Presentation on theme: "Maternal Nutrition & Hydration While Breastfeeding"— Presentation transcript:
1 Maternal Nutrition & Hydration While Breastfeeding Raissa Ameh, BSN, RN, Sarah Dennis, BSN, RN, Megan Heusinkvelt, BSN, RN, Jessica Xie, BSN, RNUniversity of Nebraska Medical Center, College of Nursing, Omaha, NEBackgroundMajor Recommendations for Healthcare Providers Caring for Breastfeeding Women (Clinical Guideline)Infants should be fed exclusively on breast milk for at least six months(WHO, 2002)Benefit of breastfeeding:TrainingAssess personal beliefs toward breastfeedingEnsure health care professionals working with women of childbearing age have knowledge & skills to giveadvice on:Nutritional needs of all pregnant & breastfeeding women & infantsImportance of a balanced diet while breastfeedingBenefits of milk intake while breastfeedingRecommendations & rational for dietary supplementsStrategies for improving eating behaviorsImportance of breastfeeding, benefits of breastfeeding, & barriers to breastfeedingFood supplementation ProgramHealthcare providers should screen all patients to determine need for government assistanceProvide supplemental food to low income womenDiet during lactationAssess patient’s dietary habits, knowledge, & myths about diet & breastfeeding*Educate breastfeeding women on consumption of gas producing foodsEducate women & partner about food preparation methods: grilled or baked, not friedEducate women on limiting high salt & sugar content foodsEducate women on avoiding/limiting caffeine, carbonated beverages, & alcoholEducate women on the importance of a healthy balanced diet while breastfeedingEducate women on the importance of milk intakeNutritional supplementsEducate women on the recommendations of dietary supplementsVitamin DFolic acidCalciumMultivitamin or prenatal vitaminFatty acidAdequate caloric intake to maintain breast milk supplyLactating women with a healthy weight need to increase energy intake to 500kcal/day during first 6months of breastfeeding+Adequate fluid intake to support milk production14-50 year old lactating women: 3.8 L/day+Teach women strategies to improve eating habits5 portions of fruits & vegetables a day, & 1 portion of oily fish a week*ObesityEducate overweight lactating women that restricting their energy intake by 500kcal/day will help them loseweight while meeting daily dietary requirements-Best method to weight loss is to decrease intake of foods high in fat & simple sugars & increase intakeof foods high in calcium & vitamin DAdvise women with a Body Mass Index (BMI) over 30 that weight loss during lactation will not affectquantity of quality of milk*Encourage exerciseAllergiesAssess women & partner for family history of allergies*Educate women that breastfeeding may help to prevent or decrease occurrence of allergy developmentAdvise women to breastfeed for 6 months & to continue to breast feed while introducing solid foodsSupportConsider religious & cultural experiences that may prevent or influence the patient to breastfeedAssess skills & knowledge of the patientProvide breastfeeding support program for breastfeeding womenStart breastfeeding education early—during the pregnancy if possibleProvide patients with reliable informational sources—website & print materialsInclude the patient’s spouse or significant other during breastfeeding education sessions*Health care providers should pay extra attention to women who are least likely to breastfeed (i.e. young women, thosefrom disadvantaged groups, limited education)*Ensure that patients whose first language is not English have access to interpretation services & printmaterials on breastfeeding in their native language*Have a breastfeeding expert readily available for questions, support & additional educationMedicationsDiscuss medication needs with breastfeeding mothers*Ensure safe medications are prescribed that will not affect milk supply*(NICE, 2008) +(Butte, 2010) -(Lovelady, et. al., 2006) RA, SD, MH,JXReduced mortality in preterm infantsReduced infant morbidity from infections: gastrointestinal, respiratory,urinary tract & middle-earReduced risk of infections, allergies, & chronic diseases in the infantEnhanced cognitive