Newborn Nutrition Flashcards
1
Q
Current recommendations for infant feeding?
A
- American Academy of Pediatrics: mothers breastfeed their infants for 2 years, or as long as mutually desired by mother and infant.
- World Health Organization: infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to two years of age or beyond.
- American Dietetic Association: breastfeeding exclusively for the first six months of life, continuing in conjunction with other food at least until the newborn’s first birthday.
2
Q
Benefits of breastfeeding for the mother?
A
- Rapid uterine involution
- Early return to pre-pregnancy weight (additional 250-500 calorie expenditure)
- Decreased risk of ovarian cancer
- Decreased risk of breast cancer
- Decreased risk of type II diabetes
- Increased bone density
3
Q
Benefits of breastfeeding for the baby?
A
- Decreased incidence of many infectious diseases including:
- Bacteremia
- Diarrhea
- Respiratory infections
- Necrotizing enterocolitis
- Middle ear infections
- Urinary tract infections
- 21% lower post-neonatal infant mortality rate in U.S.
- Provides pain relief for infants during or after procedures
- Higher IQ scores
- Decreases length of hospitalization time for preterm infants
4
Q
What do infants need for proper nutrition?
A
- Fluids
- Infants can become dehydrated quickly
- Energy
- Carbohydrates
- First 6 months of life need 60 g/day and the second 6 months need 95 g/day
- Fat
- Major energy source for infants, 50% of the calories in breastmilk and formula
- Protein
- Vitamins
- With the exception of vitamin D, human milk contains all of the vitamins required for infant nutrition
- Minerals
5
Q
Describe anatomical aspects of human lactation.
A
- Alveoli: grapelike clusters of milk-producing cells
- Milk Ducts: intricate system of ducts that transport milk from alveoli to the nipple
- Nipple: delivery system for milk
- Areola: dark circle that surrounds the nipple
- Montgomery Glands: secrete a lubricating and sterilizing substance onto the areola and nipple
6
Q
What are the hormones used in lactation?
A
- Prolactin: triggers synthesis and secretion of colostrum and milk
- Oxytocin: triggers milk ejection from alveoli to nipple (let down)
7
Q
Describe Lactogenesis Stage I.
A
- 16-18 weeks gestation
- Colostrum production begins
- Immunoglobulins: IgA (main one), IgM, IgG, IgD, IgE
8
Q
Describe Lactogenesis Stage II.
A
- After delivery of placenta
- Colostrum rich in antibodies, very concentrated
- High in protein
- ”Milk comes in” around day 3 postpartum
- Transitional milk introduces Lactobacillus bifidus flora to infant intestinal tract
9
Q
Describe Lactogenesis Stage III.
A
- 10-14 days after delivery
- Mature milk higher in fat
- Production responds to growth spurts
- Promotes colonization of infant’s microbiome
10
Q
What are the different types of human milk?
A
- Colostrum, a clear, yellowish fluid (day 1 to 3)
- More concentrated than mature milk
- Extremely rich in immunoglobulins
- Higher concentration of protein and minerals
- Less fat than mature milk
- Mature Milk-Composition changes during each feeding
- Lower fat “foremilk” changes to higher fat “hindmilk”
11
Q
Newborn hunger cues?
A
- Hand-to-mouth or hand-to-hand movements
- Sucking, mouthing motions
- Rooting reflex—infant moves toward whatever touches the area around the mouth and attempts to suck
- Crying is a late hunger cue
12
Q
Indicators of effective breastfeeding?
A
- Most breastfed infants should have 3-4 stool diapers by 4th day of life
- Stool should no longer be meconium-like, but yellow in color
- Urine is pale yellow and not concentrated
- Infant seems content between feeds
- Infant gains weight
13
Q
Nursing care to promote successful breastfeeding?
A
- Newborn infants should breastfeed 8-12 times per day to establish a breastfeeding pattern and optimize the hormone levels.
- Most newborn infants feed on average 15-20 minutes each side.
- Encourage parent to offer both breasts at each feeding.
- Start feedings on the breast on which the infant completed the last feeding.
- Encourage parents to respond to hunger cues even if that means breastfeeding more frequently than every 2-3 hours!
14
Q
Describe proper latch & positioning for breastfeeding.
A
- Hand in “C-shape” or “U-shape”
- Express colostrum
- Infant should have wide-open mouth
- Point nipple toward infant’s nose to facilitate filling infant’s mouth with breast tissue
- Infant’s top and bottom lip should be “flanged outward”
- Infant’s mouth should cover or almost cover the entire areola
- Avoid letting the infant “hang” from the nipple
- Break suction by a clean, dry finger between the infant’s jaw to avoid “tugging” on the nipple
15
Q
What are the categories of the LATCH assessment?
A
- Latch
- Audible swallowing
- Type of nipple
- Comfort of nipple
- Hold (positioning)
