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OB/Community Health > Newborn Nutrition > Flashcards

Newborn Nutrition Flashcards

1
Q

What is breastfeeding ?

A

transfer of human milk from mother to the infant directly from the mother’s breast

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2
Q

What is exclusive breastfeeding ?

A

infant receives no other liquid or solid food

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3
Q

What is human milk feeding ?

A

infant fed expressed breast milk from the mother or donor milk bank

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4
Q

What is formula-fed

A

infant fed commercially-made alternative to breastmilk

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5
Q

What is complimentary foods ?

A

nutrient-dense foods that are semi-solid, mashed, or pureed

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6
Q

What does the American Academy of Pediatrics (AAP) recommend ?

A
  • infants exclusively breastfed for first 6 months
  • continue for at least 12 months and beyond as desired
  • complimentary food introduced after 6 months
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7
Q

What does WHO recommend ?

A
  • exclusively breastfeed for first 6 months
  • continue until 2 years of age or beyond
  • complimentary foods beginning at 6 months
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8
Q

What are some newborn benefits of breastfeeding ?

A
  • decreased incidence of illness
  • decreased rates of infant mortality (SUIDS, DM, obesity, asthma)
  • analgesic effect
  • enhanced cognitive development
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9
Q

What are some mother benefits of breastfeeding ?

A
  • decreased postpartum bleeding
  • decreased rates of ovarian and breast cancer, HTN, heart disease, and osteoporosis
  • increase in “maternal role”
  • unique bonding experience
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10
Q

What are some society benefits to breastfeeding ?

A
  • less environmental waste
  • convenient and cost effective
  • less parental absence from work due to sick child
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11
Q

What are some contraindications to breastfeeding ?

A
  • newborns with galactosemia
  • HIV (different in some countries)
  • illicit drug use
  • ebola
    Temporary
  • meds
  • diagnostic imaging with radiopharmaceuticals
  • active HSV lesion on breast
    Expressed milk only
  • active TB
  • active varicella
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12
Q

What are some newborn nutrition needs ?

A
  • no supplemental H20
  • rapid growth and brain development in first 3 months = highest energy needs
  • high fat content needed for brain growth
  • all Vita and mineral provided (except Vita D in human milk) (breastfed infants will need supplemental Vita D)
  • full-term infants have enough iron stored for 1st 6 months of life, then can introduce iron-fortified cereals (iron-deficiency anemia more common in preterm infants)
  • cow’s milk lacks complete nutrition and is not as easily digested as human milk or formula (can introduce after 12 months)
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13
Q

What are some breast changes during pregnancy ?

A
  • estrogen, progesterone, human placental lactogen affect changes on breasts
  • increase in size d/t growth of glandular and adipose tissue
  • blood flow doubles
  • sensitivity increased
  • nipples and areola enlarge and darken
  • Montgomery glands (small goosebump-like glands on the areola)
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14
Q

How many stages of lactation are there ?

A

human milk composition and volume varies by stage of lactation
- 3 stages

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15
Q

What is the 1st stage of lactation ?

A

Lactogenesis Stage 1
- begins 16-18 weeks of pregnancy
- prepares colostrum
- “liquid gold”
- high concentration of protein and minerals, low in fat
- rich in immunoglobulins

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16
Q

What is the 2nd stage of lactation ?

A

begins at birth
- drop in estrogen and progesterone
- triggers release of prolactin from anterior pituitary gland

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17
Q

What is the 3rd stage of lactation ?

A
  • day 10 and beyond
  • supply meets demand
  • mature milk
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18
Q

How does a RN support prenatal education on breastfeeding ?

A
  • assess knowledge, provide info, help develop goals and plans
  • include significant other and family
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19
Q

How does a RN support breastfeeding info during admission ?

A
  • assess plans for breastfeeding and knowledge of benefits
  • review obstetric and medical history
  • physical exam of breasts and nipples
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20
Q

How does a RN support breastfeeding during delivery & postpartum ?

A
  • assist with feedings, assessing hold and latch
  • encouragement and promote confidence
  • lactation consultant
  • connect with community support (WIC, la leche league, hospital-based groups_
21
Q

When do you initiate breastfeeding ?

A

within 1 hr of birth
- Feeding readiness cues: hand-to-mouth, sucking motions, rooting reflex, mouthing, crying & deep sleep are late signs of hunger

22
Q

What are the different positions for breastfeeding ?

A
  • Football/clutch: recommended for early feedings & c/sections
  • cross-cradle: using opposite hand to support the newborn head
  • cradle: widely used after good breastfeeding habits established
  • side-lying: recommended for perineal pain or swelling
23
Q

What are the steps to latching baby for breastfeeding ?

