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38 Cards in this Set
- Front
- Back
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BREAST MILK &FORMULA CONTAINS
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20kg/oz
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FULL TERM NEWBORN DAILY REQUIRES:
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100-110 kcal/kg or 45-50 kcal/pound
NEEDS 550-600 cc OF FORMULA OR BREAST MILK/DAY 1st day of feeding 5-7 ml Day 3 .75-3ml Day 7 1.5-2oz |
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Babies loose weight the first:
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7-10 days of life
INFANTS SHOULD LOSE less than 10% OF BODY WEIGHT NEWBORNS CONSUME LESS THAN NEEDED @ 7% WEIGHT LOSS—CAUSE SHOULD BE IDENTIFIED TO ASSURE ADEQUATE NURSING SSMALL STOMACH END OF 1ST WEEK, STOMACH CAPACITY INCREASES INFANT SLEEPS THRU HUNGER INFANTS USUALLY REGAIN WEIGHT BY 14 DAYS NEWBORN MAY SLEEP THRU HUNGER MUST WAKE BABY UP EVERY 2-3 HOURS TO FEED SMALL STOMACH CAPACITY MAY ONLY TAKE AN OUNCE AT EACH FEEDING AT 1 DAY OF AGE STOMACH CAPACITY WILL INCREASE NORMAL EXCRETION OF MECONIUM & URINE----^ WEIGHT LOSS |
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WATER NEEDS
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MORE THAN AN ADULT IN PROPORTION TO SIZE BREAST MILK OR FORMULA MEETS ALL FLUID REQUIREMENTS OF THE NEWBORN
40-60 ml/kg (18-27 ml/lb) MORE THAN AN ADULT IN PROPORTION TO SIZE BREAST MILK OR FORMULA MEETS ALL FLUID REQUIREMENTS OF THE NEWBORN |
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Colustrum :
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FIRST WEEK
RICH IN IMMUNOGLOBULINS ESTABLISHES NORMAL INTESTINAL FLORA FACILITATES PASSAGE OF MECONIUM NUTRIENT COMPOSITION GEARED TOWARD NEWBORN |
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Mature Breast Milk
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REPLACES TRANSITIONAL
MILK @ 2 WEEKS BLUISH, THINNER THAN COLOSTRUM APPROPRIATE 20 kcal/oz CALORIES & NUTRIENTS Contains: |
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PROTEIN
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CONCENTRATION IN BREAST MILK PERFECT
BABY’S KIDNEYS IMMATURE BABY MAY REACT TO PROTEIN IN COW’S MILK DECREASED ALLERGIES IN BREAST MILK Breast milk contains Taurine important for Bile conjunction and Brain Development. Tyroseine, and phenalynine are low in breast because baby does not have enzymes to digest them. |
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CARBOHYDRATE
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LACTOSE INCREASES ACIDITY IN INTESTINES
DECREASES UNDESIREABLE BACTERIA INCREASES GOOD BACTERIA AIDS IN ABSORPTION OF CALCIUM MAGNESIUM & PHOSPHORUS |
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FAT
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30-55% OF CALORIES
DIFFERENT FROM COW’S MILK FAT MORE EASILY DIGESTED ANTIMICROBIAL |
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FOREMILK & HINDMILK
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HINDMILK
MORE FAT MORE SATIETY HELPS WEIGHT GAIN Use only iron fortified milk first year. |
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Vitamin D
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VITAMIN D IS LOW IN BREAST MILK
LOW SUN EXPOSURE, DARK SKIN AT RISK FOR LOW VITAMIN D DEFICIENCY VITAMIN D SUPPLEMENTATION IS RECOMMENDED |
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MINERALS
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COW’S MILK FORMULA INHIBITS IRON ABSORPTION
NEEDS TO BE IRON FORTIFIED IRON IN BREASTMILK MORE EASILY ABSORPED BREASTFED BABIES HAS IRON STORES FOR 6 MONTHS IRON SUPPLEMENTATION @ 4-6 MONTHS MINERALS ^ IN FORMULA--- MUST DILUTE PROPERLY FOR KIDNEYS |
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FORMULA
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REPLACES BREAST MILK
DO NOT USE COW’S MILK FOR INFANTS LESS THAN ONE YEAR SPECIAL FORMULA FOR INFANTS WITH PROBLEMS Do not introduce formula until been breast feeding 3-4 weeks |
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FACTORS INFLUENCING FEEDING METHOD
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FAMILY SUPPORT
CULTURE EMPLOYMENT |
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PHYSIOLOGY OF MILK PRODUCTION
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during pregnancy the anterior pittuatary secretes high levels of prolactin, hormone that causes breasts to produce milk. However, milk production is prevented by estrogen, progesterone, and human placental lactogen, which inhibit breast response to prolactin.
Prolactin is increased when placental hormones decrease. suckling increases and at night. Prolactin decreases first few weeks unless breast is stimulated. |
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Oxytocin:
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increases from the posterior pituatary increases in response to nipple stimulation and causes the milk-ejection reflex , commonly known as le-down reflex.
