Newborn Nutrition and Feeding

Chapter 27: Newborn Nutrition and Feeding

• Optimal nutrition is crucial, which is essential for healthy growth and development in infancy.
• Infant feeding involves nutrition as well as social and psychological interaction between parent and infant, establishing lifelong eating habits.
• Breast milk is scientifically proven to be the best nutrition for infants because it is uniquely tailored to their needs and is superior to formula.
• Nurses educate and support parents in making informed infant feeding decisions, both before and after birth.
• Exclusive breastfeeding means the infant receives only breast milk, with some exceptions for supplements or medications.
• Nurses support and education regardless of whether parents breastfeed use pumped breast milk, or formula-feed.
• Establishing healthy feeding practices in the first 6 months, particularly the newborn period, is important.
• All nursing care and parent education regarding infant feeding are based on current research and standards of practice.

Recommended Infant Nutrition

• Human milk is considered the optimal food for infants.
• Multiple health organizations recommend exclusive breastfeeding for the first 6 months of life for healthy, term infants.
• At 6 months, nutrient-rich complementary foods should be introduced, alongside continued breastfeeding for 2 years or longer.
• If weaning occurs before 12 months, iron-fortified infant formula should be used.

Breastfeeding Rates

• Breastfeeding initiation rates in Canada have significantly increased from less than 25% in 1965 to 90% in 2015/2016.
• There is regional variation in breastfeeding initiation rates across Canada.
• Over half of Canadian mothers continue breastfeeding for at least 6 months.
• A significant proportion of mothers who initiate breastfeeding stop before their newborn is 1 month old.

The Importance of Breastfeeding

• Human milk is uniquely designed for human infants and is nutritionally superior.
• Human milk is considered a living tissue due to its high live cell content
• Human milk is bacteriologically safe and fresh.
• Human milk nutrients are more easily absorbed than formula nutrients.
• Breastfeeding and human milk have extensive health benefits for infants, some of which extend into adulthood.

Contraindications to Breastfeeding

• Specific contraindications to breastfeeding include:
• Maternal cancer therapy, radioactive isotopes, or radioactive iodine
• Active tuberculosis in the mother if the mother is untreated
• If the mother has HIV then HIV can be passed through breast milk from an HIV-positive patient, even if the viral load is undetectable and the patient is on antiretroviral medications
• Classic galactosemia may be a contraindication in the infant.
• Maternal infection with Hepatitis A or C
• Maternal substance abuse is a contraindication to breastfeeding.
• Hepatitis B surface antigen (HBsAg)–positive status requires the newborn to receive immunoglobulin and vaccine
• Maternal herpes simplex lesion on a breast (Mothers can continue to breastfeed on the unaffected breast

Benefits of Breastfeeding for Infant/Child

• Breastfeeding decreases the risk of infant and child death.
• Breastfeeding enhances the development of the infant's gastrointestinal tract and immune system.
• Breastfeeding protects against and reduces the risk of infections and chronic diseases.
• Gastrointestinal Conditions (e.g Gastroenteritis, celiac conditions)
• Infectious Diseases (e.g Otitis media/ear infections, RSV, pneumonia)
• There is a lower incidence of allergies among breastfed infants, particularly for families at high risk (lymphoma)
• Metabolic/Chronic Diseases (Obesity, potentially diabetes (type 1 and type 2)
• SIDS (Sudden Infant Death Syndrome): Breastfed infants may be more easily aroused from sleep and breastfeeding delivers antibodies which may be protective

Developmental and pain relief Benefits

• Breastfeeding may improve cognitive development and reduce the chance of dental malocclusions.
• Breastfeeding can provide pain relief for newborns during procedures

Benefits of Breastfeeding for the Mother

• Decreased risk of ovarian & breast Ca
• Pre-pregnancy weight achieved sooner
• Helps with uterine involution
• Protective against osteoporosis
• May also decrease the risk of rheumatoid arthritis.
• Decreases risk of type 2 diabetes, hypertension, cardiovascular conditions.
• May be protective against perinatal mood disorders
• Promotes bonding

Benefits of Breastfeeding for Society

• Breastfeeding is bacteriologically safe & fresh
• Convenient, portable, inexpensive
• Less environmental waste