A
  • 1st: mom will stimulate baby by rubbing nipple onto it’s mouth (use C-hold to support breast and this helps compress breast for milk expression)
  • 2nd: stimulate until baby opens mouth wide and tongue down
  • 3rd: quickly bring baby onto the breast and chin and cheeks should be touching breast (mouth should cover all of nipple and 2-3 cm of areola which creates seal for good suction)
  • 4th: break latch by inserting finger in side of baby’s mouth (pulling baby off can cause nipple trauma and pain)
24
Q

What are signs of a proper latch ?

A
  • feel tugging sensation but not pain
  • baby’s cheeks are rounded
  • baby’s jaw glides smoothly and silently with sucking
  • audible swallowing
25
Q

What is the let-down reflex ?

A

milk ejected that is stimulate when baby begins sucking onto nipple which causes release of oxytocin from posterior pituitary gland

26
Q

What are signs the let-down reflex is happening ?

A
  • tingling sensation in nipple and breast
  • slower, drawing sucking pattern
  • audible swallow
  • uterine cramping/increased lochia
  • mother feels relaxed or drowsy
  • opposite breast leaks
27
Q

What is the frequency of feedings ?

A
  • newborns feed 8-12x in 24 hrs or q2-3 hrs
  • good feeding time is 15-40 mins
  • newborns can be sleep first 24-48 hrs so need to arouse baby to feed
  • cluster feedings typically happen 2nd night and during growth spurts
  • demand feedings after breastfeeding established and gaining weight
28
Q

What are indicators of effective breastfeeding ?

A
  • feeding diary
  • 6-8 wet diapers q24 hrs after day 4
  • 3 BM q24 hrs after day 4
  • easily releases breast at end of feeding
  • infant is relaxed and content after feeding
29
Q

When are pacifiers okay to give to baby ?

A

after breastfeeding established (3-4 weeks) to decrease risk of SIDS

30
Q

What are some reasons for supplementation/pacifiers ?

A
  • weight loss > 8-10% of birth weight
  • hyperbilirubinemia
  • hypoglycemia
  • poor output
  • physician order
31
Q

Why would we not want to introduce pacifiers ?

A

can cause nipple confusion
- first choice expressed breast milk

32
Q

What are some special considerations for supplementation ?

A
  • sleepy baby
  • fussy baby
  • slow weight gain
  • jaundice
  • preterm infants
  • multiples
33
Q

What are some reasons for expressive and storing breast milk ?

A
  • maternal/infant separation (NICU)
  • engorgement
  • emergency supply
  • exclusive pumping
  • meds “pump and dump”
34
Q

What are the storage requirements for breastmilk ?

A
  • room temp: 3-4 hrs
  • refrigerated: 72 hr
  • frozen: 6 months
35
Q

How much formula should a infant consume ?

A

15-30 mL (0.5-1oz) with each feeding

36
Q

How often does an infant need to be fed formula ?

A

q3-4 hrs or 6-8x in 24 hrs
- might need to be awakened to feed
- held snuggle, in semi-upright position with good head and neck support

37
Q

What are signs of overfeeding ?

A
  • infant falling asleep
  • turning head
  • cessation of sucking
38
Q

How should bottles be cleaned ?

A
  • warm, soapy water
  • boiled for 5 mins after every use or put in dishwasher to sanitize
39
Q

Why we do burp infants ?

A

to prevent regurgitation and emesis
- do halfway through and at end of feeding

40
Q

What is cow milk based formula used for ?

A

most widely used

41
Q

What is soy based milk formula used for ?

A

used for lactose or cow milk protein intolerance

42
Q

What is casein or whey based formula used for ?

A

used if intolerant to cow’s milk and soy formula

43
Q

What is amino based formula used for ?

A

used for intolerance to multiple food proteins ?

44
Q

What are the different types of formula ?

A
  • concentrated
  • powder
  • ready-to-feed
45
Q

What is concentrated formula ?

A
  • diluted with equal parts water and mixed
  • use within 48 hrs (refrigerated)
46
Q

What is powder formula ?

A
  • least expensive, mixed with water
  • 1 scoop per 60mL water
47
Q

What is ready-to-use formula ?

A
  • most expensive
  • used directly from packaging
  • once opened, use within 48 hrs (1 hr if individual bottle)
48
Q

How do you heat refrigerated formula ?

A

in pan of warm water
- never use microwave
- do not save leftovers
- discard after 1 hr

OB/Community Health (12 decks)

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