Infant Feeding Flashcards
Most BF newborns lose weight until the 3rd or 4th day
- wt loss up to 10% of birth wt is considered NORMAL
- however > 7% warrants a close assessment of the adequacy of BF latch & milk transfer
- babies should return to birth weight by 2-3 weeks
- babies should gain 110-200 g/wk or 20-28 g/day
Signs of Adequate Br Milk Transfer in Mother
- onset of copious milk production by day 3-4
- firm tugging sensation on nipple as infant sucks but no pain
- uterine contractions & increased vaginal bleeding while feeding
- feels relaxed & drowsy while feeding
- Increased thirst
- breasts soften or feel lighter while feeding (after lactogenesis II)
- with milk ejection (let down) can feel warm rush or tingling in breasts, leaking of milk from opposite breast
Signs of Adequate Br Milk Transfer in Infant
- infant feeds 8-12 feeds/24 hours
- latches without difficulty (need latch assessment)
- has bursts of 15-20 sucks/swallows at a time
- audible swallowing is present
- easily released breast at end of feeding - drowsy, sleepy & relaxed appearance
- infant commences feed eagerly & appears content after feeding
- Has at least 3 substantive BMs
- 6-8 wet diapers q24 hours after day 4
Newborn Nutritional Needs
Breastfeeding is an unequalled way of providing ideal food for the healthy growth & development of infants… recommend that exclusive breastfeeding for 6 months is the optimal way of feeding infants
Breastfeeding should continue for 1 year & thereafter as desired by mother & her infant
Thereafter infants should receive safe & nutritionally adequate complementary foods beginning at 6 months & continue breastfeeding up to 2 years of age or beyond d
Steps to Successful BFing
- Discuss the importance and management of breastfeeding with pregnant women and their families
- Facilitate immediate and uninterrupted skin-to-skin contact and support mothers to initiate breastfeeding as soon as possible after birth
- support mothers to initiate and maintain breastfeeding and manage common difficulties
- Do not provide breastfed newborns any food or fluids other than breastmilk, unless medically indicated
- enable mothers & infants to remain together and to practise rooming-in 24 hours a day
- support mothers to recognize and respond to their infants cues for feeding
- counsel mothers on the use and risks of feeding bottles, teats and pacifiers
- coordinate discharge so that parents and their infants can have timely access to ongoing support & care
Non-nutritive benefits of Breastfeeding: maternal
- enhanced uterine involution, faster completion of lochia flow (less iron less)
- enhanced metabolism - mobilization of fat stores, easier pp weight loss
- enhanced satisfaction/well-being as mother
- > bonding with infant
- decreased risk of CA of breasts, ovarian CA
- decreased risk of HTN, hypercholesterolemia & CVD
- decreased risk post-menopausal osteoporosis, & rheumatoid arthritis
Non-nutritive Benefits of breastfeeding - Infant
Breast milk is uniquely designed for the nutritional needs of each specific baby as baby grows
- enhanced bonding through regular physical contact of feeding episodes
- immune system benefits: bifidus factor, resistance factor, lipase, anti-inflammatory agents, contains live macrophages, anti-viral and anti-bacterial properties
- Reduced risk of many common childhood diseases
- intellectual benefits
Infants who are not fed Human Breastmilk have greater incidence of:
- Lymphoma/leukemias
- type 2 diabetes
- allergies
- necrotizing entercolitis
- inflammatory bowel diseases
- crohns disease
- ulcerative colitis
- celiac disease
- rhematoid arthritis
- asthma
- SIDS
Decreased Incidence of SIDS
- SIDS is a leading cause of post neonatal infant mortality
- meta-analyses study showed that any bfg is protective against SIDS with exclusive breastfeeding conferring a stronger effect
- breastfeeding duration of at least 2 months was associated with half the risk of SIDS. breastfeeding does not need to be exclusive to confer this protection