Baby-Friendly Initiative

• The Baby-Friendly Initiative (BFI), a joint effort of the WHO and UNICEF, promotes breastfeeding by establishing 10 steps for hospitals and community health services to follow.
• The Baby-Friendly Hospital Initiative (BFHI) has since expanded.
• The BFI designation signifies that a facility meets the Ten Steps and adheres to the WHO International Code of Marketing of Breastmilk Substitutes.
• Benefits of BFI designation include increased patient-centered care, improved staff attitudes and skills, decreased formula use, and increased mother-newborn contact.
• The number of BFI-designated facilities in Canada is growing, including hospitals, birthing centers, and community health centers.
• The BFI aims to re-establish a breastfeeding-supportive culture and provide evidence-informed, family-centered care and breastfeeding is recognized as a human right.
• The BFI does not prohibit discussions about formula feeding
• Aspects of BFI care apply to all families, regardless of feeding method, including responsive feeding, pain management, skin-to-skin contact, and professional support.

Informed Decisions about Infant Breastfeeding

• High initial breastfeeding rates don't always translate to long-term breastfeeding.
• Truly informed decisions require comprehensive information and support.
• Support from partner, employer, and community is important for individual circumstances.
• Cultural context plays a significant role for autonomous decision-making.

Breastfeeding

• Mothers often choose breastfeeding due to an awareness of infant benefits.
• Breastfeeding is more than nutrition; it's a bonding experience.
• Partner and family support is important both for the decision to breastfeed and successful breastfeeding.
• Maternal weight, if overweight/obese, and previous infant feeding methods influence decisions.
• Exclusive breastfeeding is linked to knowledge of health benefits and comfort with social breastfeeding.
• Barriers to breastfeeding can include discomfort, pain, and lifestyle incompatibility
• Individualized prenatal breastfeeding education is vital.
• Supportive healthcare providers are crucial for breastfeeding.

Information about Formula-feeding

• Reasons for formula feeding vary (insufficient milk production, maternal disease, conscious decisions.)
• Parents who cannot breastfeed due to medical reasons may experience difficult emotions and require support.
• Reasons for choosing formula feeding can include personal reasons, misinformation about breastfeeding, convenience, shared feeding, and more.
• Previous trauma, like sexual abuse, and mental illness can also impact the decision not to breastfeed.
• Regardless of the parents right to choose the health care providers should explore and support the decision.
• Nurses should use sensitive open-ended questions to understand parental concerns and support their decision.

Cultural Influences on Infant Feeding beliefs

• Beliefs and community norms influence infant feeding practices, as well as Canada's history of bottle-feeding and formula marketing
• Child-rearing beliefs, like the concept about "spoiling" babies can also affect breastfeeding.
• Nurses need to be aware of the cultural beliefs.
• Indigenous breastfeeding practices and beliefs vary amongst Indigenous communities, and breastfeeding rates declined previously, however it is increasing presently.
• Specific cultures illustrate diverse beliefs, such as the Cree, and Mexican views, as well as food beliefs related to milk production such as Korean seaweed soup.
• Immigrants may abandon breastfeeding in their new country due to perceived cultural norms.
• Language barriers can hinder successful breastfeeding, and nurses should provide culturally sensitive support.
• The Canada Prenatal Nutrition Program (CPNP) Program aim to support breastfeeding education.
• Sociocultural values, such as patriarchal family structures, can affect a breastfeeding person from receiving breastfeeding education if communication is filtered through a family member

Lactation support for LGBTQQ2S

• LGBTQ2 families face similar parenting and breastfeeding challenges as heterosexual families, with more unique needs.
• More LGBTQ2 individuals are becoming parents and providing human milk through various methods.
• LGBTQ2 families experience similar lactation issues, as heterosexual families, but can have more unique challenges.
• Co-nursing is common for lesbian partners, one partner can give birth, while the other can induce lactation to give an adequate and balanced diet.
• Same-sex couples may use donor milk or surrogacy services.
• Transgender men may give birth and chestfeed.
• Healthcare providers need to be familiar with the specific needs of LGBT2 Families.
• Using appropriate specific language is crucial.
• Resources such as Rainbow Health Ontario, and Milk Junkies, can offer detailed information.

Nutrient needs

• Generally, if an infant is receiving enough milk, the necessary nutrients should be met.
• Assessment is crucial.

Fluids

• Fluid requirements for newborns vary by age (from 60-80 mL/kg/day in the first 2 days to 120-180 mL/kg/day by day 8-30).
• Neither breastfed or formula-fed newborns need supplemental water, even in hot climates, as milk is 87% water.
• Giving newborns water reduced calorie intake during rapid growth.
• Newborns need to be monitored for fluid intake and loss.
• Weight loss in the first few days is often due to fluid loss.