resulting contraction in Alveoli (myoepithelial cells) release milk into the ducts. When mother thinks or hears child they have increase oxytocin resulting in let down. Pain or lack of relaxtion can inhibit. Also may have uterine contractions. |
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HUNGER CUES
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LICKING MOVEMENTS
LIP SMACKING ROOTING HANDS TO MOUTH SUCKING ON HANDS INCREASED ACTIVITY CRYING (LATE SIGN) |
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LATCH SCORE
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PROPER LATCH
AUDIBLE SWALLOWING TYPE OF NIPPLE COMFORT OF NIPPLE OR BREAST HOLD OR POSITIONING |
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INVERTED NIPPLES SHELLS MAY OR MAY NOT BE HELPFUL
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Retracted nipple appears flat and broad.-
Inverted nipple can be pulled out from sulcus where it hides. PUMPING BREASTS WITH AN ELECTRIC BREAST PUMP BEFORE FEEDING MAY BE EFFECTIVE |
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C HOLD—SOME USE V HOLD FOR HOLDING THE BREAST WHILE NURSING
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positions: cradle hold, cross cradle hold,football hold, lying down
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FEEDING PRACTICES
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8-12 TIMES DAILY q 2-3hours (formula 3-4)
CLUSTER FEEDS IN LATE AFTERNOONS & EARLY EVENING NURSE AS LONG AS THE INFANT IS NURSING VIGOROUSLY ON ONE SIDE…..BURP AND DO NOT WASH MOTHER’S NIPPLES WITH SOAP & WATER Removes the natural protective oils Can cause soreness & dryness SWITCH SIDES THERE ARE INDIVIDUAL NURSING VARIATIONS |
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NEONATE TEMPORARY GROWTH SPURT
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AT 2 WEEKS OF AGE
*BABY WILL INCREASE FREQUENCY OF FEEDING* *MOTHER IS NOT LOSING HER MILK* |
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ESTABLISHING EARLY MILK SUPPLY
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SUPPORT, TEACHING REFERRAL TO MOTHER
AVOID FORMULA SUPPLEMENTATION ENCOURAGE ADEQUATE MILK SUPPLY WITH FREQUENT FEEDINGS, REST, DIET ETC AVOID NIPPLE CONFUSION BREAK SUCTION WHEN REMOVING FROM BREAST |
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BREAK SUCTION WHILE NURSING
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slide finger into mouth to stop
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Nipple confusion
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avoid formula while breastfeeding. Nipple feeding is a different mechanism than bottle feeding baby is confused.
Tips: babies should be breasfed within an hour of delivery. Avoid bottles and pacifiers first few weeks |
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ENGORGEMENT
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NORMAL—2ND TO 3RD DAY
TEMPORARY, NORMAL DOESN’T INTERFER WITH NURSING ANOTHER ENGORGEMENT— CAUSED BY MILK RETENTION BY TOO SHORT, Apply cold after feedings, apply heat before feedings. NORMAL—2ND TO 3RD DAY TEMPORARY, NORMAL DOESN’T INTERFER WITH NURSING ANOTHER ENGORGEMENT— CAUSED BY MILK RETENTION BY TOO SHORT, INFREQUENT, DELAYED FEEDINGS MASSAGE BREASTS (ENHANCES LET-DOWN) COLD/HEAT, BRA INFREQUENT, DELAYED FEEDINGS MASSAGE BREASTS (ENHANCES LET-DOWN) COLD/HEAT, BRA |
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NIPPLE PAIN
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USUALLY FROM
IMPROPER LATCH CRACKED NIPPLES IF SEVERE—MAY NEED REFERRAL |
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PLUGGED DUCT
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HARD, TENDER, AREA ON BREAST
MASSAGE AREA, APPLY HEAT NURSE FREQUENTLY TO EMPTY DUCT & BREAST Position infant's chin toward lump will help drainage. can lead mastitis |
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Mastitis
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infection of the breast. caused by staphylococcus aureus or viridan streptococci (skin flora) carried by mom or infants nose. engangement and stasis may precede
causes: bra too tight, fatigued and stressed mother. Thrush from baby may be cause. Work thru it.....keep going |
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Breast Pump
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should be used within 6 hours of birth. q 3-4 hours or 2 x a night when prolactin levels are high.
sessions should be 15 to 20 minutes long. 8-12 sessions in a 24 hour period are best. |
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INDIVIDUAL BABY BOTTLES
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SHOULD ONLY BE USED FOR ONE FEEDING
IT SHOULD BE DISCARDED DUE TO BACTERIAL GROWTH |
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TYPES OF FORMULA
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READY TO USE
CONCENTRATED POWDERED |
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FORMULA FEEDING
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BOTTLES & NIPPLES INDIVIDUAL CHOICE
PREPARE A SINGLE OR 24 HOURS FEEDING IF SAFE WATER SUPPLY—NO STERILIZATION BOTTLES CAN BE WASHED IN DISHWASHER NIPPLES WASH BY HAND Bottle of formula use 1 time----throw away if not used. |
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*ASEPTIC STERILIZATION*
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BOTTLES AND EQUIPMENT
ARE BOILED SEPARATELY FROM WATER FOR DILUTING THE FORMULA |
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*TERMINAL STERILIZATION*
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STERILIZE
FORMULA AT THE SAME TIME AS THE BOTTLES |
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FORMULA FEEDING
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POSITIONING
BURPING FREQUENCY FEED Q 3-4 HOURS—TAILOR TO DEMAND BABY WILL TAKE ½ TO 1 OZ PER FEEDING DAY ONE THEN WILL ^ TO 2-3 OZ PER FEEDING BY DAY 3-5 |
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FORMULA FEEDING
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DON’T HEAT IN MICROWAVE
DON’T PROP THE BOTTLE |
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Benefits of breastfeeding
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Allergies are less likely to develop.
May prevent or delay atopic dermatitis, cow's milk allergy, and wheezing. Immunologic properties help prevent infections. decreased incidence of respiratory infection; meningitis, some cancers, sudden infant death syndrome (SIDS), and infant mortality. Increases visual acuity. composition meets the infant's specific nutritional needs. Nutritional and immunologic properties change according to infant's needs Easily digested, with nutrients that are well absorbed. Protein, fat and carbohydrate occur in the most suitable proportions. page 530 continue |
