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NUR 102 OB Assessment #1 > Newborn Feeding > Flashcards

Newborn Feeding Flashcards

1
Q

Nutritional Needs of the Newborn

Calories

___ kcal/kg of body weight daily

Weight Loss

Infants may lose up to ___% of their body weight in first few days

A

108

10%

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2
Q

Nutritional Needs of the Newborn cont’d

Nutrients

* Carbohydrates, proteins, & fats are provided in breastmilk or formula

> Breastfed infants may need Vitamin D supplementation

Fluid Intake

___ mL/kg of fluid per day

A

100

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3
Q

Breast Milk Composition

Lactogenesis Stages I, II, & III

Colostrum

Transitional Milk

Mature Milk

A
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4
Q

Breast Milk Composition - ?

Can have a bluish color; rx’s & illness can also affect color

Contains 20 kcal/oz & sufficient nutrients to maintain infant needs

A

Mature Milk

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5
Q

Breast Milk Composition - ?

Immunoglobulins & proteins start to decrease

Lactose, fats, & calories start to increase

A

Transitional Milk

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6
Q

?

A thick, yellow milk

Contains higher levels of protein, vitamins, & minerals

Lower in carbohydrates, fat, & lactose

Rich in immunoglobulins

A

Colostrum

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7
Q

Breast Milk Composition

Nutrients

* Proteins (amino acids, casein, whey)

* Carbohydrates (lactose)

* Fats (mostly in ___ ?)

* Vitamins (A, E, and C high)

* Minerals (iron; which is absorbed better than the iron in formula [that is iron-fortified]

A

hindmilk

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8
Q

Breast Milk Composition cont’d

Enzymes

* Pancreatic amylase (helps to break down foods in the GI system)

Infection-Preventing Components

* Immunoglobulins, secretory IgA

  • Vitamin D is low in breastmilk
  • If the mother is vegan, may need Vitamin B12 supplement
A

Infant Formulas

Variety of formulas available, varying in price & ingredients

* Modified cow’s milk formulas (unmodified can cause anemia & GI bleeding in infant)

* Soy formulas

* Protein hydrolysate formulas

* Amino acid formulas

* Lactose-free formulas

* Low Phenylamine formulas

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9
Q

The American Academy of Pediatrics (AAP) recommends infants receive only breastmilk for the first ___ months of life, and breastfeeding should continue at least ___ months w/the addition of complimentary foods

A

6

12

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10
Q

Benefits of Breastfeeding - For the Infant

* Less likely to develop allergies

* Prevents infection - provides immunoglobulins

* Decreased incidence of SIDS & chronic illnesses like asthma & diabetes

* Composed to meet infant-specific needs

* Nutritional & immunologic properties change according to infant needs

* Less likely to result in overfeeding & to develop constipation

* Unlikely to be contaminated

A

Benefits of Breastfeeding - For the Mother

* Oxytocin release enhances uterine involution

* Less blood clots, delayed return of menses

* Delays ovulation

* Reduces the risk of certain cancers

* Able to rest during feedings

* Encourages balanced diet which improves healing

* Frequent skin-to-skin enhances bonding

* Convenient & economical

* Working mothers miss less time to care for sick infants

* Makes travel easier

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11
Q

Reasons for Formula Feeding

* Embarrassed by breastfeeding

* Dislike the thought & the sensation

* Minimal experience w/ relatives/friends who breastfed

* Lack of support for breastfeeding

* Want partner to be able to help w/feedings

* Maternal rx’s that cross into the breastmilk

A

Factors Influencing Feeding Choice

* Support from others

* Culture

* Employment (the return to work)

* Staff knowledge

* Other factors (i.e. the woman’s knowledge, past experiences)

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12
Q

Normal Breastfeeding

* Breast changes during pregnancy

* Milk production

* Hormonal changes at birth

* Continued milk production (a supply-and-demand process)

* Preparing the breasts for breastfeeding

* Colostrum is present at ___ to ___ weeks of pregnancy

* Most of milk is made during suckling

A

12-16

* Prolactin levels are highest during suckling & during the night

* Oxytocin increases in response to nipple stimulation & this causes the milk ejection reflex

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13
Q

Breast Assessment

Breast

* Soft, filling, engorged

Nipples

* Red, bruised, blistered

* Fissured, bleeding, tender

A

Hunger Cues in the Infant

* Licking or sucking movements

* Lip smacking

* Rooting (turning head)

* Hand-to-mouth movements

* Sucking on hands

* Increased activity

* Crying (late sign)

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14
Q

Latch Score

L = ?

