Infant Feeding Flashcards
what are the feeding cues?
- Sucking movements
- Sucking noises
- Lip licking
- Head movement from side to side
- Rapid eye movement
- Restlessness
- Crying ( a late cue)
what is responsive feeding?
- Feed baby in response to feeding cues
- Feed baby when baby is in need of comfort
- Feed baby in response to mum’s needs eg if breasts are full/ wanting to sit down and cuddle her baby/ feed before going out
what is effective positioning and attachment?
- C - close- close to mum’s body
- H - head free so baby can tilt head back
- I - in line- baby should not be twisted
- N - nose to nipple- this gets baby in the right position for good attachment
what are the four positions for BF?
- football hold
- laid back
-side lying - cradle
how do we enable effective attachment?
- Wait for gape – baby to have a wide open mouth
- Mother assists her baby towards her breast with its head tilted back and chin leading
- Bottom lip touches breast well away from the base of the nipple and nipple aimed towards the rear of the roof of the baby’s mouth
what are the signs of effective attachment?
- Mother is comfortable during feed – sucking does not cause pain
- The baby is contented and stays on the breast
- Baby’s mouth is wide open
- Baby’s chin indents the breast
- Baby’s cheeks are full and round
- Areola – if any is visible then more will be visible above the baby’s top lip
- No clicking sounds when baby is feeding
- Nipple not changing shape after a feed
- Sucking is appropriate to the age of the baby ( usually rapid initially, then deep and rhythmic with pauses and audible swallows)
- Suck : swallow ratio no more than 2:1
wet nappies
effective attachment and ineffective attachment
Increase with days of life until day 6, then 6 wet heavy daily
less than recommended or none
dirty nappies?
effective attachment and ineffective attachment
First 24hrs: pass meconium
Day 3-4: 2 or more changing stools
Day 5: 2 a day, yellow, running still meconium after day 3.
Less than 2/day
number and length of feeds?
effective attachment and ineffective attachment
At least 8-10 in 24hrs
Baby feeds for 5-40 min at most feeds.
Less than 8 feeds in 24hrs or constant feeding. Consistently feeding for less than 5 min or longer than 40 min.
sucking patterns?
effective attachment and ineffective attachment
Sucking-swallowing 2:1
No clicking heard, gulping may be present
Frequent sucking before swallowing, clicking or other sounds.
offer second breast?
effective and ineffective attachment?
Offered, baby feeds from 2nd or not
Mother restricts baby to one breast or insist on 2 per feed.
shape of nipple?
effective and ineffective attachment?
Same as when feed began or slightly elongated and rounded.
misshapen or pinched at the end
behaviour after feeds?
effective and ineffective attachment?
Content after most feeds
Unsettled, irritable
baby’s condition
effective and ineffective attachment?
Active, alert.
No jaundice (or physiological day 3-5)
Sleepy, difficult to wake up
Severe Jaundice
mother comfort?
effective and ineffective attachment
Breast and nipples comfortable.
Sore or damaged nipples.
Engorged breast or mastitis
weight?
effective and ineffective attachment
Has lost <10% from birth weight
Lost >10% from birth weight