Week 12- Newborn Nutrition/ Immediate Post Birth Care Flashcards
Colostrum is high in ___ and lasts how long ____.
High in protein
Lasts up to day 5
Transitional milk is higher in ____ and lasts until ____.
Protein and carbs
Lasts until 2 weeks
Mature milk is composed of what?
Foremilk- carb rich
Hindmilk- protein/fat rich
Contraindications to breastfeeding:
- Certain maternal meds
- Maternal substance abuse
- Cytotoxic and immunosuppressive drugs
- Active TB
- HSV lesion on breast
- Active varicella infection
- HIV infection in developed countries
- Neonatal galactosemia
Breast milk may be stored at room temp for:
4-6 hours
Breast milk may be stored with cooler with ice for:
Up to 24 hours
Breast milk may be stored in fridge up to:
3-8 days
Breast milk may be stored in the freezer ____ and deep freezer ___.
Freezer- 4-6 months
Deep freezer- 6-12 months
Formula prep:
I scoop per 2 ounces
Hydrolyzed formula is:
Partially broken down
Amino acid formula is good for-
Soy/dairy intolerance
3 or more hours a day of crying for 3 or more days a week for more than 3 weeks in a row is?
Colic
When does colic typically start and resolve?
3w
3 m
How much are newborns expected to lose in the first days of life?
5-8% of body weight in bottle fed
10% in breastfed babies
When should newborns return to birth weight?
By 2 weeks of life
When do newborns double birth weight?
5-6 months
When do infants normally triple their birth weight?
1 year
Infant weight below the 3rd percentile requires-
Frequent follow up
Complications of poor weight gain in the infant?
Developmental delay
Poor bonding
Severe dehydration
All states require what on newborn screening?
Congenital hypothyroidism
Cystic fibrosis
Sickle cell
PKU
Any referred metabolic screening should be retested by:
3m of age
When should metabolic screen be done?
As close to hospital discharge as possible.
If born at home- within 1-2 days
2 types of newborn hearing tests:
- Auditory- brain response
2. Otoacoustic- emissions testing- most common and measures ciliary movement
When are you most concerned with jaundice?
If visible within 1st 24 hours of life or if it appears excessive
Glucose may fall how low in newborns?
May fall as low as 25-35 in first hour of life
Who gets vitamin K?
Infants greater than 1.5 kg get 1mg vitamin K
Who should get hep B?
Medically stable infants over 2kg should receive within 1st 24 hours of life
What do green stools indicate?
More foremilk than hindmilk
Blood in stool may indicate-
Protein allergy
Bilirubin is the:
End product of heme metabolism
This is bound to glucuronic acid and is water soluble (more easily secreted):
Conjugated bili
This is inbound and not water soluble (difficult to excrete)
Unconjugated bili
What is the peak level of bilirubin in newborns?
6mg/dl which occurs between 2-4 days of life
What causes hyperbilirubinemia?
Hepatic immaturity
Decrease ability to conjugate bili
Decreased rate of excretion
Mild dehydration/ low caloric intake
Screening for hyperbili?
Transcutaneous bilicheck- 5 measurements and get average
Can’t be used on infants less than 37w
What infants are at higher risk of hyperbili?
Less than 38w gestation and breastfed infants
Other major risk factors of hyperbili?
Jaundice within first 24 hours A sibling who had jaundice Unrecognized hemolysis Non-optimal sucking/nursing Deficiency in G6PD Infection Cephalohematoma East Asian Or Mediterranean descent
Pathologic jaundice caused by:
Isoimmunization Erythrocyte biochemical defects Structural abnormalities Infection Sequestered blood
