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Women's health > Week 12 Newborns: Nutrition, developmental care, and hyperbilirubinemia > Flashcards

Week 12 Newborns: Nutrition, developmental care, and hyperbilirubinemia Flashcards

1
Q

how much of their body weight can an infant lose after delivery?

A

7-10% up to 3 to 4 days after delivery

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2
Q
  1. normal weight gain is ____ per day
  2. infant will return to birth weight by _____ weeks
  3. Failure to return to birth weight by ___ weeks = failure to thrive
A
  1. 0.5oz to 1oz/day
  2. 2 weeks
  3. 3 weeks
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3
Q
  1. An infant will double their birth weight by ___ months
A

4 to 6 months

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4
Q

infants typically ____ their birth weight by 1 year and height is increased by ____% by the end of 1st year

A

double & 50%

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5
Q

Extrinsic Factors of Poor Weight Gain

  1. infants should not be encouraged to sleep throughout night before _____ weeks
  2. Fewer than ____ bottle feedings
  3. Fever than ____ breast feedings in 24 hours
A
  1. 8 to 12 weeks
  2. 8 bottle feedings
  3. 12 breast feedings
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6
Q

T/F

  1. Infants who do not regain BW by 3 wks should be referred for failure to thrive
  2. A weight gain of 0.25oz/day represents adequate growth for an infant
  3. Inadequate milk supply or error in formula recipe are 2 potential etiologies for poor weight gain in the infant
  4. The WHO growth chart is recommended for all children under 2 years, especially those who are exclusively breastfed
A
  1. Yes
  2. No; 0.5 to 1oz
  3. yes
  4. yes
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7
Q

What are contraindications to breast feeding?

A
  • maternal substance use
  • Cytotoxic & immunosuppressive drugs
  • HIV in developed countries
  • Active TB (pumped milk ok)
  • Active varicella (pumped ok)
  • HSV lesions on breast
  • neonatal galactosemia
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8
Q

What are the stages of breast milk?

A
  1. colostrum 1 to 5 days
  2. Traditional 5 to 10 days (breast milk with some colostrum) Thin blue/grey
  3. Mature milk 10+ days
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9
Q

how do you know if a baby has been adequately fed?

A
  • audible swallow
  • active & alter
  • good skin
  • 6 soiled diapers/day
  • satisfied behaviors
  • height/weight/head circumference
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10
Q

What is the pattern of breast feeding?

A

suck swallow breathe

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11
Q

When should you start vitamin D supplementation?

When can you stop?

A

Start: few days after birth 400 IU

Stop: 1L formula OR solid foods or 4c whole milk/day

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12
Q

When do you start iron supplementation in exclusively BF infants?

How much?

When can you stop iron supplementation?

A

Start: 4 months

Dose: 1mg/kg/day

Stop: 6 months from iron fortified meals

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13
Q

What makes up the “all purpose nipple ointment”

A

mupirocin

betamethasone

miconazole

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14
Q

what is a risk factor for developing a candidal infection?

what should women take to prevent this?

A

recent abx for GBS+ women

Tx: take probiotics for 3 weeks to rebalance flora

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15
Q

When is mastitis most common?

Cause of mastitis?

Symptoms?

Treatment

A
  • 6-7 weeks after birth; 10-30%. mothers
  • Cause: milk stasis, nipple trauma, engorgement, maternal fatigue/stress
  • S/S: Unilateral/red/hot/swollen
    • “flu like”
    • Fever >101
  • Treatment: antibiotics
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16
Q
  1. IgG is the most abundant antibody found in breast milk
  2. signs of adequate BF include 6+ wet/soiled diapers/day, audible swallowing, infant content, sleeping between feeds
A
  1. NO; IgA
  2. yes
17
Q
  1. formula fed infants start being offered ____ every ____
  2. On avg, formula fed infant should take ____ oz of formula for every pound of body weight
A
  1. 1-2oz Q2-3 hours in first few day life of
  2. 2.5 oz of formula per lbs/body weight
18
Q

What is the criteria for constipation?

A

No stooling for 2 weeks time

19
Q

what would you give to an infant <6 months old for constipation?

A

laculose

20
Q

what would you give to a constipated infant >6months old?

A

miralax

21
Q

What is supportive care for infant with constipation?

A
  • 5 to 15ml prune juice 1-2x/day
  • glycerin suppository (soap stimulant)
    *
22
Q

when would you refer a constipated infant to GI?

A

refractory to tx

affecting feeding/growth

concern for underlying condition

23
Q

When does colic occur and what age is it most common

A
  • 1-3 months; common first 6 weeks
24
Q

how to diagnose colic

A

“rule of 3s”

3+ hrs/day

3+ days/week

3 week period

25
Q

What are the causes of hyperbilirubinemia?

A
  • Immature liver
  • decreased ability to conjugate bilirubin
  • decreased exretion
  • poor feeding caused mild dehydration
  • Prematurity
26
Q

When does bilirubin peak?

A

Day 3 to 4 of life

level peak 6mg/dl

27
Q

when does jaundice usually resolve on its own?

A

after 2 weeks

28
Q

What are the parameters for pathologic jaundice?

A

TSB rise of 5mg/dl per day of life

or

TSB >15mg/dl

29
Q

Potential causes of pathologic jaundice

A
  • erythrocyte defects
  • structural abnormalities in liver (biliary atresia)
  • infection
  • sequestered blood
30
Q

what are the risk factors for hyperbilirubinemia

A
  • Jaundice within 1st 24 hrs of birth
  • sibline w/jaundice
  • unrecognized hemolysis
  • non optimal feeding
  • G6PD
  • Infection
  • Cephalohematoma
  • East Asian/Mediterranean descent (ABO incompatibilities)
31
Q

When do you screen for hyperbilirubinemia?

A

prior to d/c AND 3-5 days after birth

32
Q

What are the complications of hyperbilirubinemia?

A

Acute bilirubin encephalopathy

Kernicterus (nuclear jaundice)

33
Q

describe acute bilirubin encephalopathy

A
  • Fever
  • Lethargy
  • High pitch cry
  • Arching body/neck
  • poor feedings
34
Q

what is Kernicterus

A
  • High bilirubin
  • sight/hearing deficits
  • athetoid cerebral palsy
  • cognitive delays
  • death

permanent!!!

35
Q

how to manage low risk bilirubin infants

A

recheck levels

check I/O

36
Q

When can bilirubin levels rebound after phototherapy?

A

18-24 hours

37
Q

What are the potential side effects of phototherapy?

A

skin rash

loose stools

overheating/dehydration

“bronze baby” syndrome

38
Q
  1. All infants should be screened for hyperbilirubinemia prior to hospital dc and again 3-5 days after birth?
  2. Cephalohematoma is a risk factor for jaundice?
  3. BF infants undergoing phototherapy for tx of hyperbilirubinemia require supplemental formula?
A
  1. yes
  2. yes
  3. no; unless there is a issue where they’re not feeding vigorously

Women's health (10 decks)

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