Energy Consumption Infants

• Sufficient calories are needed for growth and proper digestion as well as overall activity for the infant.
• Energy is influenced by maturity, growth rate, health, environment, and overall activity.
• Breastfed newborns typically need about 85-100 kcal/kg/day, where formula fed infants need 100 -110 kcal/kg/day.
• It is important to note that human milk provides about 67 kcal/100 mL primarily from fat.
• Infant formulas are designed to mimic the same caloric content, as milk at 20 kcal/30mL.

Carbohydrates

• The recommended carbohydrate intake for infants is 60 g/day (first 6 months) and 95 g/day (second 6 months).
• Carbohydrates should provide 40-50% of total calories due to limited glycogen stores in newborns.
• Lactose is primary.
• Corn syrups are added for lactose with cow milk.
• Oligosaccharides are great to promote bacteria.

Fat

• Fat in breast milk provides the greatest amount of energy at 50 percent
• Formula is easier to digest.

Fat (Cont.)

• It is recommended that infants under 6 months get 31 g/day
• Human milk contains acids for growth and health.
• Cow's milk is not suited for infant formulas and often corn oils are used instead.

Proteins

• High-quality protein is essential for growth.
• Neonates often get 9.1/day
• Human milk also contains whey and easier lactoalbumin to aid this process.
• Amino acids make up the proteins and are very healthy.

Vitamins

• Apart from Vitamin D human milk has more than enough
• Infants in Canada should take this supplement.
• Vitamin K is essential to help aid clotting if baby guts do not produce this and it's injected for the first six hours, as gut does it
• Vegans may need Vitamin B12 supplements.

The proper Minerals

• Formulas must meet the minimal content but it can be varied.
• Cow milks have improper levels where iron intake could be increased.
• Infant output shows volume

Breast Anatomy

• Consists of 15 to 25 lobes each side
• Each lobe contains alveoli or producing cells which produce myoepithelial cells ejecting milk
• The pore has multiple pores
• The ratio of glands vary amongst lactation, glandular being more milk production.
• Complex network of milk help transports into nipple.
• Breasts do not determine indicators

Lactogenesis

• Is the process of creating breast tissue
• Progesterone drops helps trigger.
• Oxytocin is released from the posterior.

Breast milk

• The way baby gets milk from breast is by using their jaw, keep cuddle newborn while they search for the breast.
• Rapid weight does exist.
• If first hours not there keep with mother then.

Human Milk-the best for the baby

• High initial breastfeeding rates don't always translate to long-term breastfeeding
• Truly informed requires information.
• Support is crucial.
• Healthcare should be knowledgeable.

Formula to note

• Formula reasons vary. For a child to be breast fed is important.
• Open ended questions should be asked for the parents.
• Healthcare providers support.

The milk that is proper

• 60% of milk for infants help get the necessary nutrients.
• Weight loss is a factor as fluid are necessary.

BreastFeeding Importance

• A baby helps find good nutrition
• If a latch is bad
• This gives the baby what is necessary for development.

Frequencies to Help the Child Grow

• Vary from child to child depending what they see as the proper needs.
• Avoid strictness.
• Help get them to eat.

Proper Support for The Child

• Breastfeeding can be a comfort to the mother as she knows the baby.
• Breastfeeding should give appropriate.

Feeding and Nursing

• For new parents and children this gives good support and appropriate.
• This gives the family and child more success and health for the future.

Benefits of Breastfeeding

• Should occur with both children and parents
• There should be no interference.

Benefits for all

• It should help provide food
• It should happen before the other

Benefits for Health

• Supplementation that requires proper management of health can help with the success for future growth.

Nursing Care

• First two weeks are challenging for many.
• There is the need to educate about feeding.
• Make sure assessment happens in the right setting.
• Education should be proper.

Challenges - Assessment for Mom

• A clinical assessment involves a mom, a baby and the process can vary and a child may have a slow growth.
• Breast size and shape etc does not affect the production.

Care for The Child

• A semi rectangle position matters
• Encouraging can help with the mother.

Note and Support

• Can help with the mothers comfort.
• Can help with the right effective ways.

Steps

• Steps for helping will allow parents to understand.
• More information also matters.

