Week 7 - newborn feeding Flashcards
how many months is exclusive breast milk recommended for?
6 months
How much vitamin D should be given for all breast/human milk babies?
400 IU
What mineral should be present in foods at six months?
Iron rich
Why is human milk considered living tissue?
-because it contains almost as many live cells as blood
- baceriologically safe
What are 4 benefits of human milk to babies?
- Immunity
- Decreased risk of many types of diseases
- Anaglesic for NBs
- Enhances brain development
What are the benefits of breast/chest feeding to the birther?
- decreased risk of many issues- namely PPH (helps uterine involution)
- helps decrease weight after pregnancy
- Helps with infant bonding
- convenient and free
Who is contraindicated to breast/chest feed?
- HIV birthers
- birthers undergoing cancer treatments
- substance using birthers (gets to baby)
- Herpes simplex lesion on breast
Can birthers on methodone or subboxone breast/chest feed?
yes!
helps with withdrawl symptoms in babies also
How long should we keep baby on birther’s chest/skin to skin?
start of birth (PP) until after the 1st feed
how often should parents feed their baby?
8-12 x per day and PRN
When does lactogenesis begin?
Stag 1 - in pregnency and ends with the start of increased milk production
What is stage II lactogenesis?
starts with increased milk about 2-3 PP until day 8
What is stage III of lactogenesis?
when mature milk is produced
usually 9+ days
What are the 2 most important signs of good infant fluid intake during Post partum time?
- gaining weight </= 7% weight loss
- hydrated enough (no signs of dehydration
what vitamin does breast milk not contain?
vitamin D
what hormone produces milk during lactogenesis?
prolactin
When are prolactin levels the most high?
first 10 days after birth
How is prolactin produced?
-in response to infant suckling
- removal of milk from breast/chest
What two hormones are involved in lactogenesis?
Oxytocin
Prolactin
what does oxytocin do for breast feeding?
milk ejection reflex (the let down)
what reflex is integral to lactation?
the nipple-erection reflex
how is oxytocin stimulated during breastfeeding?
nipple is stimulated by infant
hypothalamus prompts the posterior pituitary to produce oxytocin
What is the major immune globulin in human milk?
secretory immunoglobulin A
what is colostrum rich in?
immunoglobulins
what does colostrum have a higher consentration of than regular human milk?
protein
fat-soluble vitamins
minerals
- less fat that mature milk
What are the three stages of breast milk?
- colostrum
- transitional milk
- mature milk
what decreases in transitional milk?
- immunoglobulins
- protein
what increases in transitional milk?
lactose
fat
total calories
what increases in mature milk?
fat
lactose
what decreases in mature milk?
protein
what is the average duration of feedings per breast?
20 min per breast
how often should baby be fed in 24 hours?
8-12 feedings
and PRN (cues)
how do we know breastfeeding is effective?
- urine & stool (1=1 day, 2=2 days- etc up to 4-6 by day 4)
- weight - once a day weights
if ______ is still present in stools on day 3-4 we ned to reassess breast/chest feeding
meconium
What are indications of a good latch?
- The mother feels a firm tugging sensation on the breast, but feels no pinching
or pain. - The baby sucks with cheeks rounded, not dimpled.
- The baby’s jaw glides smoothly with sucking.
- Swallowing is usually audible
- The baby cannot be easily removed from the breast.
- The mother’s nipple is not distorted when the baby releases from the breast.
What do we assess birther nipples for?
erythema
cracks
how often do we assess breasts using the LATCH-R acronym ?
Q8 hours
how much should baby be gaining day 4 onward?
20-35g/day
when should babies be back at birth weight?
10-14 days of age
how often should babies be weighed in hospital?
after first feed
Q24 hours
what are the 6 feeding cues?
- hand to mouth
- sucking motions
- rooting reflex
- mouthing
- flexed arms and legs with clenched fists
- crying - late sign
What are 4 newborn assessment findings we need to notify the provider about ?
- not feeding well
- not passing a void in 24 hours
- excessive regurgitation or vomiting
- masses in the abdomen
what is the min amount of calories a birther should eat postpartum?
<1800 cal
What should we not put on the breasts/nipples?
soap
creams (except specific)
no underwires
plastic lined breast pads
What are the 4 things breastfeeding birthers should focus on for their own health?
- good nutrition
- hydration
- exercise
- Rest
If someone wants to use lactation as birth control, how often must they feed/express and what else is important for it to work?
- no period
- q4-6 hours day /night
- *can still ovulate before period
what is a harm reduction approach with breastfeeding and smoking?
not within 2 hours
When is engorgement normal?
2-5 days postpartum
*bilateral
lasts <24 hours
*afebrile
What are some problems when it comes to breastfeeding?
- engorgement
- sore nipples
- Insufficient milk supply
- Plugged milk ducts
- Mastitis
what are 3 reasons for sore nipples later in breastfeeding?
- yeast infection
- latch issues
- monilial infections (fungus)
if an infant is fed formula, do they require vitamin D?
no, its in the formula unless at high risk for deficiency (individual basis)
What do we assess after hospital discharge regarding breast feeding?
- infant feeding pattern
- jaundice
- breast discomfort reasons
What 3 things do we need to educate parents about formula?
- approved by health canada
- cow’s milk with iron is recommended
- always check expiry
What is the general formula feeding guideline for the first 24 hours of life?
5-10 mls per feed Q2-3 hours
What is the general guidance for formula feeding for the first 24-48 hours of life?
10-15 mls per feed Q 2-3 hours
