Pregnancy, Lactation, Infants Flashcards
0
Q
Pica
A
Craving/eating something normally not considered food
1
Q
Problems that can occur in pregnancy
A
1) taste and smell change
2) nausea/vomiting
3) heartburn
4) constipation/hemorrhoids
5) taking herbs
6) vegetarian/vegan
7) food safety
2
Q
Pagophagia
A
Craving ice, used to be freezer ice
3
Q
Geophagia
A
Eating dirt, almost always clay
4
Q
Amylophagia
A
Eating laundry starch
5
Q
Tricophagia
A
Eating string and hair
6
Q
Two deficiencies common in people with pica
A
Iron and zinc
7
Q
Ways to help with nausea and vomiting
A
1) separate solids and liquids
2) have dry foods near bed and eat before getting up
3) small frequent meals
4) separate odors from food - leave during cooking, chill meals
5) if from supplements try a different brand
8
Q
Drugs that can help with nausea
A
1) Vitamin B6 - 10-25 mg every 8 hrs
2) Ginger - 1 g/day for 4 days
3) multivitamin mineral tablets if were taking prior to pregnancy
4) diclectin - prescription drug
9
Q
Ways to help with heartburn
A
Less caffeine Don't lay down after eating Sleep at an angle Avoid spicy foods Don't eat too much at one time Wear loose clothing Don't go to bed on a full stomach
10
Q
Why heartburn during pregnancy
A
GI tract relaxes to absorb more nutrients and sphincters also relax allowing reflux
11
Q
What meds can dietitians recommend for heartburn
A
Only TUMS - patient needs to see MD for anything else
12
Q
Why constipation during pregnancy
A
Because GI tract relaxes
13
Q
Things to help with constipation
A
Fiber
Fluids
Exercise
14
Q
What is ok for dietitian to recommend for constipation
A
Only Metamucil - no drugs - need to talk to MD for drugs
15
Q
How to avoid hemhorroids
A
Avoid constipation
16
Q
When is an herb considered a drug
A
If it has an effect - must talk to an MD
17
Q
Problems vegetarians/vegans can have during pregnancy
A
Low iron
18
Q
Why is food safety important during pregnancy
A
Because immune system is decreased
19
Q
Two bacteria of concern during pregnancy
A
1) Listeria monocytopenes - will cross placenta and cause birth defects - 25% of people have the antibody - comes from delis (slicer) and recommendation is to cook deli meat
2) toxoplasma gondii - from cat box, undercooked meat, unwashed fruits/veggies - causes blindness, seizures and termination
20
Q
Listeria Monocytogenes
A
Bacteria of concern during pregnancy - 25% of people have the antibodies (ie, have been exposed)
Effects: crosses placenta and can cause birth defects and can cause termination
Causes: deli meats (contaminated slicer) , raw/undercooked eggs, raw meat, unpasteurized milk, soft cheeses (Brie, quest fresco) unless made with pasteurized milk
21
Q
Toxoplasma gondii
A
Bacteria of concern during pregnancy
Effects: mental retardation, blindness, seizures, termination of pregnancy
Causes: cat litter box, undercooked meats, unwashed fruits/vegetables
22
Q
Shoulder dystocia
A
Medical emergency that is often a complication of LGA babies
Head comes out but shoulder gets stuck, umbilical cord can get cut off
23
Q
Placenta abruption (abruptivo placentae)
A
Placenta tears away from the uterus and causes mom to hemhorrage - can see bleeding or not - blood can pool behind the uterus
If placenta tears away prematurely and greatly mom can die and nutrients, oxygen can be restricted to the baby
24
Exercise during pregnancy recommendation
30 min/day
25
Benefits of exercise during pregnancy
- reduce constipation
- reduce backaches
- reduce bloating
- sleep better
- decrease risk of gestational diabetes
- better mood/positive outlook
- better able to cope with labor
- get back in shape easier
26
Conditions effecting pregnancy
Obesity
Bariatric surgery
Hypertensive disorders
Diabetes
27
Obesity during pregnancy
- weight loss not recommended during pregnancy because it disproportionately affects baby
- higher risk of gestational diabetes, hypertensive disorders, LGA babies, baby growing to be obese
28
Bariatric surgery and pregnancy
- common to get pregnant after because physical and mental barriers removed
- causes enormous malabsorption of nutrients - need a good nutrition assessment and biomarkers
- advised to wait 1-2 yrs before getting pregnant after bariatric surgery
29
Hypertensive disorders of pregnancy
- is a major killer of women worldwide
1) chronic hypertension
2) gestational hypertension
3) preeclampsia
4) eclampsia
30
