormone release? stress can inhibit hormonal release - high levels of cortisol/catacholamines reduce oxytocin and prolactin levels List some ways to reduce stress for breastfeeding remove visitors turn lights out skin to skin sleep massage aroma therapy side lying