A = ?

T = ?

C = ?

H = ?

A score of 7 or higher is good; less than a 7 indicates assistance needed

A

L = Latch

A = Audible swallowing

T = Type of nipple

C = Comfort

H = Hold

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15
Q

Nursing Actions to Assist with Breastfeeding

* Initiate breastfeeding within the 1st hour after birth (if able)

* Assist the mother w/positioning herself & the infant

* Elicit latch-on from the infant

* Supervise 1st few feeds to assess latch & provide feedback

* Provide reassurance

* Teach how to properly unlatch the infant

A

* Educate the family on feeding frequency & expected length of feedings

* Breastmilk travels through the stomach twice as fast as formula

* Infant wakes every 2-3 hours for feeding; would have to wake them up

* Alternate breast used at each feeding

* Nutritive vs non-nutritive suckling

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16
Q

Breastfeeding Positions

Cradle / Cross-cradle / Football / Laid back / Side-lying

A

Foremilk vs Hindmilk

* Hindmilk has more fat & calories to help the infant gain weight

17
Q

Your baby is probably getting enough milk if:

* You hear the baby swallow frequently during feedings

* You see nutritive suckling

* Your breasts get softer during the feeding

* You see milk in the infant’s mouth or dripping from the breast

* You feed your baby 8-12 times every 24 hours

A

! Your baby is producing enough wet & dirty diapers

* Your baby seems satisfied & relaxed after feedings

* Your baby is gaining weight @ well-checks

18
Q

Common Breastfeeding Concerns: Infant

* Sleepy infant (difficulty in maneuvering breast vs bottle)

* Nipple confusion (pacifiers prevent SIDS but are discouraged in 1st 3-4 weeks of life while lactation established)

* Latch-on problems (dimpling of cheeks; compress on areola)

* Infant complications (jaundice; bili lights)

* Illness & congenital defects (i.e. cleft lip/palate)

A

* Poor feeding can be an early sign of illness

* Late preterm infants look full-term but have a lot of similarities to premature infants

* Poor coordination of suck, swallow, breathe

* Get sleepier @ breast

* Are at the greatest risk for poor feeding & hospital readmission for failure-to-thrive

19
Q

Common Breastfeeding Concerns: Maternal

Engorgement / nipple pain (mastitis) / flat/inverted nipples (nipple roll)

Plugged ducts (massage, apply heat) / Illness (use breast pump) / Medication transfer (antihistamines can interfere w/milk production; NO breastfeeding if undergoing chemotherapy)

A

Previous breast surgery / employment / milk expression & storage / home care (support services)

Breastfeeding of multiples / weaning (if weaned, <12 months give pumped breast milk or iron-fortified infant formula only)

Don’t introduce regular milk, cow’s milk, soy milk, or similars until >12 months

20
Q

Breastmilk Storage

* Fresh, unrefrigerated breast milk should be used within 1 hour

* Breast milk may be kept in a refrigerator up to 48 hours

* If freezing, place in freezer within 24 hours

> Regular freezer for 1 month

> Deep freezer for 6 months

> Thaw frozen milk in the refrigerator or by running under water

A

! Any milk not used should be discarded

* New milk should NOT be added to containers of prior pumped milk

* NEVER warm breastmilk (or formula) in a microwave (as it could cause infant burns)

21
Q

Formula Feeding

* Assess prior knowledge of formula feeding

* Teach about the different types & preparations of formula (ready-to-use does not get diluted)

* Teach correct preparation techniques of formula

* Explain feeding techniques for bottle feeding (BPA-free; semi-upright position; burp > every 1/2 oz)

* Caution on common errors associated w/bottle feeding

A

! Open formula cans are to be used within 48 hours

* Powder formula NEW formula every feeding

* Concentrated liquids get diluted

NUR 102 OB Assessment #1 (11 decks)

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