Infant and Young Child Feeding PDF

 Infant and young child feeding Administrative order No. 2011 - 0303 - known as "micronutrient powder Executive order 51 supplementation for children 6-23 months -Also known as...

 Infant and young child feeding Administrative order No. 2011 - 0303 - known as "micronutrient powder Executive order 51 supplementation for children 6-23 months -Also known as "milk code" - national code of marketing of breastmilk Administrative order 32, section 2010 substitutes - Expanded garantisadong pambata Republic act 7600 -“Rooming in & breastfeeding act" Administrative order 2005 - 0014 -Room-in within 30 minutes if NSD - May 23, 2005 - room-in within 3-4hrs if Caesarian delivery - Known as "national policy on infant and young child feeding" Rooming-in - place newborn in same room as the mother Infant and young child feeding practices: - to facilitate mother & infant banding Early initiation of breastfeeding - To facilitate breast-feeding exclusive breastfeeding extended breastfeeding Exemptions for rooming-in: Complimentary feeding A) mother is seriously ill Micronutrient supplementation B) mother is taking medications contraindicated to breast-feeding Exclusive breastfeeding C) violent psychotics From wet nurse D) does not permit by attending physician Lactation management Infant receives breast milk - Care of mother-infant during prenatal, stat postpartum& postnatal periods Expressed breast milk Right of the mother to breast-feed Wet nursing - Child equally has the right to her breastmilk - feeding from another mother's breast Bootlefeeding Expressed milk - Allowed only after months and need to - Manual milk expression inform health personnel Exclusive breastfeeding Republic act 10028 Best food except if with galactosemia - Known as "expanded breastfeeding promotion act" Do not give: Plain water Sugared water Republic act 8976 chewy sticky rice - Known as "Philippine food fortification act" Herbals - use of sangkap pinoy seal Starved the baby - rice, flour, cooking oil, sugar Human milk Republic act 8172 - Has anti-infective proteins - Known as "asin law" - 35% casein -act for salt-iodization nationwide " - easy to digest Executive order 382 Cow’s milk - November 7 -80% casein - National food fortification day -Difficult to digest  Variations of breast milk 3) breast engorgement - Caused by an imbalance between milk supply 1) colostrum - thick/yellowish in color 4) breast - More whey than mature milk - No need to wash before and after feeding -Rich in vitamin A - regular washing and no soap - growth factors: helps intestine to grow 5) months food intake 2.) mature milk - malunggay (moringa oleifera) - larger in quantity Galactagogue-promotes milk flow Foremilk-produce early in feeding Hindmilk-produce later and contains more fat 6) causes of uterine pain - stimulate release of oxytocin 3) breastmilk - Makes uterus contract - Is the best food - Reduce bleeding - Contains essential nutrients - Natures first immunization 6 to 9 months (IMCI) Benefits of breastfeeding: - breastfeed as often Best for babies - give thick porridge or mashed foods Reduce the incidence of allergies - start to give tablespoon Economical - gradually increase to 1/2cups Antibodies - give 2 to 3 meals/day Sterile and pure - offer 1 to 2 snacks/day Temperature is always ideal Fresh 9 to 12months (IMCI) Easy once established - breastfeed as often Emotional bonding - give variety of mashed food Digested easily (2 to 3hrs) - give 1/2 cup at each meal Immediately available - give 3 to 4 meals/day Nutritionally optional - offer 1 to 2 snacks/day Gastroenteritis reduced Techniques of breastfeeding 1) position - infant should be close to mom - tummy to tummy Different positions are: A) cradle hold B) cross cradle hold C) side-lying hold D) football I clutch underarm hold 2) flat, inverted nipple - Syringe method (pull plunger) - shape breast (c-hold) Newborn screening Galactosemia - convert galactose into glucose is missing Disorder tested for newborn screening: Clinical manifestations: Congenital hypothyroidism - poor growth - born without the ability to make -Jaundice normal amounts of thyroid hormone -Bleeding -Occurs about 1 in 3000-4000 children - Cataracts - liver & spleen damage Causes: impaired neurological function Stunted growth Nursing interventions: Physical deformities -Milk substitution -Dietary restrictions Signs & symptoms: - Read food labels - less active - sleep more than normal Phenylketonuria (in born) - difficulty in feeding - Decreased metabolism of amino acid - constipation Signs & symptoms: Nursing interventions: - A musty odor in the breath, skin and urine - maintain a stable weight - Seizures - Intake foods rich in fiber -Eczema - abnormally small head Congenital adrenal hyperplasia (genetic) - affect the adrenal glands Glucose-6-phosphate- dehydrogenase deficiency (G6PD) - high level of male hormones - deficiency that affect red blood cell - Severe deficiency is called "favism" Hormones: cortisol- regulates the body response to Signs & symptoms: illness or stress - rapid heart rate Mineralocorticcids - (aldosterone) regulate - shortness of breath sodium and potassium level - Urine is dark or yellow-orange Androgens - (testosterone)male sex hormone Maple syrup urine disease Two types of congenital adrenal hyperplasia: - inherited disorder 1) Classic CHA- can be detected usually in infancy - body is unable to process