Chapter 24: Newborn Nutrition and Feeding Perry: Maternal Child Nursing Care, 6th Edition

1. A new mother recalls from prenatal class that she should try to feed her newborn daughter when she exhibits feeding readiness cues rather than waiting until her infant is crying frantically. On the basis of this information, this woman should feed her infant about every 2.5 to 3 hours when she:

a. waves her arms in the air.

b. makes sucking motions.

c. has hiccups.

d. stretches her legs out straight.

b. makes sucking motions.

2. A new father is ready to take his wife and newborn son home. He proudly tells the nurse who is discharging them that within the next week he plans to start feeding the infant cereal between breastfeeding sessions. The nurse can explain to him that beginning solid foods before 4 to 6 months may:

a. decrease the infant's intake of sufficient calories.

b. lead to early cessation of breastfeeding.

c. help the infant sleep through the night.

d. limit the infant's growth.

b. lead to early cessation of breastfeeding.

3. A pregnant woman wants to breastfeed her infant; however, her husband is not convinced that there are any scientific reasons to do so. The nurse can give the couple printed information comparing breastfeeding and bottle-feeding. Which statement is most accurate? Bottle-feeding using commercially prepared infant formulas:

a. increases the risk that the infant will develop allergies.

b. helps the infant sleep through the night.

c. ensures that the infant is getting iron in a form that is easily absorbed.

d. requires that multivitamin supplements be given to the infant.

a. increases the risk that the infant will develop allergies.

4. A after birth woman telephones about her 4-day-old infant. She is not scheduled for a weight check until the infant is 10 days old, and she is worried about whether breastfeeding is going well. Effective breastfeeding is indicated by the newborn who:

a. sleeps for 6 hours at a time between feedings.

b. has at least one breast milk stool every 24 hours.

c. gains 1 to 2 ounces per week.

d. has at least 6 to 8 wet diapers per day.

d. has at least 6 to 8 wet diapers per day.

5. A primiparous woman is delighted with her newborn son and wants to begin breastfeeding as soon as possible. The nurse can facilitate the infant's correct latch-on by helping the woman hold the infant:

a. with his arms folded together over his chest.

b. curled up in a fetal position.

c. with his head cupped in her hand.

d. with his head and body in alignment.

d. with his head and body in alignment.

6. A breastfeeding woman develops engorged breasts at 3 days' after birth. What action would help this woman achieve her goal of reducing the engorgement? The woman:

a. skips feedings to let her sore breasts rest.

b. avoids using a breast pump.

c. breastfeeds her infant every 2 hours.

d. reduces her fluid intake for 24 hours.

c. breastfeeds her infant every 2 hours.

7. At a 2-month well-baby examination, it was discovered that a breastfed infant had only gained 10 ounces in the past 4 weeks. The mother and the nurse agree that, to gain weight faster, the infant needs to:

a. begin solid foods.

b. have a bottle of formula after every feeding.

c. add at least one extra breastfeeding session every 24 hours.

d. start iron supplements.

c. add at least one extra breastfeeding session every 24 hours.

8. A new mother wants to be sure that she is meeting her daughter's needs while feeding her commercially prepared infant formula. The nurse should evaluate the mother's knowledge about appropriate infant care. The mother meets her child's needs when she:

a. adds rice cereal to her formula at 2 weeks of age to ensure adequate nutrition.

b. warms the bottles using a microwave oven.

c. burps her infant during and after the feeding as needed.

d. refrigerates any leftover formula for the next feeding.

c. burps her infant during and after the feeding as needed.

9. The nurse is discussing storage of breast milk with a mother whose infant is preterm and in the special care unit. What statement would indicate that the mother needs additional teaching?

a. "I can store my breast milk in the refrigerator for 3 months."

b. "I can store my breast milk in the freezer for 3 months."

c. "I can store my breast milk at room temperature for 8 hours."

d. "I can store my breast milk in the refrigerator for 3 to 5 days."

a. "I can store my breast milk in the refrigerator for 3 months."

10. According to the recommendations of the American Academy of Pediatrics on infant nutrition:

a. infants should be given only human milk for the first 6 months of life.

b. infants fed on formula should be started on solid food sooner than breastfed infants.

c. if infants are weaned from breast milk before 12 months, they should receive cow's milk, not formula.

d. after 6 months mothers should shift from breast milk to cow's milk.

a. infants should be given only human milk for the first 6 months of life.

