Normal feeding in infants and neonates

Question 1

posterior pituitary

Answer 1

oxytocin - smooth muscle contraction

Question 2

anterior pituitary

Answer 2

prolactin - milk secretion

Question 3

Good attachment

Answer 3

more areola visible above than below lower lip
mouth wide open
lower lip curled outwards
chin touching or almost touching breast

Question 4

Poor attachment results in

Answer 4

engorged breasts = mastitis
poor intake with dehydration/ poor weight gain
frustrated baby refuses feed - fussy

Question 5

How does hospital become baby-friendly

Answer 5

10 steps successful breastfeeding

• written BF policy
• training health care to implement policy
• inform pregnant about BF
• initiate BF within 1 hour after birth
• help mothers BF
• no other fluids apart for BF
• practise rooming-in
• encourage BF on demand
• no artificial teeth or dummies
• BF support groups

Question 6

How does human milk differ from formula

Answer 6

long chain polyunsaturated fatty acids - neurological development (added in 2000’s)
whey>casein (in formula casein > whey)
BM - low vit D
BM - anti-infective and bioactive peptides

Question 7

Unique factors that positively affect

Answer 7

Nutritional status and somatic growth - amylase, insulin, lactoferrin, lipase

Neurodevelopment - choline, LCPUFA, oligosaccharides,

Anti-infective or Immunological properties - IgG, lactoferrin, lipase, lysozyme, macrophage colony stimulating factor, oligosaccharides, polysaccharides, secretory IgA

Question 8

Energy provided by breastmilk after 6m

Answer 8

6m-1year = provides 1/2 energy needs
1-2years = provides 1/3 energy needs 

6-8m = 200kcal in addition to BM 
9-11m = 330kcal in addition to BM 
12-23m = 550kcal in addition to BM

Question 9

Infant conditions in which baby cannot receive BM

Answer 9

galactosaemia
phenylketonuria
maple syrup urine disease
infants who receive BM but need additional food for short period time - VLBW, preterm, at risk hypoglycaemia