Infant Nutrition Flashcards
How many calories should a newborn be given each day?
50 calories per pound of body weight
How many calories are in each ounce of formula/breast milk?
20 calories per ounce
When should an infant be back at birthweight after losing the weight initially?
10-14 days
What percentage of the birthweight will babies typically lose?
5-10% (begin to worry and assess infant at 7%)
What is the average newborn intake for the first 24 hours? By day 4? By day7?
First 24 hours: around 2-10ml per feed
By day 4: around 30-60ml per feed
By day 7: around 60-90 ml per feed
What is the gastric size of a newborn at birth?
Around 6 ml/kg (15-24ml)
What are 5 common hunger cues?
Hand to mouth, rooting, sucking, whimpering, crying
Why might babies be sleepy and have difficulty coordinating the sucking motion in the first 24-48 hours?
Epidural anesthesia may still be affecting the infant
Is formula equivalent to breast feeding?
No, but it will meet all of the nutritional needs of the infant
What are the main types of formulas?
Cow’s milk based and iron fortified, soy based, elemental, lactose free
Is it okay to dilute breast milk or formula to stretch how long the milk can be used?
No. this will deplete the infant of nutrients and could kill the infant over the course of time
How often should an infant be fed?
Every 3-4 hours
Why is it important to hold the infant in an upright position when bottle feeding?
To prevent ear infections
When should a baby be burped?
In the middle and at the end of feedings
Will a breast fed or formula fed baby gain weight quicker? Why?
Formula fed baby, because these babies tend to overeat as they will finish the entire bottle of milk, even when full
What is the stool of a formula fed baby like, compared to a breastfed baby?
Firmer, foul odor, and tend to cause constipation
What is an indication that a baby may be ready for solid foods?
Drooling
How long should an infant be only reliant on milk?
Around 6 months
When can a baby be given cow’s milk?
Around 12 months
When is the earliest babies should be given solid foods?
4 months
When can babies be given honey?
After 1st year
Benefits of breast feeding for mom
Helps uterine involution, delays return of normal ovulation, decreases risk of ovarian/breast cancer, burns calories
Disadvantages of breastfeeding
Nipple tenderness, leaking milk, stress, unequal feeding responsibility for parents, diet restriction, limited hormonal birth control, vaginal dryness
Who should not breast feed?
Mothers with HIV, AIDS, alcoholics, mothers who use drugs, chemotherapy, active herpes on breast, active varicella, active tb, and mothers who have galactosemia
What makes the muscle cells of the breast contract and release milk?
Oxytocin
What makes milk-secreting cells secrete and produce milk?
Prolactin
When does milk production begin?
48-72 hours after delivery
What stimulates milk production initially?
Decrease in estrogen/progesterone following the birth of the baby
What happens in lactogenesis-1?
Colostrum is produced
What is produced in lactogenesis-2?
Transitional milk is produced
What is produced in lactogenesis-3 and when does this happen?
Mature milk is produced by 10-14 days
What is foremilk?
Thirst-quenching milk in the beginning of feeding
What is hindmilk?
Higher fat concentration milk that provides the main source of energy for the infant and is produced at the end of a feed
When does engorgement happen?
3-5 days postpartum during lactogenesis-2
How can engorgement be relieved?
Frequent nursing, warm shower before nursing, a supportive nursing bra, cold cabbage leaves / cold packs
How many feedings should an infant have per day? How long should each of these feedings be?
8-12 times a day for around 10-20 minutes per feeding
How many wet diapers should an infant have daily? By what day should this be seen?
6-8 wet diapers daily by day 6
How many stools should an infant produce daily? By when?
4-8 stools daily by day 4
How much weight should an infant be gaining weekly?
4-7 ounces
When is the “golden hour” for breastfeeding?
Immediately after birth
How often should an infant be breast fed/formula fed?
Breastfed: every 2-3 hours
Formula fed: every 3-4 hours
When should thawed breast milk be used?
Within 24 hours
4 main breast feeding positions
Cradle, cross-cradle, lying down, football
What are some maternal complications of pregnancy?
History of breast surgery, flat or inverted nipples, poor latch, nipple trauma with pain or cracked nipples, engorged breasts, plugged ducts,mastitis,complications from newborn issues
Newborn breastfeeding issues
Sleepy!!, jaundice, premature/late preterm infants,congenital defects, ankyloglossia (tongue tie)
What can nipple shells be used for?
Flat or inverted nipples and sore or cracked nipples
What can a nipple shield be used for?
Flat or inverted nipples, sore or cracked nipples
What is the downside of using a nipple shield?
Too much let-down & too much milk flow
What percentage of a dose of medication given to the mother will transfer to the breast milk?
Generally <1%
can drugs be taken while breastfeeding?
Yes, many drugs can be taken safely while breastfeeding
What are some breastfeeding resources?
Nursery and postpartum nurses, lactation consultants, La leche league,local breastfeeding and motherhood resources handout, WHO, CDC, baby friendly USA website
What is the ideal nipple shape for breastfeeding?
Everted nipples
Should breastfeeding mothers wash their nipples daily with soap and water?
No
How is risk of Alzheimer’s linked to breastfeeding?
Breast feeding may lower Alzheimer’s risk for mothers
What is a big indication of dehydration in newborns?
Dry mucous membranes and soft fontanelles that can be inverted
Why does an infant become hungry so quickly?
Gastric size is very small (around 6mL/kg)
What is a late hunger cue?
Crying
Normal blood sugar for newborns is (higher/lower) than blood sugar of adults?
Lower
Why is cow’s milk not ideal for babies?
It has too much protein, the protein is difficult to break down, and the electrolytes are not balanced for humans
Why is soy based formula not ideal?
Soy is not a complete protein
What kind of formula is most common?
Elemental
What is the best type of water to mix in with formula?
Bottled water
How should a bottle be held to feed a baby? why?
Nipple should be completely filled with milk in order to decrease amount of air that the baby is swallowing
What is gastroesophageal reflux?
Spitting up
If a baby is spitting up ______ tablespoons, the provider should be contacted
2-3
How many ounces of juice should a baby be given in a day?
No more than 4 ounces
How many hours should a mom wait to breast feed per alcoholic beverage?
2 hours
Which hormone is responsible for the milk ejection reflex?
Oxytocin
When do babies have growth spurts?
2,4, 6 weeks and 3 months
Why does jaundice occur?
Excess of bilirubin present
common cause of mastitis
Cracked nipples
What can be used to treat cracked nipples?
Lanolin
What forms of supplemental feeding can be used when breastfeeding is not working?
Spoons, cups, syringes ⇒ keeps baby from getting used to a bottle