11. Which statement concerning the benefits or limitations of breastfeeding is inaccurate?

a. Breast milk changes over time to meet changing needs as infants grow.

b. Long-term studies have shown that the benefits of breast milk continue after the infant is weaned.

c. Breast milk/breastfeeding may enhance cognitive development.

d. Breastfeeding increases the risk of childhood obesity.

d. Breastfeeding increases the risk of childhood obesity.

12. The nurse is explaining the benefits associated with breastfeeding to a new mother. Which statement by the nurse would be inaccurate and provide conflicting information to the patient?

a. Women who breastfeed have a decreased risk of breast cancer.

b. Breastfeeding is an effective method of birth control.

c. Breastfeeding increases bone density.

d. Breastfeeding may enhance after birth weight loss.

b. Breastfeeding is an effective method of birth control.

13. While discussing the societal impacts of breastfeeding, the nurse should be cognizant of the benefits and educate the patient accordingly. Which statement as part of this discussion would be incorrect?

a. Breastfeeding requires fewer supplies and less cumbersome equipment.

b. Breastfeeding saves families money.

c. Breastfeeding costs employers in terms of time lost from work.

d. Breastfeeding benefits the environment.

c. Breastfeeding costs employers in terms of time lost from work.

14. The best reason for recommending formula over breastfeeding is that:

a. the mother has a medical condition or is taking drugs that could be passed along to the infant via breast milk.

b. the mother lacks confidence in her ability to breastfeed.

c. other family members or care providers also need to feed the baby.

d. the mother sees bottle-feeding as more convenient.

a. the mother has a medical condition or is taking drugs that could be passed along to the infant via breast milk..

15. With regard to the nutrient needs of breastfed and formula-fed infants, nurses should understand that:

a. breastfed infants need extra water in hot climates.

b. during the first 3 months breastfed infants consume more energy than do formula-fed infants.

c. breastfeeding infants should receive oral vitamin D drops daily at least during the first 2 months.

d. vitamin K injections at birth are not needed for infants fed on specially enriched formula.

c. breastfeeding infants should receive oral vitamin D drops daily at least during the first 2 months.

16. Nurses providing nutritional instruction should be cognizant of the uniqueness of human milk. Which statement is correct?

a. Frequent feedings during predictable growth spurts stimulate increased milk production.

b. The milk of preterm mothers is the same as the milk of mothers who gave birth at term.

c. The milk at the beginning of the feeding is the same as the milk at the end of the feeding.

d. Colostrum is an early, less concentrated, less rich version of mature milk.

a. Frequent feedings during predictable growth spurts stimulate increased milk production.

17. In assisting the breastfeeding mother position the baby, nurses should keep in mind that:

a. the cradle position usually is preferred by mothers who had a cesarean birth.

b. women with perineal pain and swelling prefer the modified cradle position.

c. whatever the position used, the infant is "belly to belly" with the mother.

d. while supporting the head, the mother should push gently on the occiput.

c. whatever the position used, the infant is "belly to belly" with the mother.

18. The process whereby parents awaken the infant to feed every 3 hours during the day and at least every 4 hours at night is:

a. known as demand feeding.

b. necessary during the first 24 to 48 hours after birth.

c. used to set up the supply-meets-demand system.

d. a way to control cluster feeding.

b. necessary during the first 24 to 48 hours after birth.

19. With regard to basic care of the breastfeeding mother, nurses should be able to advise her that she:

a. will need an extra 1000 calories a day to maintain energy and produce milk.

b. can go back to prepregnancy consumption patterns of any drinks, as long as she ingests enough calcium.

c. should avoid trying to lose large amounts of weight.

d. must avoid exercising because it is too fatiguing.

c. should avoid trying to lose large amounts of weight.

20. The breastfeeding mother should be taught a safe method to remove the breast from the baby's mouth. Which suggestion by the nurse is most appropriate?

a. Slowly remove the breast from the baby's mouth when the infant has fallen asleep and the jaws are relaxed.

b. Break the suction by inserting your finger into the corner of the infant's mouth.

c. A popping sound occurs when the breast is correctly removed from the infant's mouth.

d. Elicit the Moro reflex to wake the baby and remove the breast when the baby cries.

b. Break the suction by inserting your finger into the corner of the infant's mouth.