Chronic hypertension
When you come into pregnancy with HBP
- Definition - greater than or equal to 140 diastolic or 90 systolic
- Treatment - same as before pregnancy - would have sodium restriction
- would me more likely to have preeclampsia and eclampsia, also placenta abruptiva
31
Gestational hypertension
- definition - when you develop HBP in the second half of pregnancy (after 20 weeks)
- similar to preeclampsia/eclampsia but without protein in the urine
32
Preeclampsia 4 warning signs
Hypertension
Edema
Protein in urine
Insulin resistance
33
Effects of preeclampsia
- Coagulation problems - blood clotting everywhere (liver, brain)
- mom is more likely to have hypertension and diabetes later in life
34
Preeclampsia treatment
- No one knows cause - thought maybe placenta not embedded in uterine wall and body rejects
- only cure is to get rid of the placenta - deliver baby
- disease usually goes away as soon as baby is delivered
- restricting sodium does not work
- antioxidants, fish oils, folic acid have no effect
- calcium and vitamin D supplements help IF the mom is low helps
- using multivitamin before pregnancy helps
- evidence that diet high in plant food helps
35
Eclampsia
Development of preeclampsia into seizure and imminent death
36
Consequences of uncontrolled diabetes on pregnancy
Preeclampsia, stillbirth, baby grows up to have hypertension and diabetes
37
When pregnant women tested for diabetes
Beginning of pregnancy - checking for undiagnosed DM
At 24-28 weeks - checking for gestational diabetes with oral glucose tolerance test
38
How pregnant women can manage diabetes with diet
- low simple sugars
- low glycemic index foods
- carb counting (10-20% breakfast; 20-30% lunch; 30-40% dinner; 30% snack)
- calories for normal weight gain
39
Two types of twins
1) identical (monozygotic) - after fertilized the egg splits
| 2) fraternal (dizygotic) - two eggs released and both fertilized
40
Weight gain for twins
Normal weight - 37-54 lbs
Overweight - 31-50 lbs
Obese - 25-42 lbs
41
Research shows for multiples
- folic acid is important
- morning sickness increases
- time in OB's office increases
- placenta previa, preeclampsia and gestational diabetes increases
- C-sections increase
- low birth weight increases
42
Most common cause of children with HIV/AIDS
Vertical transmission from mom to fetus during pregnancy or from mom to infant during breastfeeding
43
Chance baby gets HIV/AIDS from mom with no med care
25-35%
44
Chance in US that baby gets HIV/AIDS from mom with med care
Less than 1%
45
Breast feeding recommendation if mom has HIV/AIDS
Don't breast feed
46
Two types of laws about testing for HIV when pregnant
1) opt in - doc must tell you you should get tested but you have to sign a paper to have the testing
2) opt out - you get tested unless you sign a paper saying no
47
Colorado's law on HIV testing for pregnant women
Opt out
48
Treatment during pregnancy and after baby is born if mom has HIV
- mom on combo of HIV drugs for entire pregnancy
- mom gets IV with anti-viral drug called AZT when goes into labor
- baby gets AZT orally for 6 weeks after birth
- baby gets tested 14-21 days; 1-2 m; 4-6 m
49
HIV drugs teratogenic
Certain are teratogenic for first trimester but not after - so have to see doc right away if might be pregnant
Protease inhibitors increase chances of hypoglycemia and diabetes
50
When c-section recommended for mom with HIV?
Only if mom not treated and has a high viral load
51
US policy on breastfeeding
All babies should be breastfed from birth to 1 year, and breastfed exclusively for the first 6 months. Breastfeeding can continue as long as mutually beneficial from mom and baby.
52
When does breast milk become nutritionally inadequate?
1 yr
53
Breast feeding and obesity
Breastfed babies are less likely to become obese
54
IBCLC
International Board Certified Lactation Consultant
- must be reimbursed for services under ACA
55
Lobules
Milk producing glands made of alveoli and eventually empty in multiple openings at nipple
56
Areola
Dark circle around nipple
57
Ducts are lined with
Myoepithelial cells
58
2 stages of breastfeeding
1) milk production
| 2) milk letdown (ejection)
59
Letdown
Myoepithelial cells contract and send milk towards the nipple
60
2 hormones involved in milk production
Prolactin and oxytocin
61
Prolactin function and location
Causes alveoli to make breastmilk.