Assessment Techniques

• The mouth shall provide as much
• As each newborn begins sucking, the MER or letdown reflex, is stimulated. Several, also occurs.

Proper Frequency of Feedings

• Feed the baby at least eight times within 24 hours
• If a newborn does not wake feed after 24 hours, the parent should wake them

Newborn Patterns

• The newborn may feed in clustered patterns
• These patterns can occur around 2 to 3 hours.

How Newborn Stools Should Appear

• During 3 to 4 transitional stools, they appear after 2-4 days.
• For breastfeeding parents and families, these patterns can occur around 4-6 dry stools. The infant stools can be 5 to 10.

Infant Diet

• Diet helps to regulate infant
• Colostrum helps build health
• If a infant has jaunde they will be noted to have problems with the baby's urine

###Supplementation

• Supplementation is always needed
• Supplementation should happen with breastfeeding.

Notes

• Breast or baby to support confusing needs
• After 3- 4 weeks the needs can be fulfilled appropriately.
• At night care for a baby, check the parents to test on this

Infants

• The infant health needs to be met for success for them in the future.
• It needs to ensure them during solid foods.

Notes on The Needs

• Exclusive breastfeeding can help the child develop
• Vitamin D should be administered

Needs

• Iron is needed on the chart
• Water should be monitored

Diets on the Chart

• Solid foods before 6 months is terrible

Infants With Care

• It is important that there is a constant assessment for the baby
• It needs good milk and other minerals for successful.
• Note: it is said that with high quality, no fruit drinks are necessary

With Good Success

• Milk is healthy
• Tooth formation is also proper.

###Solid Intake At 6 Months

• pureéd, minced or diced meats or tofu help bring needed nutrition to the baby.

Solid notes

• All baby should be seen well and a good nutrition plan should be present.
• The solid and milk intake is not 9-12 months. It should be earlier.

Helping All

• A good goal is to help ensure the chewing ability to perform.
• Good food is necessary as well.

Tips

• Help with the newness
• Do not combine new notes.
• Help be sure your baby has the right help for the future, a great option can help show the world.
• Let the baby has his own control

Notes When Helping

• It is important to watch and encourage food intake
• The parent role has hunger and the like.

Fluid Recommendation

• 6-13 give the baby sip, you can help.
• After 12 help the child and you can feel safe

Concerns Are Here

• 20-30 percent can be very normal
• Three must be assessed during health: medical test, symptoms, and infants with the like
• Common three include the following: hours, days, and weeks etc.
• 8-12 are great

All To Think Here

• Care to look
• Diets will bring new nutrition
• Formula, for the proper nutrition

Newness and Help

• Test may need aid as proper

The Proper Way To Do It

• The good way needs the right help to be successful.
• You get what you need.

General Help

• Help in assessment will do well.

The System Needed

• A needed plan is necessary for any child.
• A strong foundation is necessary for the start.

During Process

• Assessment is great
• Needs can vary during the process

Care As Needed

• There can have success but it helps assess needs
• Heat is needed during the tests.
• Hypothermia can happen

Eye Health, Vision

• The eye is contracted in the birth
• The infection is present

Needs

• Parents can not help with that said test
• Prophylaxes can help

Vitamins that help

• It needs test performed.
• Administering is good for the infant

Health Needs Is High

• Health and newness should be what you seek
• You need good assessment

####The needs needed

• You need coupling
• New assessment is great
• This helps with the team work

Tips To Remember

• It is very needed

All Tips

• A brief exam can help with assessment.
• Good help can mean the world to the child as they learn
• In heat is what children need.

Care Is Important

• This what we need.
• Give them great support.

Action is Good

• Action is the most important
• A chart
• The O2 that you need in good balance and the temp

All Of This Helps

• There will give you help and info.

• Let them be cared for in what they need.

• There test for needs can cause you concern. But the right plan can have success.

• There need to be good education plans.

Some Good News

• Tests and the results will help with better care later.
• Great help as needs vary test care results.

Newness

• Newborns will test these and not know why. This can result.

With Tips and Notes

• A list can help you.
• The time is high, but it can depend for success. Thanks!

Support

• With all that it is to give the children best

More Help And Guidance

• To give support to each family
• To help with their needs it will be important.

Care Always

• There care always to support each.

Help Now

• With all and thanks you can to give the right
• The process will let you succeed with family and the child.
• This world we can create to help future the family.

Support As They Grow

• There a way. And the team will show.
• With respect and love your support will be very important.