9.1e Formula Feeding and Parent Education

Question 1

Signs of Feeding Readiness

Answer 1

• Stable vitals
• Effective breathing patterns
• Presence of bowel sounds
• Active sucking reflex

Question 2

Feeding Patterns

Answer 2

• First 24-48 hours 15-30 mL
• By the end of the week 90-150 mL
• Newborns should not go longer than 4 hours without feeding even if it means waking up baby
• 6-8 feedings a day

Question 3

Stress during Feedings

Answer 3

SIGNS OF STRESS DURING FEEDING

• Turning head
• Arching back
• Changing color
• Moving arms
• Tensing Fist
• Calm baby before resuming feeding
• Babies fed from bottles most likely swallow some air and need to be burped

Question 4

Bottle Feeding Education

Answer 4

• Overfeeding during the first week of life increases risk of overweight by age 2
• Breastfed babies likely gain extra weight during 1st week of life
• Complementary foods should not be introduced before 6 months

Question 5

Common Concerns

Answer 5

• If infant spits up, they may need to lower the amount per feeding and and eat more frequently
• Burping infant when they slow or stop can decrease spitting up
• Hold baby upwards for 30 minutes after feedings can also help
• Spitting can be overeating or GER
• Report projectile vomiting or vomiting more than 1/3 of feeding on most feeding sessions
• Do not change baby formula without notifying provider

Question 6

Formula Preperation

Answer 6

• Hand hygiene and clean table where bottle will be prepared
• Wash bottle and all components in a basin that is solely used for formula preparation with hot soapy water. Squeeze water through the nipples to make sure they are patent
• Place bottles and accessories in boiling water for 5 minutes for the first time use, then dishwasher is okay after.
• Mix formula with tap water deemed safe by health department. Allow cold water to run for a minute before using it. If water is not safe, boil water for a minute and allow to cool no longer than 30 minutes
• If you are using can ready formula, wash the top with hot soap water and shake well
  MIXING FORMULA
• Ready-to-feed does not require mixing or water
• Concentrate - Add formula than equal amount of cooled boiled water. Shake
• Powder - 1 Scoop for every 2 Oz of water
• Formula needs to be used within 48 hours
• Ready-To-Feed cans are good at room temperature
• When heating up refrigerated formula, never use microwave, place bottle in pan of hot water.
• Bottle should be discarded within 1 hour after feeding. Do not save

Question 7

Feeding Techniques and Tips

Answer 7

• Wash hands before feeding
• Feed at least once every 4 hours. Feeding pattern is usually established by 2 weeks
• Feedings gradually increase after each feeding, do not save formula
• Use a feeding diary to record amount eaten during each feeding, and how many wet diapers and bowel movement the baby has
• Hold infant in semi-reclining position during feedings and talk to baby. This is perfect time for social interaction and cuddling
• Put nipple of bottle on roof of mouth to stimulate opening. Make sure bottle is tipped to prevent air from getting in
• Baby usually sucks with pauses in between
• PACED BOTTLE FEEDING - Baby is placed upright, and pauses between bursts of sucking. Remove nipple when baby is done, then resume when baby is ready again. Good technique for babies who are primarily breastfed
• Burp baby because they sometimes swallow air
• Infant is full when they spit out nipple, seal lips together, slower suck, or turns away from nipple
• 2-3 days stool is yellow and soft. First 2 weeks baby may have stool after each feeding. It is not abnormal for babies to have stool every other day.

Question 8

Safety

Answer 8

• Never leave baby alone during feeding
• Never prop the bottle (choking hazard)
• Infants who fall asleep with a propped bottle are more prone to cavities
• Mother should know how to use bulb syringe incase of choking

Question 9

Vitamin/Mineral Supplementation

Answer 9

• Commercial iron fortified formula is good for the first 6 months of life
• After 6 months baby may need fluoride supplementation

Question 10

Weaning

Answer 10

• Bottle-fed babies should gradually learn how to use a cup

- Should be transitioned gradually

Question 11

Introducing Solid Foods

Answer 11

• Should be introduced at 6 months

Question 12

Nipple Pain

Answer 12

• Does the mother wait for mouth to be wide open and then bring to breast
• Are the infants lips on the areola
• Are the lips flared outward
• Is the tongue under the breast
• Does the mom remove infant from breast by placing finger in corner of mouth to break seal
• Is the nipple everted
• Is the nipple red or blistered
• Are the breasts engorged

Question 13

Sore Nipples

Answer 13

• Flat nipples/Engorgement (use breast pump)

- Lanolin ointment, gel pack, or warm water/breast milk should be applied to nipples for red/sore nipples