chapter 16 newborn nutrition Flashcards
American Academy of Pediatrics recommends
- exclusive breastfeeding for the first 6 months of age
- addition of solid foods along w/ breastfeeding for another 6 months, world health organization addition of breastfeeding for 2 years or more
infant nutritional needs
- calorie needs based on their age, size, and sex
- higher during the first year of life
- measured by length and weight on growth chart
- calories are from protein, fat, and carbohydrates in diet
- water from adequate breast milk or formula
newborn infant eats only ___ for the first few days
small amounts
infant stomach capacity
- day 1: 5-7 ml
- day 3: 22-27 ml
- day 10: 45-60 ml
- overfeeding can lead to regurgitation
the breastfeeding mother and infant
- increase in exclusive breastfeeding to promote infant health and reduce mortality
- promote breastfeeding early in prenatal care
policies to promote breastfeeding
- plac the newborn in direct skin to skin contact w/ the mother after delivery
- assist w/ latching on during the first hour after birth
- mother and infant should not be separated on the postpartum unit
- mother and infant should sleep in close proximity
- avoid supplements such as water or formula
lactogenesis
milk production
- nipple stimulation occurs from latching the infant onto the breast
- stimulates pituitary gland to increase prolactin
- prolactin causes alveoli to take proteins, sugars, and fat from the blood supply and make breast milk
colostrum
first substance produced by the breasts
- during second and first trimesters
- easy to digest
- concentrated w/ carbohydrates and fat
- contains secretory immunoglobulin A
- has a laxative effect to help pass the first meconium stool
frequent breastfeeding
8-12 times a day
- stimulates pituitary to increase prolactin
- increases volume of breast milk
- mature milk: produced 3rd or 4th postpartum day
let down reflex
- release o prolactin to produce milk and oxytocin caused by nipple stimulation, baby crying, or thinking about baby
- tingly or warm sensation in breasts
- milk drip or spray during let down
components of breast milk
- proteins (60% whey, 40% casein)
- lactoferrin
- secretory IgA
- lysozyme
- bifidus factor
- cholesterol and fats
- vitamins
- carbohydrates
- antibodies
stages of human milk
stage 1; colostrum
stage 2: trainsitional milk
stage 3: mature milk
- foremilk vs hindmilk
advantages of breastfeeding
- provides exact nutrients
- immunological protection
- convenient and economical
- promotes close physical contact
- low risk of developing premenopausals breast and ovarian cancer
disadavantages of breastfeeding
- mother must be available for feeding
- embarrassment
- medications can interrupt breastfeeding
- uncomfortable
- leaking of breast milk
contraindications for breastfeeding
- infant diagnosed with galactosemia
- mother infected with : HIV
- taking antiretroviral medications
- untreated, active tubucerlosis
- infected w/ human t cell lymphotropic virus type 1 or type 2
- using or dependent on an illicit drug
- herpes lesion on breast
- taking prescribed cancer chemotherapy agents
- undergoing radiation therapies
breastfeeding techniques
newborn cues
positioning
latch on
signs of effective breastfeeding
-mother’s breasts soften
-hear infant swallowing
- number of wet diapers increases to at least 6-8 by 6 days old
- infant has 2-3 yellow stools by the 5th day after birth
breastfeeding challenges
- sore nipples
- nipple confusion
- low milk supply
- engorgement
- flat or inverted nipples
warning signs of breastfeeding problems
- loss of more than 7% of birth weight
- not gaining back birth weight by 10 days of age
- not having at least 2-3 bowel movements per day after day 2
- does not have at least 6 wet diapers/day by day 4 with clear or pale yellow urine
cow’s milk not suitable for infants under 1 year of age
- high level of protein
- fat which is difficult for the infant to digest
- poor source of iron
- contains small amounts of vitamins c, e, and copper
- sodium level too high
advantages of formula
- mother has a chronic illness and takes medications
- provides adequate and acceptable nutrition
- anyone can feed the infant
- more comfortable to feed in public
- food or alcohol intake won’t affect the baby
- easier to leave the infant w/ a sitter or family member
disadvantages of formula feeding
- breastmilk may come in, causing engorgement
- formula can be expensive
- bottles, nipples, and formula must be purchased
- bottles and formula must be carried along w/ the infant
- increased risk of serious illness including GI illness
types of formula
- must have 20 calories in each ounce
- prepared formula should be in a covered container in the refrigerator
- unused formula thrown out after 24 hours
- hypoallergenic formula should be used if allergy to milk based formula is suspected
- soy based formula should be used if dairy based products are not ingested for health, cultural, religious, or personal reasons
parent teaching: how to prepare formula
- ready to feed formula: can or carton; should not be diluted
- liquid concentrated formula: diluted w/ equal amounts of water
- powder formula: dissolved in water
bottle feeding the infant
- check the expiration date on the formula container
- sterilize the bottles and nipples
- washing bottle and nipples with soap and water or in the dishwasher is sufficient
- follow package directions to prepare formula
- if water supply is not safe, mix the formula w/ boiled water
- wash the formula container w/ soap and water before opening it
- check temp of warmed formula
- use correct nipple size
- wash hands before every feeding
- be in a comfortable position
- angle the bottle
- keep the nipple filled w/ formula
- stop and take burping breaks
- do not use a bottle sitting out for more than 2 hours
- never force a baby to finish a bottle
- do not let the baby fall asleep w/ a bottle in the mouth