Prolactin produced in hypothalamus and stored in anterior pituitary
62
Oxytocin function and location.
Responsible for letdown; causes uterus to contract, controls bleeding, helps uterus to return to normal size; "love" (bonding) hormone.
Produced in hypothalamus and stored in posterior pituitary
63
When has breast anatomy matured enough that breast feeding possible
16 weeks pregnant
64
When in pregnancy can breast feeding start and why
After placenta is gone because placenta puts out a hormone (maybe estrogen) that suppresses milk production
65
Lactogenesis means
Process of producing milk
66
3 stages of Lactogenesis
1) birth to 2-3 days: colostrum
2) 2-5 days: milk comes in
3) 10 days - mature milk
67
Colostrum is
First milk, yellow and thick due to beta-carotene. Filled with antibodies and growth maturation factors. Most important milk for the baby.
68
Watery and bluish milk
Mature milk
69
Foremilk and fat content
First milk that comes out. Will be lower in fat.
70
Hindmilk and fat content
Milk that comes out after foremilk. Has higher fat content.
71
Engorgement and how to treat
When milk comes in and overshoots. Best think to do is feed the baby so the milk amount can stabilize.
72
Amount of additional kcal required for breastfeeding
623 kcal. But mom should pull some of that from fat laid down when pregnant. Recommendation is to eat an extra 500 kcal/day for the first 6 m and an extra 400 kcal/day for 2nd 6 m.
73
Nipple care
Do not toughen
Clean with water - no soap or alcohol
Let air dry
74
Only things that should be put on nipples
Breastmilk and lanolin
75
How milk production is regulated
Supply and demand
76
Why babies should not have cow's milk or goat's milk before 1 year
Forms hard curd in stomach and can cause GI bleeding and cause baby to lose iron through stools.
Also breastmilk is much higher in fat and cholesterol - breastfed babies modulate their cholesterol better possibly because breastmilk had cholesterol.
No vit C in cow's goat's milk because they have the enzyme to make their own.
Cow and goat milk too high in sodium and calcium - kidneys cannot handle the solute load
Goat's milk low in folate and babies develop folate deficiency
Also human milk has more lactose than any other animal on the planet, which is good because IQ data and creation of acidic environment that gives immunity protection.
Iron is low in all 3 milks but the form in human milk is highly bio available (lactoferrin - very available to humans but not to bacteria)
77
Correlation between lactose and IQ
Direct correlation between amount of lactose in milk and your IQ.
78
Likelihood that babies have lactose intolerance
Extremely rare - only in profoundly retarded - intolerance is usually temporary and will pass.
79
Why breastfed instead of formula
1) balance of nutrients is perfect for humans
2) breastmilk is dynamic - composition of milk changes with time
3) isosmotic - exact same as human blood - water in formula is hypotonic and causes hyponaturemia (kidneys cannot hold Na so it gets eliminated with urine)
4) low curd tension
5) increased EPA and DHA
6) minerals are in special forms
80
Benefits of breast feeding for baby
1) growth factors
2) decreased mortality (necrotizing enterocolitis)
3) decreased SIDS
4) decreased acute infections (ear infections)
5) decreased chronic diseases (IBS, celiac, leukemia, asthma, atopic dermatitis, eczema
6) decreased obesity - 4% reduction per month breastfed
7) cognitive benefits
8) analgesic effects - circumcision
9) economic benefits
10) less work missed due to baby being sick
81
Breastfeeding benefits for mom
1) oxytocin - decrease in bleeding and size of uterus
2) delayed fertility - but not reliable form of bc
3) self-confidence and bonding for new mom
4) decreased risk of ovarian and breast cancer (if young and breastfeed for a year)
5) decreased rheumatoid arthritis
82
Colostrum nutrition compared to mature milk
More protein, sodium, potassium and chloride
| Less cholesterol and fat (because putting out immunoglobulin)
83
Kcal in mature milk
20 kcal/ml
84
Thrush
Infection in nipple - intensely painful
niastatin in baby's mouth and on nipple will make it go away
85
How to tell if baby is getting enough milk
1) 6 wet diapers per day and 3-4 mushy poopy diapers
- no brick dust (means dehydrated)
2) weigh baby before and after eating
3) weigh baby and see if growing ok
86
Signs baby wants to eat
Rooting, figiting, mouth. Crying is too late.
