Lecture 6 Newborn nutrition

Question 1

Current guidelines state that a newborn should receive exclusive breastfeeding for the first _, at which time _ should be introduced with continued breastfeeding.

Answer 1

6 months; complementary foods. [Breastfeeding continues until 18 months-2 years of age, or longer as desired by the infant and mother.]

Question 2

Production of colostrum (prepartum milk) occurs in the _ around the _ week of pregnancy.

Answer 2

Alveoli; 16th week.

Question 3

Prolactin

Answer 3

Prepares the breasts to secrete milk; released by the anterior pituitary in response to a drop in progesterone after the woman gives birth; levels are highest during the first 10 days after birth, but remain elevated for as long as the woman is lactating.

Question 4

Oxytocin

Answer 4

Released by the posterior pituitary in response to the stimulation of the nipple and produces the let-down reflex (milk ejection reflex); causes the myoepithelial cells to contract and send the milk forward.

Question 5

Hindmilk vs. foremilk

Answer 5

The foremilk has less fat and the hindmilk has more fat; therefore during a feeding more fat is delivered toward the end of the feeding. The hindmilk contains the denser calories from fat necessary for ensuring optimal growth and contentment between feedings.

Question 6

Rooting reflex

Answer 6

The infant moves toward whatever touches the area around the mouth and attempts to suck - a feeding-readiness cue.

Question 7

A breastfeeding mother requires an extra _ calories in her diet.

Answer 7

400-500.

Question 8

Lactogenesis stage I

Answer 8

Begins at 16-18 weeks gestation through day 1-2 after birth.
Breasts prepare for milk production and colostrum is present - rich in immunoglobulins, high in protein, low in fat, has laxative properties that facilitate passage of meconium.

Question 9

Lactogenesis stages II and III

Answer 9

Day 3-5 through day 10. Copious milk secretion which changes to mature milk.
Breasts often become engorged, referred to as milk “coming in”.
By Day 10, the woman produces “mature” milk which continues to change over months of breastfeeding.

Question 10

Hormones of breastfeeding

Answer 10

Prolactin (anterior pituitary) causes synthesis and secretion of milk; release is stimulated by the drop in estrogen and progesterone after birth.
Oxytocin (posterior pituitary) causes the let-down reflex which sends the milk forward; release is stimulated by infant suckling.

Question 11

Frequency of feedings

Answer 11

8 or more in 24 - every 2-3 hours (or 4 if the baby is sleeping).

Question 12

How does the mother know the baby is getting enough breast milk?

Answer 12

The infant has 6-8 wet diapers per day.

Question 13

LATCH score mnemonic

Answer 13

Latch
Audible swallowing
Type of nipple
Comfort (breast/nipples)
Hold (positioning)

Question 14

Infant growth spurts occur at _

Answer 14

10 days, 3 weeks, 6 weeks, 3 months, and 6 months.

Question 15

A new father is ready to take his wife and newborn son home. He proudly tells the nurse who is discharging them that within the next week he plans to start feeding the infant cereal between breastfeeding sessions. Which information should the nurse provide regarding this feeding plan?

Answer 15

“Feeding solid foods between breastfeeding sessions before your son is 4 to 6 months old will lead to an early cessation of breastfeeding.”

Question 16

How many kilocalories per kilogram (kcal/kg) of body weight does a breastfed term infant require each day?

Answer 16

95 to 110. [For the first 3 months, the infant needs 110 kcal/kg/day. At ages 3 to 6 months, the requirement is 100 kcal/kg/day. This level decreases slightly to 95 kcal/kg/day from 6 to 9 months and increases again to 100 kcal/kg/day until the baby reaches 12 months.]