Feeding Flashcards
Which baby reflexes are involved in breast feeding?
Babies reflexes: rooting (searching with wide open mouth), suckling – jaw goes up and down whilst tongue compresses the areola against the palate and then swallowing reflex.
What advice should be given to mothers who have some problematic feeds?
Breastfeeding can be difficult, but a few problematic feeds isn’t an issue as babies have large reserves and will not starve. Avoid topping up with bottle feeds as long as possible if issues continue.
Avoid forcing baby onto the nipple
Support the breast if large and make sure both the face and shoulder are facing the breast
Mouth should be wide open with chin touching the breast
Lower lip should be curled back and baby should be drawing in breast too
Slow rhythmic and deep jaw movements as well as sucking movements should be seen.
To assists with placing tease the baby with the nipple then draw away to gain a large gape.
When is the best time to start breast feeding?
Best time to start is just after birth although be wary of intrapartum opiate analgesia.
Why is expressing milk important?
Important skill to learn as it can be used to relieve an engorged breast, to maintain milk production especially in premature babies, to aid nutrition if sucking is reduced or if the mother is going to separated from the baby for any length of time.
How should a mother express milk?
Can get pumps easily or practice with a clean towel
• Briefly rolling the nipple to induce the let-down reflex
• Stroke the breast gently towards the nipple
• With circular movements massage the breast gently with the 3 middle fingers.
• Take care that the fingers don’t slip onto the nipple and damage the ducts
• Milk lasts 5 days in the fridge or 6 months if frozen. Should be thawed by standing in jug of warm water and if unused should be thrown away after 24h
What is the best feed for a preterm infant?
In preterm infants’ breast milk is the best feed they can have. It should be fortified with Vitamin D and K and phosphate (if needed).
When is breast feeding contraindicated?
HIV +ve mother, Amiodarone, Antimetabolites, Antithyroid drugs and Opiates
What are the main benefits of breastfeeding over bottle feeding?
- Nutrients are better suited for age
- Demand led rather than supply
- Immunisation
- Bonding
- Breast cancer protection
Can bottle feeding ever be encouraged?
Promoting bottle feeding is not allowed unless there are contraindication for breastfeeding.
What milk can be used for bottle feeding?
Soya milk not recommended. Formula milk primarily consists of cow’s milk that is modified to make it more human.
How much formula milk should you be offering?
After first 5 days - 150ml/kg/day for term baby or 110-120kcal/kg/day
Build up from 50ml day one to 150ml by day 5 (roughly)
What happens if feeding doesn’t happen in the first few days of life?
If not feeding correctly in first few days then there is higher risk of hypoglycaemia. Normal for otherwise healthy term babies to tolerate hypoglycaemia fairly well via ketones.
How much weight loss is normal in babies in the first few weeks of life?
Less than 10% weight loss normal in first 1-2 weeks (7% really). Same for term and preterm babies but preterm likely to lose a bit more due to excess water. By 2nd week should have regained birth weight (3rd for preterm)
How much weight should a baby be gaining in the first month
6 oz. weight gain per week is acceptable (1 ounce (=30g) a day except on Sunday for term). Preterm 16-20g/kg/day. Both should follow growth chart centiles
When should weaning occur?
Weaning to solids can occur from 6 months. Avoid adding salt or sugar and encourage home cooking and eating together as a family.
