Newborn Nutrition Chapter 26

Newborn Nutrition Need protein, carbs, fat. Inability to concentrate urine, increase fluids if hot or ill Need vitamins and minerals Formula fed gain weight faster, need more formula to get necessary nutrients Breastfed babies gain weight more slowly

Stages of Human Milk Colostrum-2-4 days, yellow creamy, increase in pro., vit, min.and IgA Transition -until 2 wks PP, increase in fat and calories Mature-90% water Foremilk- H20, vit, protein Hindmilk-more fat Should BF 6-12 months

Advantages Provide immunologic protection for up to 18 months More easily and efficiently absorbed BF+ sunlight= no supplements BF promotes attachment Contraindication-breast CA, HIV, galactosemia, flagyl, jaundice, another pregnancy

Bottlefeeding Parents can share caring for newborn Higher incidence of allergic reaction(cow) Problem with powder concentration Cow milk not acceptable for infant feeding. Too much protein,calcium,phos, sodium potassium

Newborn Feeding Indications of newborn hunger? Colostrum can be aspirated without irritation. Benefits- oxytocin production, stimulates peristalsis, decrease bilirubin, + attachment Newborn may play with nipple, recognize odor of mother Assess for fistula or atresia To R side for drainage and gastric emptying

Feeding Patterns Established by newborn Breastfed babies feed more frequently Newborn cues of hunger Newborns needs are better met with couplet care Support informed decision regarding type of breastfeeding

Breastfeeding Positions Football, lying, cradling, across lap. Use pillows for positioning Rub feet for sleepy baby May have to soothe upset newborn before feeding Explore cultural considerations of breastfeeding

Physiology of Breastfeeding Lobes-alveoli- small to larger lactating ducts flow toward nipples Breast development influenced by estrogen Prolactin increases after birth and with sucking Sucking stimulates post pituitary to release oxytocin Letdown-caused by stimulation of myoepithelial cells

Teaching Breastfeeding Good positioning, facing mom Use C or scissors Stimulate to open mouth Baby to breast Alternate breast Do not set restrictive time limits Mother and baby will become sleepy

Bottle/Breast Feeding May confuse newborn Use different muscles Mothers can use use pump (electric) or express manually. Can store milk in refrigerator or freezer Better to store in plastic Never microwave

Effects of Drugs on BF Avoid long acting drugs Give meds right after BF Observe infant for adverse effects Use drugs that metabolize quickly Weigh risks and benefits

Bottlefeeding Education Never prop up bottle Assess nipple for size of hole Point nipple directly into mouth Burp at intervals Regurgitation is normal Fat baby not necessarily healthy Discuss amt and frequency with client

Assess Weight Gain Assess growth and weight gain Six wet diapers/day Should not exceed 32 oz./day Can calculate needs and have parents keep records