protein building blocks 2) non-classic CAH - milder and more common Leucine Signs and symptoms: - contributes to regulation of blood sugar levels - will produce excessive male hormones - Growth and repair of muscle - if female, will produce ambiguous external genitalia - wound healing Nursing interventions: isoleucine - allow the parents to grief - oxygen-carrying pigment inside RBC - provide emotional support - Help control blood sugar - Provide education about the disease Valine - is an amino acid - Used in the biosynthesis of proteins  Standard 6 test Disorder screened Effects if not screened Effects if screened and treated Golden period Treatment Severe growth & CH Normal 4 weeks Supplementation Mental retardation CAH Death Alive and normal 7-14days Supplementation GAL Death or cataracts Alive and normal 2 weeks Avoidance PKU Severe mental retardation Normal 3 weeks Avoidance Severe anemia G6PD Normal Exposure to agents Avoidance Kernicterus 12-24 hours after birth Avoidance MSUD Death or mental retardation Alive and normal Or 2-3 days Supplementation  Family Health nursing Gay/lesbian Family -Couple of same sex National statistical coordination board -not legal - A group of person usually living together - Composed of the head by blood Classification of Family Johnson Based on pattern of Residence - With larger society Based on pattern of lineage Based an amount of mates Allen Based on authority - characterized by birth, marriage, adoption or choice Based on authority Patriarchal - authority is on the Friedman oldest male in the family, often father - joined together by bonds of sharing - identify themselves as part of family matriarchial- authority is on mother's skin Executive order 209 Family code - contract of permanent union of man & Matricentric - prolonged absence & woman of father gives mother position in the family Family structures Patricentric- Dyad - empty nester Based on pattern of Residence Cohabitating - live in Patrilocal - couple lives near - Common law spouses husband's family Compound family Matrilocal - couple lives near - Man has more than 1 wife mother's family -PD 1083 "code of Muslim" Neo-local - couple sets up home Blended separate from either side of families - bring in child from previous marriage Based on pattern of lineage Nuclear -Husband, wife, children Patrilineal family - when property & title inheritance through father's Extended side - 3 generations - married siblings Matrilineal family - when property & title inheritance through mother's Single parent side - pregnancy outside of wedlock - Separation  Based an amount of mates Monogamous Family - husband only has 1 wife - Western idea of marriage polygamous Family - husband has more than one wife - Mostly found in Saudi Arabia Polyandrous Family - a wife with more than one husband - Can be found in southern India Assessment tool for Family genogram - known as mcgoldrick - gerson study - pictorial display of person's family and medical history Ecomap - aimed at mapping & understanding personal connections Culturagram - identify appropriate interventions for the family  Maternal strategy Bemoc -Dated May 10, 2009 - basic emergency obstetric care strategy - reduction for maternal and neonatal mortality - emergency obstetric care facilities for every 125,000 population Maternal CHN-general principles -Coordination with DOH 1) every pregnancy is wanted 2.) every pregnancy is managed 6 signal OB function: 3) every delivery is facility based 1.) administration of oxytocin in 3rd stage of labor 4) every mother & newborn secures postnatal care 2) administration of anticonvulsants 3.) administration of antibiotics Causes of maternal & neonatal deaths: 4.) assisted deliveries Risk factors 5) removal of retained products of conception Unplanned pregnancy 6.) removal of retained placenta No adequate care during pregnancy No skilled birth attendant BEMONC should be: No proper post partum care Accessible - should be reached 30 minutes within home Staff - minimum of 1 doctor, 1 nurse and 1 midwife Delays Operation - should be 24hours Identification of complication With access to transportation Referral Management of complication C) third tier-CeMONC - Comprehensive emergency maternal obstetric Safe motherhood program newborn care Shifted in preparing all mothers for complications Public or private facilities designated as end-referral facility aim to strengthen ability of health system priority of disadvantage women Pregnancy package Iron 60mg MNCHN Strategy Folic acid 400mcg 1 tab daily for 3-6 months 1) universal access while utilization Vitamin A 10,000 IU 1 cap 2x per week 2) Service Delivery network Iodized oil capsule with 200mg iodine 1 cap for 1 year 3) organized use of instruments ages 15-45 Promotion on the use of iodized salt MNCHN network Healthy lifestyle A) first tier Smoking -Community level service provider Regular exercise -Rhu & health centers Moderate alcohol intake - led by midwife, nurse or Barangay health team Healthy diet B) second tier Antenatal care services - BEmONC - first 270 days - Basic emergency maternal obstetric newborn care -Care provided by skilled health professional to -District hospital pregnant woman -Private hospital - Republic act 11148 known as " kalusugan at nutrition ng mag -Lying-in & Barangay health station nanay act”  Prenatal visit 2 records of pregnant woman - in 2016, they Recommended 8 prenatal visit/check up 