1. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Newborn Nutrition Chapter 11

2. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Factors Influencing a Woman’s Choice to Breast-Feed or Bottle-Feed Culture Age Prior experience with, or exposure to, breast-feeding Intent or need to return to work or schoo

3. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Advantages of Breast-Feeding Maternal benefits –More rapid uterine involution –Less bleeding in the postpartum period –A quicker return to pre-pregnancy weight level –Decreased incidence of ovarian and pre- menopausal breast cancers

4. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Advantages of Breast-Feeding (cont.) Infant benefits –Provides immunologic properties from the woman –Provides unique experience for maternal– newborn bonding –Decreases the risk in overfeeding of the newborn –Decreases incidences of otitis media, diarrhea, and lower respiratory tract infections –Possibly protects against certain conditions or diseases such as SIDS, insulin-dependent diabetes, and allergic diseases

5. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Contraindications to Breast-Feeding Illegal drug use Active untreated TB HIV infection Chemotherapy treatment Herpetic lesions on the breast Insufficient production of breast milk Galactosemia or phenylketonuria in the infant

6. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Newborn Features Facilitating Breast-Feeding Uniquely shaped nose and mouth The rooting reflex Innate ability to suck

7. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Factors Controlling Lactation Physical control of lactation Hormonal control of lactation Sensory stimulation

8. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Composition of Breast Milk Colostrum –Produced during the second trimester –A thick, yellowish-gold substance higher in antibodies and protein than breast milk, but lower in fat Foremilk –Very watery and thin, may have a bluish tint; what the infant first receives during the nursing session Hind milk –Thicker and whiter with a higher quantity of fat and caloric content than foremilk

9. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Care for the Breast-Feeding Woman Assessing breast-feeding readiness Assisting with breast-feeding technique Assessing the breast-feeding session Ending the breast-feeding session Assessing newborn fluid intake Teaching about breast-feeding special concerns Relieving common maternal breast-feeding problems

10. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Positions for Breast-Feeding Cradle hold –The newborn’s abdomen is facing and touching the woman’s abdomen Football hold –The newborn is held with its head under the woman’s breast Side-lying position –Both the woman and the newborn are on their sides facing each other while lying in bed

11. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Common Maternal Breast-Feeding Problems Sore nipples Engorgement Plugged milk ducts Mastitis

12. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Signs a Newborn Is Not Feeding Well Dry mouth Not enough wet diapers per day Difficulty rousing the newborn for a feeding Not enough feedings per day Difficulty with latching and/or sucking

13. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Teaching Topics for the Breast-Feeding Woman Signs newborn is not feeding well Growth spurts Available resources Using supplements Breast-feeding amenorrhea Contraception while breast-feeding Pumping and storing breast milk

14. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Advantages of Formula Feeding Feeding infants who are adopted Feeding infants in cases where breast-feeding would be harmful Quantifying the amount of formula consumed Perceived ease of formula feeding vs. breast-feeding Involvement of others in feeding infant

15. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Disadvantages of Formula Feeding It is inferior nutrition It has no immunologic properties It is harder for the newborn to digest There is a higher correlation between infants who are formula fed and some illnesses like otitis media and allergies It is expensive

16. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins 3 Main Types of Formula Milk-based Soy-based Hypoallergenic

17. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Care of the Formula-Feeding Woman Assisting with formula-feeding technique Assessing the formula-feeding woman and newborn Teaching about formula-feeding concerns –Preparing bottles of formula –Adding supplements –Maternal breast care –Common problems in the formula-fed newborn

18. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Common Problems in the Formula-Fed Newborn Not wanting to eat Not tolerating the formula Dental caries