Infant Nutrition PDF

Infant Nutrition Lactation/Nursing Support Bottlefeeding © 2002 Delmar, a Thomson Learning company 1 Lesson 9.2 Objectives 1. Discuss the elements of informed decision-making related to the choice of breastfeeding or bottle-feeding the newborn. 2.Describe nursing interventions to su...

Infant Nutrition Lactation/Nursing Support Bottlefeeding © 2002 Delmar, a Thomson Learning company 1 Lesson 9.2 Objectives 1. Discuss the elements of informed decision-making related to the choice of breastfeeding or bottle-feeding the newborn. 2.Describe nursing interventions to support breastfeeding, including positioning and the physiology of lactation. 3. Explain the principles of the Baby Friendly Initiative 4. Describe techniques of formula preparation and feeding 5. Plan appropriate discharge teaching Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Nutritional Needs of Newborn At birth, the passive intake of nutrition ends and the newborn must actively consume and digest food Newborn has unique nutritional needs Healthy term newborn requires 80–100 mL/kg/day of water to maintain fluid balance and growth 110–120 kcal/kg/day to meet energy needs for growth and development Breast milk is superior nutritionally to commercial formulas Canadian Pediatricians recommends Exclusive breast-feeding until 6 months of age Continuation of breast-feeding until at least 12 months of age SELECTION OF A FEEDING METHOD Choices: Breast-feed exclusively Breast-feed and supplement with expressed breast milk in a bottle Breast-feed and supplement with formula Formula-feed exclusively SELECTION OF A FEEDING METHOD Factors that influence choice of method Culture Sociodemographic factors Prior experience with or exposure to breast-feeding Intent or need to return to work or school Support Benefits of Breastfeeding for Newborn Correct nutrients that the newborn needs Is easily digested Provides natural immunity, Lower incidence of: childhood respiratory and gastrointestinal diseases, otitis media, diabetes mellitus, childhood leukemia, obesity, and necrotizing enterocolitis. May prevent the development or delay the onset of allergies in the newborn, especially if there is a family history of allergies. May have a role in improving brain development of the newborn. Promotes elimination of meconium, and adequate intake may decrease the risk of jaundice in the early days of life. Breastfed newborns are rarely constipated. Promotes jaw and mouth development. Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Benefits for the Breastfeeding Person Promotes return of uterus to its pre-pregnant state. Reduces risk of developing uterine, breast, and ovarian cancers, and osteoporosis Facilitates weight loss. Birth control method for up to 6 months. Health teaching required, as there are many factors that could result in pregnancy. Enhances parent–infant bonding. Is convenient and economical. Eliminates the risks of a contaminated water supply or improper dilution Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Possible Contraindications to Breastfeeding Infections: HIV, Ebola, untreated brucellosis. Herpes lesions on breasts, active varicella zoster virus and untreated infectious tuberculosis (in these cases, expressed milk can be provided). Use of certain substances (e.g., illicit drugs) or is undergoing treatment (chemotherapy, radioactive isotope therapy). Galactosemia in the infant Copyright © 2020 by Elsevier, Inc. All Rights Reserved. The breast and lactation Unique organ designed to provide the newborn with nourishment through lactation Consists of 15–20 lobes containing the milk-producing alveoli Makes milk in response to several different stimuli Physical emptying of the breast Hormonal stimulation Sensory stimulation Stages of Lactation (pg 234) Stage 1 (secretory differentiation) Stage 2 (secretory activation) Stage 3 (galactopoiesis) Stage 4 (involution) Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Milk Production Hormones Prolactin - secretion of breastmilk into the alveoli, stimulates production of milk by alveoli, prolactin concentration is highest at night Oxytocin - : milk delivery, contraction of the muscles around the alveoli sacs, sending milk through the duct system to the nipple (milk ejection, or let-lown reflex), breastfeeding person feels tingling (maybe), and might feel uterus cramping. Multiple milk ejections occur in a feeding session. Supply and demand Changes in fat content of milk Foremilk – beginning (less fat) Hindmilk - end (highly fatty) Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Nursing Care Skin-to-skin Hand expression Galactogogues - use of “breast milk stimulators.” These are interventions taken by the breastfeeding person to facilitate lactation. Nurses must be culturally respectful of these practices. Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Breastfeeding Positions Baby-led nursing Cradle hold Modified cradle Side-lying position Football hold – most comfortable after a csection Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Breastfeeding Techniques Hunger cues Latch-on Suckling patterns Removing the newborn from the breast Frequency and duration of feedings Responsive cue-based breastfeeding 8-12 times per day (Q2-3h) Burping Copyright © 2020 by Elsevier, Inc. All Righ ts Reserved. Essential factors in breastfeeding involve: Proper body alignment Correct grasp of the areola Proper hand positions on the breast The parent should wash their hands before breastfeeding. Attempting to express some colostrum on the nipple prior to breastfeeding will increase the erectness of the nipples. Feeding from both breasts at every feed Hunger Cues Hand-to-mouth movements Mouth and tongue movements Sucking motions Rooting movements Clenched fists Kicking of legs Crying (a late sign) Copyright © 2020 by Elsevier, Inc. All Righ ts Reserved. Latch-On Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Removing Infant From Breast Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Evaluating Intake of Infant Breast feels soft after feeding Let-down reflex occurs Infant stays awake at breast a minimum of 8 times per day An audible swallow is heard Infant cues to feed and appears relaxed after feeding Infant has 6-8 wet diapers per day by age 6 days Infant passes several stools per day Does not lose more than 10% of birth weight Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Overcoming Challenges The sleepy infant The fussy infant Flat or inverted nipples Supplemental feedings Concerns with transitioning between breast and bottle Breast engorgement Sore nipples Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Nutritional Requirements During Lactation Requires a little more food each day – one extra snack Protein intake should be same as during pregnancy Adequate fluids to relieve thirst Vitamin supplements are often continued during lactation Limit intake of caffeine and alcohol Medications should only be taken upon the advice of the health care provider Some foods may cause a change in the taste of the milk or cause the infant to develop gas (flatus) Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Baby Friendly Hospital Initiative (BFI) Goal is to support, protect, and promote breastfeeding Has had a positive impact on breastfeeding initiation and exclusivity 10 Steps to Successful Breastfeeding Breastfeeding is protected by The Canadian Human Rights Commission Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Formula Feeding Types of formulas Ready to feed Concentrated liquid Powdered Regardless of type, it is important to follow manufacturer’s instruction on preparation and storage of formula products Should feed on-demand based on infant’s cues Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Feeding the Infant Overdilution or underdilution of concentrated liquid or powdered formulas can result in serious illness Do not microwave formula Do not prop bottle Involve partner and family in bottle feeding of infant Copyright © 2020 by Elsevier, Inc. All Rights Reserved. Breastfeeding Resources Public Health/Breastfeeding Clinics Lactation consultants La Leche League International Lactation Consultant Association (ILCA) ©Chapter 2002 Delmar, 30 a Thomson 25 Learning company