87
How often should new baby eat
8-12 times/day, about every 3 hours
Should be baby led unless baby is too sleepy
88
Baby weight loss after birth
No more than 7% and should be back up to birth weight by 1 week
89
What supplements are needed if breastfed
Vit K shot at birth for all babies to stop bleeding
Vit D if Mom is African American or Muslim wearing traditional garb - 500 IU given starting with 2nd month for rickets
Iron and zinc after 6 months
90
Mom's diet affect on breastmilk
Affects quantity not quality unless a really poor diet
91
What components of breastmilk fluctuation with mom's diet
Fat and water soluble vitamins.
92
Does breastfeeding help mom with weight loss
Found not to be true
93
How much weight recommended for mom to lose when breast feeding
Up to 1 lb/week - any more might affect quantity of breastmilk
94
Exercise recommendation while breastfeeding
Exercise ok but lactic acid may make milk taser sour to baby
95
Water recommendation for breastfeeding moms
2.7 L/day - some can be from fruit and veg
96
Definition infant colic
Baby cries 3 or more hours per day without a medical reason
97
Folk reason for colic
Thought to be something in mom's diet that affects gas and cramping in baby - and it is treated that way. Eliminate cow's milk, onion/cabbage/broccoli, and chocolate
98
What influences breast feeding in the US
Healthcare system and formula companies
99
What is the baby friendly hospital initiative
Global initiative by WHO and UNICEF (both part of UN) that is aimed at stopping hospitals from being obstacles to breastfeeding by certifying hospitals as baby friendly if they meet 10 rules
1) written policy where breastfeeding is the norm
2) train staff with skills to promote breastfeeding
3) inform all pregnant women of benefits of breastfeeding
4) help initiate breastfeeding within an hour after birth
5) show how to breastfeed and how to maintain breastfeeding when mom and baby are separated
6) no other food or drink for baby unless medically necessary
7) rooming in available
8) encourage breastfeeding on demand
9) no pacifiers or artificial nipples
10) foster breastfeeding support groups after mom gone from hospital
100
Underlying hold up for there not being more baby friendly hospitals
No free formula - hospital has to pay for it
101
Number of baby friendly hospitals in US and Colorado
243 in US and 3 in Colorado
102
Where women can get help with breastfeeding
1) La Leche League - totally volunteer organization where moms who have breastfed will help new moms
2) IBCLC - have to be in healthcare profession, have 90 hrs of accredited education, a certain number of practice hours, and take an exam
103
Potential breastfeeding problems
1) flat or inverted nipples
2) let down failure
3) hyperactive let down
4) engorgement
5) plugged ducts
6) mastitis
7) maternal meds
8) herbs
9) alcohol
10) smoking
11) marijuana
12) caffeine
13) jaundice
104
Plugged ducts
Milk forms clog in one of the tubes, breast gets red, hot and painful. Treatment is massage, warm compress, position baby different, pump to empty breast
105
Mastitis
Same symptoms as plugged duct but plus fever and flu symptoms. Is med emergency (can result in abscess/surgery) and can come from untreated plugged ducts. Doc may give an antibiotic, but you have to feed/pump, continually empty the breast
106
Alcohol when breastfeeding
Is not a contraindication but goes through to milk in same concentration as in your blood.
Will be in your milk until completely sober. Can pump and dump.
107
Smoking and breastfeeding
Not a contraindication - smoking and breastfeeding is better than not breastfeeding
108
Marijuana and breastfeeding
Is a contraindication
109
Caffeine and breastfeeding
Goes through to milk but equivalent of 3 cups is considered ok.
Baby doesn't process caffeine well and could make the baby crabby
110
How breastmilk changes for preterm infants
More carbohydrates and less fat
111
Breastmilk benefits for preterm babies
Decreased infections
Less necrotizing enterocolitis
Less nosocomial infections
Much better vision
112
What to do if breastmilk not enough to support fast growth of preterm baby
Human milk fortifier for increased calories and nutrients
113
Contraindications to breastfeeding
1) mom has HIV - 20% transmission rate - not recommended in US, Canada and Western World
2) galactesemia - baby cannot metabolize lactose
3) active TB
4) T-lymphocyte virus I and II
5) illicit drugs (including marijuana)
6) chemotherapy
7) radiotherapies
114
Rules for storing breastmilk
- 6-8 hours at room temp
- in fridge up to 5 days
- in freezer inside fridge - 2 weeks
- in separate freezer - 3-6 months
- in deep freeze - 6-12 months
115
How to thaw frozen breastmilk
In fridge or under cold running water
116
Feeding infant rules
- breastmilk or formula only until 4-6 m
- need iron and zinc at 6 m
- fortified infant cereal (rice) by tradition at 4-6 m, then other cereals, veg, fruit, meats
- one new thing for 3-5 days with spoon
- by 1 yr eating same as family in a high chair
117
Developmentally baby needs to be able to do this to eat
Hold up head and move tongue
118
Only things that go in bottle
Breastmilk, formula or water
119
Why babies should not have juice
Don't need it, setting up for obesity and tooth decay
120
What foods baby can't have for first year
Honey - botulism
Corn syrup - maybe botulism
Cow's milk - but foods with cow's milk ok
121
When should baby stop bottle
1 year
122
Mom's saliva ok in baby's mouth?