developmentBreastfeeding women have lower incidence of breast cancer, ovariancancer, endometrial cancer & hip fracturesDelay in return of ovulationBreastfeeding women with return to pre-pregnancy weight more quicklyReduced health inequalities for low-income mothers & children if breastfedfor 6 months **(NICE, 2008) RA, SD, MH, JXHealth Promotion ModelThe Health Promotion Model focuses on helping patients develop positive health seeking behaviors by incorporating their personal experiences & individual characteristics. This model acts as a guideline to allow the healthcare provider to make accurate identifications of individual risks & situational factors, so that appropriate behavior change strategies can be suggested.Improving nutrition during pregnancy & breastfeeding leads to improved health for not only the mother & infant, but also her family. Many barriers, past life experience & situational factors affect a woman's ability to breastfeed. Through individualized education & professional support, many women can be encouraged to change their nutritional habits in order to promote breastfeeding & reduce health disparities .RA, SD, MH, JXGuideline ObjectivesTo increase awareness of dietary needs of pregnant & breastfeedingwomenTo improve nutritional status of women during conception, pregnancy,& the lactation periodTo promote breastfeedingTo promote evidence-based practiceRA, SD, MH, JXTarget PopulationArea: Southeast Nebraska: Otoe, Nemaha, Richardson, Pawnee, &Johnson CountiesMean Household Income: $37,024 (Se. NE) Vs. $47,470 (NE)*Location: Women, Infants, & Children (WIC) clinicsPopulation characteristics: All women of childbearing age who arepregnant or who may become pregnant, especially postpartum womenbetween the ages of years oldHealthcare professionals who provide care to this population*(Nebraska City Area Economic Development Corp, 2009)2 cups, Apples, Bananas, Berries, Cherries, Nectarines, Melons, 100% fruit juice3 cups, Milk, Cheese8 ounces, Whole grains, Brown rice, Oatmeal3 cups, Dark greens, Starchy vegetables, Red & Orange vegetables, Beans & Peas6 1/2 ounces, Meat, Poultry, Eggs, Seafood, Nuts & BeansRA, SD, MH, JX* These amounts are for an average breastfeeding womanStakeholdersPhysiciansPhysician AssistantsMidwivesRegistered NursesSocial WorkersPharmacistsPublic Health OfficialsClinic administratorsFamiliesCommunitiesAdvanced Practice NursesLactation ConsultantsRegistered DietitiansNutritionistChange in knowledge & dietary habits of pregnant & breastfeeding womenImproved caloric intake in women who are pregnant & breastfeeding to support milk productionImproved nutrition, well balanced meals & intake of essential vitamins & minerals for all pregnant &breastfeeding womenAdequate fluid intake during pregnancy & lactation for all pregnant & breastfeeding womenEarly identification of women at need of nutritional supportVitamin/nutritional supplementation provided for women in needIncrease in the breastfeeding rate for patients in this target populationIncrease in maternal/child health for patients in this target populationIncreased breastfeeding knowledge in healthcare providers working with the target populationExpected OutcomesRA, SD, MH, JXSourcesButte, N. F. (2010). Maternal nutrition during lactation. In S. Abrams & K. Motil (Eds.),UpTo Date. Available fromLovelady, C.A., Stephenson, K.G., Kuppler, K.M., & Williams, J.P. (2006). The effects of dieting on food & nutrient intake of lactating women. Journal of the American Dietetic Association, 106(6), doi: /j/jada National Institute for Health & Clinical Excellence (NICE) (2008). Improving the nutrition of pregnant & breastfeeding mothers & children in low-income households. National Guideline Clearinghouse. Retrieved 6 June, 2011 from Nebraska City Area Economic Development Corp (2009). Southeast Nebraska Regional Demographics. Retrieved on 29 June, 2011 fromUnited States Department of Agriculture (2011). Pregnancy & Breastfeeding. Retrieved on 29 June, 2011 fromWorld Health Organization, Infant & young child nutrition: Global strategy on infant & young child feeding. Retrieved from 21 June, 2011RA, SD, MH, JX
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