Simmons NNP 501 Newborn Care MASTERY GUIDE: Lactation Support, SUID Prevention & Infant Colic Management – Expert Protocols & Parent Education Strategies with professor verified solutions

What is colostrum?

thick yellowish milk

produced 1st several days after delivery

about 100ml produced q 24 hr

High concentration of antibodies

valuable to newborn

(asynchronous)

What is transitional milk?

produced days 4-10 postpartum

intermediate bt colostrum and mature milk

volume increases during this time

(asynchronous)

What is mature milk?

-produce around day 10 through termination of breast feeding

fats, casein, whey, nonprotein nitrogen, lactose, 750kcal/1,000mL

(asynchronous)

What hormones are responsible for lactation? In what way?

-Oxytocin is responsible for milk ejection reflux (let down) and increase in diameter of milk ducts.

-Prolactin stimulates synthesis of mRNA of milk proteins

(asynchronous)

What is engorgement?

-Temporary condition (usually subsides by end of second week)

-hormonal changes, increased vascularity, lymphatic congestion

-swollen, hard, tender breasts

(Thureen p. 184)

How can engorgement be prevented?

Frequent nursing, manual expression, gentle massage (improves lymphatic drainage)

(Thureen, p 184)

How can engorgement be treated?

Warm compresses, warm showers, expressing milk, ice packs

(asynchronous)

How long can breast milk be stored?

Warm room: 3-4 hours

Room temp: 4-8 hours

Cooler c ice: 24 hours

Refrigerator: 3-8 days or thawed in refrigerator: 24 hours

Freezer: 6 months

Deep freeze freezer: 12 months

(asynchronous)

How often should an infant breastfeed?

Immediate postpartum period: First breastfeeding should be within 1 hour of birth (during first period of reactivity) & baby should have 8-12 breastfeeding q 24 hours

(asynchronous)

q 2-4 hours, 10-15 minute per breast

(Thureen p. 373)

When should vitamin K be given after birth?

After the first feeding but within 6 hours of birth

(asynchronous)

What conditions should a mother not breastfeed? (contraindications)

Galactosemia in infant(unable to breakdown lactose)

Certain diseases in mother:

-HIV in industrialized nation(+ in developing okay due to larger risk of contaminated water)

-T-call lymphotrophic virus type I or II in mother

-Untreated brucellosis

-Active TB (can initiate breastfeeding 2 weeks after treatment)

-Active HSV lesions on breast (expressed milk is okay)

-Varicella 5 days before delivery through 2 days after (expressed milk is okay)

-H1N1 with fever (expressed milk is okay)

-Chemotherapy agents(antimetabolites) that interfere with DNA replication and cell division

-radiation therapies (temporary)

-Illicit drug use (PCP, cocain, cannabis)

(asynchronous)

What are signs of mastitis?

swelling, burning, redness, pain, flu-like symptoms

(asynchronous)

How would you treat mastitis?

warm compresses, antibiotics, frequent breastfeeding, pain medication

(asynchronous)

What are the normal weight gain/loss parameters for a normal breastfeeding infant?

-Weight loss over 7% (occasionally up to 10%) is not tolerated.

-Continued weight loss by 5th day not tolerated

-Goal for first few months: 1/2-1 oz gain/day after 1st week

of life

-Use WHO growth cart, NOT CDC growth chart for breastfeeding infants

(asynchronous)

What infants are at highest rick for SIDS?

-Age 2-4 months

-male (60%)

-African American, American Native, Alaskan Native

-Maternal Factors: increased AFP in 2nd trimester, smoking (#1), alcohol use, drug use, nutritional deficiency, inadaquate prenatal care, younger, less education, unmarried, shorter interpregnancy interval, intrauterine hypoxia, IUGR, low socioeconomic status

-Infant Factors: recent febril illness, smoke exposure, soft sleeping surface or bedding, sharing bad with a parent, thermal stress/overheating, history of acute life-threatenting event, lack of breastfeeding, sibliing with SIDS

-Unclear: URI, Genetic

(asynchronous)

What recommendations would you make to parents to reduce the risk of SIDS?

-No home electronic monitoring equipment or commercial devices

-"Back to sleep", firm sleep surface, share room but not bed, no soft objects in crib, get prenatal care, avoid smoke, avoid drugs & alcohol, breastfeed, pacifier at nap and bedtime, avoid overheating, immunize

(asynchronous)

What is colic?

Intense, inconsolable crying in an otherwise healthy well-fed child

crying bouts last 1-2 hours or longer

began in week 2-3 and is usually over by 3 months

harmless for baby

cause is unknown

(Thureen p.375)

What are the risk factors for colic?

cause is unknown

not usually caused by abd pain or gas

(Thureen p.375)

Infants of mothers who smoke during pregnancy or after delivery have a greater risk

(Colic, Mayo clinic)

What can you do for an infant with colic?

-Console baby: motion, warm bath, riding in a soft front pack

-If baby has been fed and changed and consoling doesn't work: place in crib and let cry for 15 minutes, if still crying at that time pick and and try consoling methods again. Repeat 15 min sessions until baby calms or falls asleep

-Notify provider if: cry seems to become a more painful one, crying lasts more than 3 hours at a time, if colic begins after 1 month of age, if diarrhea, vomiting or constipation occurs, if baby is inconsolable, or if the caretaker is exhausted and frustrated.

(Thureen p. 375)