Newborn Nutrition & Breastfeeding: 10 DONE

Question 1

Discuss current recommendations for infant feeding

How long should mother’s breastfeed?

For how long should the mother only breastfeed? and then what?

Answer 1

2 years, or as long as mutually desired by mother and infant

Breastfeeding ONLY for the first six months of life

Then breastfeeding and introducing foods at least until the newborn’s first birthday

Question 2

Discuss benefits of breastfeeding for Mother

Rapid?
Early return?
Decreased risk of?
Increased?

Answer 2

Rapid uterine involution (uterus getting back to original position)

Early return to pre-pregnancy weight (additional 250-500 calorie burn)

Decreased risk of ovarian cancer, breast cancer, and type II diabetes

Increased bone density

Question 3

Discuss benefits of breastfeeding for baby

Decreases?
lower?
provides?
Decreases?

Answer 3

Decreased incidence of many infectious diseases including:
* Bacteremia
* Diarrhea
* Respiratory infections
* Necrotizing enterocolitis
* Middle ear infections
* Urinary tract infections

lower post-neonatal infant mortality rate in U.S.

Provides pain relief for infants during or after procedures

Decreases length of hospitalization time for preterm infants

Question 4

Describe nutritional needs of the infant

7

Answer 4

Fats (50% of cals in formula and breastmilk)
Fluids
Carbohydrates
Minerals
Energy
Protein
Vitamins (human milk doesnt have D)

Question 5

Lactogenesis Stage 1

When?
What begins?
Which immunoglobulin?

Answer 5

16-18 weeks gestation

Colostrum production begins

Immunoglobulins: IgA (main one),

Question 6

Lactogenesis Stage 2

When?
How is colostrum?
High in?
Introduces?

Answer 6

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

Question 7

Lactogenesis Stage 3

When?

Answer 7

10-14 days after delivery

Mature milk higher in fat

Production responds to growth spurts

Promotes colonization of infant’s microbiome

Question 8

Recognize newborn feeding cues

3
late hunger cue?

Answer 8

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

Question 9

Explain infant indicators of effective breastfeeding

1. Most breastfed infants should have?
2. Stool should no longer?
3. Infant seems?
4. Infant?
5. Urine is?

Answer 9

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.

Infant seems content between feeds

Infant gains weight

Urine is pale yellow and not concentrated

Question 10

Describe nursing care to promote successful breastfeeding

Latch and positioning

Answer 10

Express colostrum

Support breast:
-Hand in “C-shape” or “U-shape”
-Nipple sandwich

Wait for open mouth

Question 11

LATCH acronym?

Answer 11

Latch: grasps nipple, tongue down, rhythmic sucking

Audible swallowing

Type of nipple, inverted, flat, out

Comfort of nipple: cracked is bad, should be soft/non tender

Hold (positioning): no assistance needed by nurse

Question 12

Problems with breastfeeding

Engorgement (milk fills up)

How to empty for Breastfeeding mothers?

How to stop milk for non breastfeeding mothers?

Answer 12

Breastfeeding mothers
-Frequent feeding, warmth before feed, ice after feed, mild analgesia

Non-breastfeeding
-Well-fitted supportive bra, ice, cabbage leaves, mild analgesia, dont stimulate milk production

Question 13

Sore nipples

Assess what?

Answer 13

Flat? Inverted? Cracks? Soreness? Blisters? Bleeding?

Assess and correct latch
Proper feeding position

Treatments
-Colostrum or Lansinoh/nipple butter
-Hydrogel pads
-Breast shells
-Lactation Consultant

Question 14

Plugged milk ducts (blocked)

Mom will be?
how does it look?
How does it feel?
Caused by?
What can u do?

Answer 14

Mom is afebrile (without fever)

One area swollen and tender, may have some localized redness

May feel hard, small pea-like lump

Caused by tight clothing or some kind of pressure on breast

Warm compress, frequent feeding, massage

Question 15

Mastitis

What is it?
Symptoms?
what kind of pain?
What to do?
Encourage?

Answer 15

inflammation of breast can be caused by infection

Flu-like symptoms

Breast pain, tenderness, reddened area, fever

Antibiotics, rest, warm compress, adequate fluid and nutrition

Breastfeeding and/or pumping to encourage emptying of that side

Question 16

Describe patient teaching for the formula fed infant

Educate parents on?
Feed every?
Never?
Washing bottles?
What supplement may be needed if bottle feeding?

Answer 16

Educate parents on preparation (Ready to feed, concentrated, powder)

Feed every 3-4 hours initially

Never prop a bottle, always hold

Nipple flow, slow-flow in newborn stage

Burping techniques

Washing bottles
-Sterilize prior to use, then use hot soapy water and bottle brush

Vitamin D supplementation may be needed if combo feeding
(formula and human milk)