No. Causes tooth decay.
123
When switch from measuring length to measuring height
2 years
124
Which growth charts used for 0-2 yrs
WHO
125
Which growth charts used for 2-20 yrs
CDC
126
What weight and length are considered normal for 0-2 years?
Between 5th and 95th percentile
127
Kids should stay on same growth chart line except
Mom's size trumps genetics - baby with small mom might jump in size after born
128
Why do babies sometimes have a weight jump at 1 yr
Parents have not gotten rid of the bottle and are giving 8 bottles/day of formula
129
Only way you can tell if child 0-2 is over or underweight
Weight-for-length growth chart
Overweight if over 95th%
underweight if below 5th%
130
Sign of acute malnutrition
Weight
131
Sign of chronic malnutrition
Length
132
On back of growth charts for kids 2-20 yrs is
BMI for height -NO RELATION to adult BMIs
133
Categories for BMI for height for kids 2-20 yrs
Below 5% - underweight
Between 5-85% - normal weight
85-95th - overweight
Over 95th - obese
134
Adiposity rebound
Point on BMI for age growth chart where line stops sloping down and starts to slope up (BMI increasing with age). The earlier it occurs, the more likely you are to be obese
135
Types of infant formulas
Standard:
(1) milk-based
(2) soy-based
(3) hydrolyzed
Specialized
136
Why soy formulas not recommended for almost all infants
Have phytoestrogens (hormones), phytates and oxalates that cause calcium to be poorly absorbed which affects bone production
137
Why soy formulas should never be used with a preemie baby
Has negative growth affects and preemie babies need to have huge growth
138
Possible situations when soy formula would be appropriate
Baby with galactosemia (cannot digest lactose) - very rare - or a vegan mom that wants baby to eat vegan
139
Hydrolyzed formulas are
Cow milk based but protein is broken down into chunks or individual AAs. Some have MCTs instead of regular fats
140
Uses for hydrolyzed formulas
Babies with true food allergies.
3D shape of the proteins is what causes the allergy, and the proteins are broken down.
141
Specialized formulas used for
Babies with a particular medical condition (eg, PKU) and sometimes preemie babies. Need a prescription.
142
Need for special shelf formulas
No. These are designed for parents and do not help babies.
143
Why lactose is good for babies
Helps develop gut bacteria
True lactose intolerance is rare. Parents mistake transitional intolerance for a true problem but should ride it out.
144
Forms of formula
Ready to feed
Concentrate - mix 1:1 with water
Powdered - 2 oz water + 1 scoop formula
145
How to prepare powdered formula
2 oz water per scoop of formula
Water in bottle first, then add level scoops. Can heat (no microwave) or not.
146
Calories in formulas
Standard 20 kcal per ounce
Preterm 24 kcal per oz (used sometimes in hospital) and 22 kcal per oz (sometimes for when leave hospital)
147
What kind of water to use with formula
Debate, but tap water usually fine if municipal supply
Problem if too many nitrates/nitrites in water (if under 6m can bind irreversibly to hG and turn baby blue)
Problem if you boil water may concentrate heavy metals or get heavy metals from the pan
148
Problem with concentrating formula
Can cause dehydration and death
149
Problem with wanting baby to finish whole bottle
Same as force feeding as is giving overheating cues. Should always have some formula left over and routinely throw away - don't save because of saliva bacteria
150
Why not put baby to bed with bottle
- Last mouthful of food backs up into ears and causes ear infections
- causes tooth rot - "nursing mouth"
- causes habit hard to break
- should hold baby when feeding to bond
151
Why not prechew baby's food or let your saliva in baby's mouth
Inoculates baby's mouth with bacteria and increases tooth decay
152
Infant calorie needs
First 6 m -108 kcal/kg
| 2nd 6 m - 98 kcal/kg
153
Infant protein needs
1st 6 m - 2.2 g/kg
2nd 6 m - 1.6 g/kg
Protein isn't a problem if baby is getting enough kcal to grow from breastmilk or formula
154
Infant fat needs
Do not restrict fat until 2 yrs - brain needs fat
155
Infant cholesterol needs
Do not restrict cholesterol. Evidence that babies that have more cholesterol do better with regulating it later in life.
