224 Obstetrics and Gynecology Board Review •••
❍ What term describes the maintenance of lactation over time after the initial episode of lactogenesis?
Galactopoiesis. It is dependent on continued stimulation to the breast and on the presence of at least baseline levels
of prolactin.
❍ When does complete involution of the breast occur?
At menopause. Partial involution occurs at each weaning, but complete involution does not occur until withdrawal
of all hormone stimulation. Women who receive postmenopausal hormone replacement will retard this process.
❍ For how long does the American Academy of Pediatrics (AAP) recommend breastfeeding?
Exclusive breastfeeding is recommended for the first 6 months after birth, with continued breastfeeding until at
least 1 year of age or longer as long as mutually desired by mother and infant.
❍ What are some important infant benefits of breastfeeding?
Superior nutrition.
Prevention of infection (including otitis media, gastroenteritis, urinary tract infection).
Increased intelligence as adults.
Long-term reduction in obesity.
Reduction in the risk of childhood cancer.
Decreased risk of cardiovascular disease and type 1 diabetes mellitus.
❍ What are some important maternal benefits of breastfeeding?
Improved uterine involution leading to decreased postpartum blood loss.
Enhanced postpartum weight loss.
Reduced risk of breast and ovarian cancer.
Decreased risk of cardiovascular disease.
Decreased cost (savings from formula, decreased expenditure for childhood illness).
❍ What are the some factors that promote success and longer breastfeeding duration?
Nursing immediately following delivery
Rooming in
Skin-to-skin contact
Frequent demand feedings in the early postpartum period.
❍ What is the average weight gain on infants that are breastfed?
Once breastfeeding is established, infants gain 15 to 40 g per day.
❍ What is colostrum?
Colostrum is the milk secreted in the first 72 hours after delivery. It contains immunoglobulins and lactoferrin. It
also contains macrophages, lymphocytes, and neutrophils. In addition to being a source of nutrients, colostrum
bolsters neonates’ immune systems.
❍ What is the caloric content of mature milk?
Approximately 70 kcal/100 mL in a well nourished mother. Colostrum has a lower caloric content (58 kcal/100 mL).