NEWBORN NUTRITION

Question 1

SIGNS OF DEHYDRATION

Answer 1

• DRY OR CHAPPED LIPS
• DRY ORAL CAVITY
• CONCENTRATED URINE
• NO URINE PRODUCTION
• DEPRESSED FONTANELLES
• SUCKEN EYES

*AGE 6 MONTHS OR LESS, INCREASED 
 FLUID REQUIREMENTS SHOULD BE MET 
 W/ADDITIONAL BREAST MILK OR FORMULA
 NOT WATER.  WATER IS NOT 
 RECOMMENDED UNTIL OLDER, CAN CAUSE
 HYPONATREMIA

Question 2

NUTRITIONAL ADVANTAGES OF BREASTFEEDING

Answer 2

*HUMAN BREAST MILK PROVIDES AN IDEAL
 BALANCE OF NUTRIENTS THAT ARE
 EFFICIENTLY ABSORBED
     *CONTAINS OVER 200 COMPONENTS
      *HIGH LACTOSE CONTENT
         - CONTRIBUTES TO BRAIN &CNS 
           DEVELOPMENT                     
          - INCREASE LEVELS OF ESTROGEN
           PRODUCED & PROGESTERONE LEVEL
           INCREASE

Question 3

STAGES OF MILK

Answer 3

*COLOSTRUM
-THE INITIAL MILK THAT BEGINS TO BE
SECRETED DURING MID PREGNANCY
AND IS IMMEDIATELY AVAIL TO BABY
AT BIRTH
*TRADITIONAL MILK: 36-92 HRS AFTER BIRTH
*MATURE MILK: PRESENT 2 WKS POSTPART

Question 4

BENEFITS OF BREASTFEEDING

Answer 4

• INFANT; REDUCE THE RISK OF:
  
  • TYPE 1 & 2 DIABETES
  • LYMPHOMA, LEUKEMIA, HODGKINS
  • OBESITY
  • HYPERCHOLESTEROLEMIA
  • ASTHMA
• MOTHER: REDUCED RISK OF:
  
  • BREAST CANCER
  • OVARIAN CANCER

Question 5

IMMUNOLOGIC ADVANTAGES

Answer 5

• PROTECTION FROM:
  
  • RESP TRACT AND GI TRACT INFECTIONS
  • NECROTIZING ENTEROCOLITIS
  • UTI
  • OTITIS MEDIA
  • BACTERIAL MENINGITIS
  • BACTERMIA
  • ALLERGIES
• SECRETORY IgA:
  
  • ANTIVIRAL
  • ANTIBACTERIAL
  • ANTIGENIC-INHIBITING

Question 6

PSYCHOSOCIAL ADVANTAGES

Answer 6

*INCREASE SELF ESTEEM
*ENHANCED BONDING
*DECREASED STRESS FOR MOM AND INFANT
*COMMUNICATES WARMTH, CLOSENESS &
COMFORT
*HELPS LEARN BEHAVIORAL CUES

Question 7

DISADVANTAGES OF BREASTFEEDING

Answer 7

*PAIN DUE TO NIPPLE TENDERNESS
*LEAKING MILK WHEN BREAST ARE FULL
*EMBARRASSMENT ABOUT BREASTFEEDING
*FEELING TIED DOWN TO THE DEMANDS OF
BREASTFEEDING
*UNEQUAL FEEDING RESPONSIBILITIES/DADS
LEFT OUT
*WATCH MED USE

Question 8

BREASTFEEDING CONTRADICTIONS

Answer 8

*MATERNAL INFECTIONS
*HIV
*TB
*HERPES
*OTHERS
MATERNAL HABITS
*ILLICIT DRUGS
*SMOKING
*PRESCRIPTION MEDS

Question 9

ASSESSMENT

Answer 9

*READINESS TO FEED - BOTTLE FED FIRST
 FEEDING BY 5 HRS
*ACTIVE BOWEL SOUNDS
*ABSENCE OF ABDOMINAL DISTENTION
*LUSTY CRY THAT QUIETS AND IS REPLACED
 W/ROOTING & SUCKING WHEN A STIMULUS
 IS PLACED NEAR THE LIPS

Question 10

EARLY FEEDINGS

Answer 10

*SKIN TO SKIN CONTACT CAN BEGIN 
 IMMEDIATELY AFTER BIRTH
*BREASTFEEDING CAN BEGIN IN THE 
 BIRTHING ROOM
*FORMULA FED BABIES ARE FED ACCORDING
 TO HOSPITAL POLICY & WHEN THE
 DEMONSTRATE FEEDING CUES