Family & Environmental Benefits
- decreased cost
- decreased time
- always ready, right there, right temperature
- less likely to become pregnant soon after birth
- contentedness of infant - makes for more relaxed home atmosphere
- no exposure to BPA
- less waste
Benefits of Breastmilk vs ABM
Artificial Baby Milk:
- adequate nutrition if breastmilk not available
- contraindications to BF
- hazards of ABM increase if not produced, prepared, stored and given according to direction
Breastmilk
- optimal nutrition that changes to meet needs of growing infant
Function of Colostrum
- Colostrum is there for a couple days after birth
- the function of colostrum appears to establish colonization of NB Gut Microbiome
- essential to immune system development
- Rather than nutritive
In comparison to Mature BM Colostrum contains
- Less fat (mature milk has 4% fat -> 50% caloric need)
- More protein
- More chloride and sodium
- More immunoglobulins, IgA & antibodies
- More lactoferrin (transport mechanism from the gut to the body for iron)
- More fat-soluble vitamins
- Less lactose
higher in protein to bind to fetal hemoglobin and prevent hyperbilirubinemia. helps it swiftly exit the baby. - fat stores are loaded because that is where vitamins are stored
- beta-carotene makes it yellow
Functions of Colostrum
- facilitates establishment of bifidus factor in GI tract (supports normal flora in neonates bowels. what creates the microbiome)
- laxative effect - facilitates passage of meconium (necessary to excrete the bilirubin. because fetal hemoglobin has been breaking down during pregnancy and sits in the gut while the baby is in utero. need a massive BM out of the gut so the bilirubin doesn’t need to be excreted through the skin
- is easier for neonate to digest and utilize than later milk
- Abundance of antibodies (open spaces between the gut that allow antibodies to pass right through to be absorbed into the babies body and then there is gut closure)
- aids in rapid gut closure (while infant immune system is still developing the immune cells are moving into the body through the porous gut to protect the baby. rapid closure helps resist invading disease organisms)
- increased leukocytes
- concentrated dose of some nutrients, eg. zinc, vit A
Colostrum kcal
Mature Breastmilk
67kcal/100mL
70-75 kcal/100mL
Average intake by healthy Newborn
First 24 hrs
24-48
48-72
72-96
2-10mL/feeding
5-15 mL/feeding
15-30 mL/feeding
30-60 mL/feeding
Anticipate 1st feed within 2 hrs of birth. Lengthy sleep for babe typically til > 8 hrs of life - then feeds q 2-3 hrs
Colostrum of BM volume Produced
Colostrum volume 1st 24 hrs: 37 mL (7-123 mL range)
BM vol - day 5: approx. 500 mL/24 hrs
BM vol - by 3 - 5 months: approx 750 mL/24 hrs
Breastmilk Statements
- breastmilk is the most complex mammalian milk
- breastmilk is unique to each mother and it cannot be duplicated
- breastmilk is a living substance that changes during a feed, between feeds and from day to day
- breastmilk helps seal the newborn’s gut and protect babies from pathogens
- breastmilk is always the right temperature
- the smell and taste of breastmilk changes depending on mom’s diet, exposing babies to a variety of flavors
How complex is breastmilk?
- one teaspoon of breastmilk has between 50,000 and 65,000,000 cells that are nutrients, anti-infective, anti-microbial, anti-inflammatory, pre-biotic, pro-biotic, hormones and stem cells
Human breastmilk also includes:
- oligosaccarides
- hamlet cells
- stem cells ++
- just 20 minutes after ingesting a foreign virus, antibodies will be produced in the breastmilk. when a child gets older and nurses less, as the milk supply decreases the concentration of immune factors increase.
- one teaspoon of breastmilk contains 3 million germ killing cells
- mother’s milk contains stem cells which are able to cross the gut and migrate into the blood of the nursed offspring. From the blood, they travel to various organs including the brain, where they turn into functioning cells