156
Important fats added to formulas
EPA
DHA
linoleic acid
Alpha- linolenic acid
157
Where do babies digest fat and why?
In their stomach (not small intestine like adults). Use special lipase for breastmilk.
158
Difference between triglycerides in human milk and triglycerides in other milk
Palmitic acid is always in position #2 in breastmilk but in position #1 or #3 in other milk. Stomach enzyme needs palmitic acid in position #2.
159
Infant fluoride requirements
1st 6 m - 0.1 mg/day
2nd 6 m - 0.5 mg/day
Don't supplement fluoride - can be toxic and cause brown teeth. Most get from water supply.
160
Infant vitamin D needs
Seeing rickets in black women and Muslim women with traditional dress - due to sun exposure.
Formula fed - don't supplement
Breast fed - 400 IU/day
161
Infant sodium issues
Hyponaturemia - Immature kidneys cannot hold sodium so they pee it out if too much water, or if vomiting/diarrhea
No water - only breastmilk for formula for first 6 m. Feed through sickness or if you can't feed give pedialyte, not water.
Beware of giving water-like liquids - manzanilla tea and coca cola
162
Infant iron requirements
Fe drops off around 4 m and need baby cereal
Term babies are ok with iron for first 4 months - preemies are not because missed iron loading.
Fe deficiency affects IQ
163
Infant lead warnings
Babies like lead around 1 year because it tastes sweet. Be ware of old paint, pipes, toys and religious objects from Mexico.
164
Food texture by when
By 8 m baby should be having lumps and texture so can learn to chew
165
Foods that infants can choke on
White bread, peanut butter, hard foods, round foods
- should mash or cut in thin strips
166
Only foods babies can't have for first year
Honey and cow's milk
167
Colic def
Crying 3 hrs/day for 3 days/week for 3 weeks - 1954 definition
Usually early in first 6 m
168
Colic helps
Swaddle
Simethicone drops
Probiotics - lactobacillus reuteri
Fennel seed extract
Gripe water - no evidence that it works
Dicyclomine - works but causes death
169
Helps for infant diarrhea/constipation
No karo syrup - causes osmotic diarrhea
No prune juice
Exercise baby or give 1-2 spoons of prune baby food
Apple juice might cause diarrhea because high in sorbitol - sugar alcohol
170
Failure to thrive
Most common cause is abuse/neglect
Have to do calorie counts
171
Allergies in infants
Common and usually grow out
Thought is to feed the allergy foods early if family allergy, not avoid.
172
Kids with special needs called
"children with special healthcare needs"
173
Colorado program for children with special needs
HCP - health care program for people with special needs
174
Definition premature
Born earlier than 37 weeks
175
At what age do premature babies do fine and not need special help
After 34 weeks
176
Survival chance of 2 lb baby
88%
177
What gestational age are docs usually unable to help a preemie baby
24 weeks
178
What do preemie babies usually die from
Lung problems - lack of surfactant
179
What can be done for a preemie baby's lungs
Inject mom with steroid before giving birth that forces the baby's surfactant to mature
Give artificial surfactant to a baby on a respirator
180
Problem with ventricles (holes in brain) and preemie baby
Ventricles have not yet attached to walls of brain and hardened. The blood vessels in the ventricles will start breaking and bleed into the brain.
181
Problems with babies born earlier than 34 weeks
(1) lung injuries
(2) cerebral palsy
(3) mental retardation
(4) injury to intestines - necrotizing enterocolitis
182
Two types of jaundice in newborns
Pathologic - caused by disease in baby - usually happens right after birth
Physiologic - normal - 24 hrs to 5 days - due to HG needing to turn into bilirubin and be cleared
183
Kernicturus
Bilirubin over a certain level - damaging to brain
184
Two types of physiologic jaundice
Breastmilk jaundice - if bilirubin over a certain level need to stop breastfeeding
Breastfeeding jaundice (non) - caused by failure of breastfeeding. Baby needs to clear bilirubin and meconium. Needs to feed more and poop more.