Question 11

FEEDING PATTERNS

Answer 11

*ON DEMAND FEEDING
*TECHNIQUES TO WAKE A SLEEPY BABY TO
FEED - UNBUNDLE BABY
*FEEDING PATTERN MAY CHANGE WHEN MOM
BREASTS BECOME FULLER
-1.5 - 3 HRS AROUND THE CLOCK
*WATCH FOR SLEEPY BABIES-AT RISK FOR
LOSING WEIGHT, DEHYDRATION
EXAGGERATED JAUNDICE

Question 12

BREASTFEED POSITIONS

Answer 12

*MODIFIED CRADLE POSITION
*CRADLE POSITION
*FOOTBALL HOLD POSITION
*SIDE-LYING POSITION
*DIFFERENT POSITIONS SHOULD BE
ENCOURAGED FOR 2ND BREAST

Question 13

FEEDING PATTERNS

Answer 13

*FORMULA-FED INFANTS GENERALLY FEED
 EVERY 3-4 HRS
*SATIETY BEHAVIORS
   -LONGER PAUSES
   -BODY RELAXATION
   -FALLING ASLEEP
*BREASTFED BABIES THAT DEMONSTRATE
 FEEDING CUES SHOULD BE OFFERED A
 BREAST
*TAKING HOLD PHASE - MOTHER OVERWHELM
 W/INFO. MAY NEED TO REPEAT TEACHING

Question 14

LATCHING ON

Answer 14

*INFANT NEEDS TO ATTACH LIPS TO AREOLA,
 NOT NIPPLE
*QUICKLY AND GENTLY DRAW BABY IN
*OBSERVE INFANT FOR SUCKING, MOVEMENT
 OF TEMPOROMANDIBULAR JOINTS AND
 SWALLOWING
*PROVIDES TEACHING OPPORTUNITY
*NURSE MUST ASSESS MOM'S INTERACTION
 AND TEACHING IMPORTANT/ASSESSMENT
*APPROX 20 MIN ON THE FIRST BREAST

Question 15

CULTURAL INFLUENCES

Answer 15

*SOME MOMS BELIEVE GETTING ANGRY WILL
 SPOIL THEIR MILK
*DISAPPROVAL OF BREASTFEEDING IN PUBLIC
*BELIEF THAT COLOSTRUM IS UNCLEAN
   -COLOSTRUM SUBSTITUTES MAY NOT BE
    HEALTHY
*HOW LONG A MOM BREASTFEEDS HER 
 INFANT (1-4 YEARS)
*ONLY INTERVENE IF PRACTICE IS HARMFUL

Question 16

BREASTFEEDING INPUT AND OUTPUT EXPECTATIONS

Answer 16

*INFANTS SHOULD BREASTFEED 8-12 X/DAY &
 SHOULD APPEAR RELAXED AFTER FEEDING
*COLOSTRUM IS ALL THE BABY NEEDS IN THE
 FIRST FEW DAYS IF LIFE
*IT IS NORMAL FOR AN INFANT TO LOSE UP TO 
 7% OF BIRTH RATE IN THE FIRST FEW DAYS; 
 CAN LOSE UP TO 10% IF MOMS BREAST ARE
 FULL, THE INFANT IS OBSERVED TO BREAST-
 FEED WELL, AND THE INFANT IS DEHYDRATED
*INFANTS SHOULD GAIN 10 GM/DAY IF MOMS
 MILK SUPPLY IS ABUNDANT (ABOUT DAY 4 OF
 LIFE)
*INFANTS SHOULD BE BACK UP TO THEIR
 BIRTH WTS BY 2 WKS OF AGE
*INFANTS STOOL SHOULD CHANGE IN COLOR,
 CONSISTENCY & FREQUENCY DURING THE
 FIRST FEW DAYS OF LIFE.  

MAXIMUM OUTPUT
DAY 1:  1 WET DIAPER
             1 MECONIUM STOOL(24 HRS)
DAY 2:    2 WET DIAPERS
               2 EARLY TRANSITIONAL STOOL 
                (24 HRS PERIOD BY 72 HRS AGE)
DAY 3:   3 WET DIAPERS
              3 TRANSITIONAL STOOL
DAY 4:    4 WET DIAPERS
               3-4 YELLOW-GREEN STOOL
DAY 5:    5 WET DIAPERS
               3-4 YELLOW MILK STOOLS

Question 17

BOTTLE FEEDING

Answer 17

• TEACHING OPPORTUNITIES
• FEEDING PATTERNS
• SYMPTOMS OF FORMULA INTOLERANCE
• I&O EXPECTATIONS
• HOW TO PREPARE AND STORE FORMULA
• FEEDING TECHNIQUES
• SAFETY AND SANITARY PRECAUTIONS
• KINDS OF BOTTLE AND NIPPLES
• BURPING
• NEVER PROP BOTTLES
• WARM WEATHER - CONTAMINATION