Feeding/Growth

Question 1

Pros of breastfeeding?

Answer 1

• immunoglobulins
• hormones
• decreases incidence of infections
• reduces SIDS
• decreases breast and ovarian cancers in mothers
• enhances performance on neurocognitive testing
• more economical

Question 2

Size and volume of newborn stomach?

Answer 2

Day 1: cherry; 5-7mL
Day 3: walnut; 22-27mL
1 week: apricot; 45-60mL
1 month: egg; 80-150mL

Question 3

What is colostrum?

Answer 3

first milk produced by breasts during pregnancy. High in Abs and Igs + has laxative effects to help newborns expel meconium

Question 4

Why do newborns lose weight?

Answer 4

Diuresis of ECF

Question 5

Normal weight loss and weight gain?

Answer 5

• Lose 5-10% of weight in first 3 days

* Regain birth weight by 10-14 days; Gain 25-30g/day from Day 4 onwards

Question 6

Expected voiding pattern?

Answer 6

• Starts in first 24h
• Same as day # until day 4-5
• Day 6 onwards - 6-8/day, pale yellow or clear, no crystals

Question 7

Expected stooling pattern?

Answer 7

• Day 1-2: 1-2 meconium
• Day 3-4: ≥ 3 brown, green or yellow
• Day 5 onwards: ≥3 soft seedy yellow

Question 8

Indications for supplementation?

Answer 8

• Hypoglycemia not improved with increased BF
• Dehydration not improved with increased BF (serum NA ≥150mmol/L, loss of ≥7% BW in 24-48h)
• Hyperbilirubinemia
• Inborn errors of metabolism (Galactosemia, PKU)
• Unable to feed due to congenital malformations
• Maternal medications contraindicated with BF
• Delayed lactogenesis
• Breast pathology

Question 9

Forms of supplementation?

Answer 9

EBM, Donor milk, Formula

Question 10

Ways of supplementation?

Answer 10

Cup/spoon, finger, lactation aid, syringe, bottle

Question 11

How to optimize BF?

Answer 11

Skin to skin, antenatal education, room in 24h, lactation counselling

Question 12

Supplement volumes?

Answer 12

Day 1: 5-15ml/feed
Day 2: 15-30ml/feed
Day 3: 5-10ml/kg/feed
≥Day 4: increasing amounts after 160ml/kg/day