1) facility-based record (ITR) - 1-1-1-5 rule (8ANC) 2.) HBMR -home based mother's record - also known as mother & child book Antenatal Registration - promotes continuity care - The only way to guide in pregnancy care - prepare for delivery Childbirth package 1.) skilled birth attendants Doh recommenced prenatal visit 2.) facility-based deliveries 1st visit - as early as possible 3.) use of partograph 2nd visit-2nd trimester 3rd visit-3rd trimester Maternal deaths - mostly occur during labor or 1st Every weeks - after 8th month until delivery 24hours postpartum Micronutrient supplementation Partograph/partogram Iron & folate-60mg|400mcg once a - is a composite graphical record day for 6 months or 180 tablets - Consist of progress of labor and maternal well bein Vitamin A -10,000 in twice a week 4) EINC - essential intrapartum and NB care - Start at 4th month - Unang yakap Iodine -200mg once during pregnancy Calcium supplement 1 _2grams elemental calcium in 3 divided doses Deworming- mebendazole or albendazole Tt/td immunization - IM deltoid muscle 0.5ml - NB protection passive immunity CEMONC provider - public and private secondary & tertiary hospitals Provincial hospitals Regional hospitals Medical centers Antenatal administration steroids in preterm labor Post-partum visit 2 visits LAM-Lactational Ammenorhea Method 1st visit-within 24hours - temporary contraception for mothers 2nd visit-within 1 week after delivery - requires full breast feeding - less than 6 months protection Post-partum maternal nutrition supplementation Iron with folate for 3 months or 90 days Vitamin A iv within 4 weeks after delivery Iodine  Family planning *Newborn screening in the US began with Dr. Robert Birth spacing Guthrie who developed screening test for phenylketonuria return to fertility all FP methods including LAM Philippine newborn screening project - started in 18 private and 6 government hospitals Early initiation of breast feeding - within an hour Administrative order No. 2018-0025 Result: baby decreases diarrhea - known as "National policy and strategic framework an Result: mother stimulate oxytocin leads to UC expanded newborn screening for 2017-2030" Essential newborn care after 90 minutes to 6 hours Administrative order No. 2014-0045 1) vitamin k Prophylaxis - "Guidelines on the implementation of the expanded new born 2.) hepa-b, BCG vaccination screening program" 3.) assessment of birth injuries 4.) additional care for SGA Presidential proclamation 540 - 1st week of October as newborn screening awareness week Care prior to discharge A) breast feeding - day and night Newborn screening B) warmth -Kangaroo mother care - simple procedure using heel prick method C) hygiene D) look for sign on jaundice Performance of newborn screening E.) perform newborn screening - shall be performed after 24hours of life - not later than 3 days from delivery Newborn care package -If ICU based, not later than 7 days of age Essential newborn care Endocrine disorder 1.) immediate drying of the baby A) congenital hypothyroidism 2) early skin to skin contact B.) congenital adrenal hyperplasia 3) timely cord clamping 4) non separation Amino acid disorder 5) giving of eye prophylaxis A) HCY - homocystinuria 6) vitamin K administration B) MAT- hypermethioninemia/adenosine/ 7.) weighing of the baby transferase 8.) first dose HBV C) MSUD 9.) first dose of BCG vaccine D) PKU E) Called Tyr 1 Newborn legal basis Fatty acid disorder Republic act No. 9288 A) camitine palmitoyl transferase deficiency type 1 (CPT 1) - procedure to detect disorder in newborn B) Camitine palmito transferase deficiency type 2 (CPT I) C) camitine uptake deficiency (CUD) Newborn screening Act of 2004 D) Glutaric acidemia type II (GA II) - May lead to mental retardation & death if left E) LCHAD Untreated F)MCHAD G)SCHAD H) VLCHAD What is the purpose of newborn screening? 1.) detect potentially fatal conditions 2.) allows treatment to begin  Organic acid disorder A) 3-MCC B) GA 1 C) IVA D) MMA E) MCD F) PA Urea Cycle defect A) CIT Cystic fibrosis A) cystic fibrosis Hemoglobinopathies A) HgB B) Beta Thalassemia C) HEMOGLOBIN C D) HEMOGLOBIN D E) HEMOGLOBIN E DOH A.O 2015-0020 -guidelines in the administration of life-saving drug during maternal care  Skills lab Acetic acid - Detects albumin/protein Bag technique Procedure': 5 drops of acetic acid & reheat If cloudiness increases, positive for albumin Public Health Bag Result: negative, trace, 1+, 2+, 3+,4+ -Equipment of the public health nurse - contains basic medications Home visit - Delivery of specialized nursing care at home Bag technique - provides care to patient at their doorstep - a tool making use of public health bag - minimize or prevent the spread of infection Contents and arrangements of bag Front of the bag (left to right) Thermometer Right rear of the bag 2 test tube test tube holder Medicine dropper Penlight Left rear of the bag Medicine glass Baby's weighing scale Bandage scissor Straight scissor Tourniquet Back of the bag-cleaning solutions Alcohol 70% Acetic acid 5% 10% & 7% betadine solution Center of the bag Kelly forceps Sterile dressings Roller bandage Benedict's test - determine amount of glucose Procedure: 5ml of the solution in test tube - heat it over a lamp, boils without overflowing - drop 8-10 drops of urine -boil again & cool down Possible result: R+++ LARGE AMOUNT O ++ MODERATE Y + LOW G +/- TRACES/NEUTRAL B - NO SUGAR