21. A newly delivered mother who intends to breastfeed tells her nurse, "I am so relieved that this pregnancy is over so I can start smoking again." The nurse encourages the patient to refrain from smoking. However, this new mother insists that she will resume smoking. The nurse will need to adapt her health teaching to ensure that the patient is aware that:

a. smoking has little or no effect on milk production.

b. there is no relation between smoking and the time of feedings.

c. the effects of secondhand smoke on infants are less significant than for adults.

d. the mother should always smoke in another room.

d. the mother should always smoke in another room.

22. Which type of formula is not diluted before being administered to an infant?

a. Powdered

b. Concentrated

c. Ready-to-use

d. Modified cow's milk

c. Ready-to-use

23. How many kilocalories per kilogram (kcal/kg) of body weight does a breastfed term infant require each day?

a. 50 to 65

b. 75 to 90

c. 95 to 110

d. 150 to 200

c. 95 to 110

24. The hormone necessary for milk production is:

a. estrogen.

b. prolactin.

c. progesterone.

d. lactogen.

b. prolactin.

25. To initiate the milk ejection reflex (MER), the mother should be advised to:

a. wear a firm-fitting bra.

b. drink plenty of fluids.

c. place the infant to the breast.

d. apply cool packs to her breast.

c. place the infant to the breast.

26. As the nurse assists a new mother with breastfeeding, the patient asks, "If formula is prepared to meet the nutritional needs of the newborn, what is in breast milk that makes it better?" The nurse's best response is that it contains:

a. more calories.

b. essential amino acids.

c. important immunoglobulins.

d. more calcium.

c. important immunoglobulins.

27. When responding to the question "Will I produce enough milk for my baby as she grows and needs more milk at each feeding?" the nurse should explain that:

a. the breast milk will gradually become richer to supply additional calories.

b. as the infant requires more milk, feedings can be supplemented with cow's milk.

c. early addition of baby food will meet the infant's needs.

d. the mother's milk supply will increase as the infant demands more at each feeding.

d. the mother's milk supply will increase as the infant demands more at each feeding.

28. To prevent nipple trauma, the nurse should instruct the new mother to:

a. limit the feeding time to less than 5 minutes.

b. position the infant so the nipple is far back in the mouth.

c. assess the nipples before each feeding.

d. wash the nipples daily with mild soap and water.

b. position the infant so the nipple is far back in the mouth.

29. Parents have been asked by the neonatologist to provide breast milk for their newborn son, who was born prematurely at 32 weeks of gestation. The nurse who instructs them about pumping, storing, and transporting the milk needs to assess their knowledge of lactation. Which statement is valid?

a. A premature infant more easily digests breast milk than formula.

b. A glass of wine just before pumping will help reduce stress and anxiety.

c. The mother should pump only as much as the infant can drink.

d. The mother should pump every 2 to 3 hours, including during the night.

a. A premature infant more easily digests breast milk than formula.

30. A new mother asks whether she should feed her newborn colostrum, because it is not "real milk." The nurse's most appropriate answer is:

a. colostrum is high in antibodies, protein, vitamins, and minerals.

b. colostrum is lower in calories than milk and should be supplemented by formula.

c. giving colostrum is important in helping the mother learn how to breastfeed before she goes home.

d. colostrum is unnecessary for newborns.

a. colostrum is high in antibodies, protein, vitamins, and minerals.

1. Examples of appropriate techniques to wake a sleepy infant for breastfeeding include: (Select all that apply.)

a. unwrapping the infant.

b. changing the diaper.

c. talking to the infant.

d. slapping the infant's hands and feet.

e. applying a cold towel to the infant's abdomen.

a. unwrapping the infant.

b. changing the diaper.

c. talking to the infant.

2. A nurse is discussing the signs and symptoms of mastitis with a mother who is breastfeeding. What signs and symptoms should the nurse include in her discussion? (Select all that apply.)

a. Breast tenderness

b. Warmth in the breast

c. An area of redness on the breast often resembling the shape of a pie wedge

d. A small white blister on the tip of the nipple

e. Fever and flu-like symptoms

a. Breast tenderness

b. Warmth in the breast

c. An area of redness on the breast often resembling the shape of a pie wedge

e. Fever and flu-like symptoms

3. Late in pregnancy, the woman's breasts should be assessed by the nurse to identify any potential concerns related to breastfeeding. Some nipple conditions make it necessary to provide intervention before birth. These include: (Select all that apply.)

a. everted nipples.

b. flat nipples.

c. inverted nipples.

d. nipples that contract when compressed.

e. cracked nipples.

b. flat nipples.

c. inverted nipples.

d. nipples that contract when compressed.