Chapter 24 Newborn Nutrition and Feeding All Elsevier items and derived items © 2014, 2010, 2006,...
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Transcript of Chapter 24 Newborn Nutrition and Feeding All Elsevier items and derived items © 2014, 2010, 2006,...
Chapter 24
Newborn Nutrition and Feeding
All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
American Academy of Pediatrics (AAP) recommends infants be breastfed exclusively for first 6 months of life
Breastfeeding should continue for at least 12 months and thereafter as desired
Complementary foods can be introduced after 6 months
Recommended Infant Nutrition
2All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
Risen steadily over the past decade 76% initiation 47% at 6 months 25% at 12 months
Healthy people 2020 goals 81% any breastfeeding 60% at 6 months 34% at 12 months
Breastfeeding Rates
3All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
Human milk designed specifically for human infants; nutritionally superior to any alternative Associated with health benefits for mother and infant Psychological benefits Convenience Economical Environmental benefits
Benefits of Breastfeeding
4All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
Breastfeeding (BF) Parents should be aware of the benefits of BF for
their infant, as well as the risks of not BF A natural extension of pregnancy and birth Support by the partner and family is necessary Mothers tend to select the same method of infant
feeding for all of their children
Choosing an Infant Feeding Method
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Cultural influences on infant feeding Hispanic women BF is the norm African-American families more likely to formula-feed Muslim and Jewish cultures value BF Cultural knowledge about BF Must be comfortable in social settings
Choosing an Infant Feeding Method (Cont.)
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Choosing to formula-feed Parents often make this decision without complete
information Myths and misconceptions about BF BF may be seen as embarrassing See formula-feeding is a way for family members to
feed the baby Mothers on WIC are more likely to formula-feed
Choosing an Infant Feeding Method (Cont.)
7All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
Maternal cancer therapy or diagnostic and therapeutic radioactive isotopes
Active tuberculosis not under treatment Human immunodeficiency virus Maternal herpes simplex lesion on a breast Galactosemia in infant
Contraindications of Breastfeeding
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Varicella Maternal substance abuse Maternal human T-cell leukemia virus type 1 or
type 2 Some medications may be incompatible with BF
Contraindications of Breastfeeding (Cont.)
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Fluids Energy Carbohydrate Fat Protein Vitamins
Vitamin D Vitamin K
Minerals
Nutrient Needs
10All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
Milk production Female breast composed of 15 to 20 segments
(lobes) embedded in fat and connective tissues; well supplied with blood vessels, lymphatic vessels, and nerves
Each lobe is glandular tissue consisting of milk producing cells the contractor symptoms milk forward to the nipple
Anatomy and Physiology of Lactation
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Lactogenesis After birth precipitates a decrease in estrogen and
progesterone levels; triggers release of prolactin from anterior pituitary gland
Prolactin levels highest during first 10 days after birth Prolactin produced in response to infant suckling and
emptying of breasts• Production as a supply-meets-demand system
Anatomy and Physiology of Lactation (Cont.)
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Lactogenesis Oxytocin: other hormone essential to lactation As nipple is stimulated by suckling infant, posterior
pituitary prompted by hypothalamus produces oxytocin
• Responsible for milk-ejection reflex (MER) Thoughts, sights, or sounds of the baby can stimulate
MER
Anatomy and Physiology of Lactation (Cont.)
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Uniqueness of human milk The ideal food for human infants Dynamic substance to meet the changing needs of
the infant Contains immunologically active components
Anatomy and Physiology of Lactation (Cont.)
17All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
Uniqueness of human milk Colostrum, a clear, yellowish fluid (day 1 to 3)
• More concentrated than mature milk • Extremely rich in immune globulins• Higher concentration of protein and minerals• Less fat than mature milk
Anatomy and Physiology of Lactation (Cont.)
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Uniqueness of human milk Composition changes during each feeding
• Lower fat “foremilk” changes to higher fat “hindmilk” Milk production increases as the baby grows
• Growth spurts occur at 10 days, 3 weeks, • 6 weeks, 3 months, and 6 months
Anatomy and Physiology of Lactation (Cont.)
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Supporting breastfeeding mothers Education and anticipatory guidance Prenatal classes La Leche League and Mocha Moms WIC Baby-Friendly Hospital Initiative
The Breastfeeding Mother and Infant
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Supporting breastfeeding mothers Positioning Latch-on Milk ejection or let-down Frequency of feedings Duration of feedings Indications of effective BF Supplements, bottles, and pacifiers
The Breastfeeding Mother and Infant (Cont.)
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Special considerations Sleepy baby Fussy baby Slow weight gain Jaundice Preterm infants Late preterm infants Multiple infants
The Breastfeeding Mother and Infant (Cont.)
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Expressing and storing breast milk Hand expression Mechanical milk expression Types of pumps Storage of breast milk Working and BF Weaning Milk banking
The Breastfeeding Mother and Infant (Cont.)
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Care of mother Diet Breast care BF and contraception BF and pregnancy BF and obesity Medications, smoking, alcohol, caffeine Herbal preparations
The Breastfeeding Mother and Infant (Cont.)
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Common concerns Engorgement Sore nipples Insufficient milk supply Plugged milk ducts Mastitis Follow-up after hospital discharge
The BreastfeedingMother and Infant (Cont.)
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Parent education Readiness for feeding Feeding patterns Feeding techniques Bottles and nipples Common concerns
Formula-Feeding
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Parent education Infant formulas Formula preparation Vitamin and mineral supplementation Weaning Complementary feedings
• Introducing solid foods
Formula-Feeding (Cont.)
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Parents have been asked by the neonatologist to provide breast milk for their newborn son, who was born prematurely at 32 weeks of gestation. The nurse who instructs them about pumping, storing, and transporting the milk needs to assess their knowledge of lactation. What statement is valid?
A premature infant more easily digests breast milk than formula. A glass of wine just before pumping will help reduce stress and
anxiety. The mother should only pump as much as the infant can drink. The mother should pump every 2 to 3 hours, including during the
night.
Question
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