Newborn Feeding / Nutrition

BENEFITS OF BREASTFEEDING

• human milk is designed specifically for infants, it is nutritionally superior to any alternative
• breast milk is considered living tissue bc is contains almost as many live cells as blood
• bacteria wise is always safe and fresh
• nutrients in bread milk are easily absorbed

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Contraindications to breastfeeding

• cancer
• active tuberculosis not under treatment
• HIV
• herpes on break
• galactosemia in infant
• maternal substance abuse

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Milk production

• after birth of infant, estrogen and progesterone levels trigger release of prolactin from anterior pituitary gland

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==PROLACTIN==

• hormone critical for milk production, levels are highest 10 days post birth
• prolactin produced in response to infant suckling and emptying of breasts

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==OXYTOCIN==

• oxytocin is another hormone essential to lactation. When nipple is stimulated, posterior pituitary promoted by hypothalamus produced oxytocin

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==COLOSTRUM==

• clear, yellowish fluid that is more concentrated than human milk
  • very rich in immunoglobulins
  • high concentration of protein and fat soluble vitamins
  • less fat than mature milk

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==HUMAN MILK CHARACTERISTICS==

• fat content of milk increases during each feeding
• initially fore milk is released that:
  • skim milk makes up 60% of volume
  • whole milk 35% volume
  • provides lactulose, protein and water soluble vitamins
• hindmilk (cream)
  • usually 5% usually let down 10-20mins into feeding
  • contraints denser calories from fat ensuring optimal growth

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ASSESSMENT OF LATCH

• baby head and body is in a straight line
• babys whole body is supported
• baby approaches breast, nose to nipple
• mouth is wide open, lips are flanged
• chin is pressed into great
• more areola is seen above baby’s top lip
• sucking should be slow, deep with pauses

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KEY TEACHING POINTS

• offer both breasts at each feed
• feed frequently, 8 times in 24hrs
• baby may want to cluster feed, this is normal when baby is recently born
• make sure mom is comfortable
• observe for hunger cues
• break an uncomfortable latch, get help is needed
• baby is getting enough milk if they are gaining weight, having 6 or more wet diapers and 3 soiled diapers a day

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STORING BREASTMILK

• expressed breast milk should be kept in a clean container, glass bottle or milk bags with date marked
• breast milk cab be stored for
  • 6 to 8 hrs @ room temperature
  • up to 5 days in the refrigerator
  • 2 weeks in a refrigerator freezer
  • 3-6 months in a freezer compartment of a refrigerator with separate doors
  • 6-12 months in a separate chest type freezer
• ** never mix fresh bread milk with chilled or frozen bread milk, it can cause bacteria to grow and lead to food poisoning

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==CARE OF THE MOTHER==

• breastfeeding mother require 350-400 calories/day
• continue to take prenatal vitamins
• drink enough fluids
• caffeine in moderation

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==BREASTFEEDING COMPLICATIONS==

• engorgement
• sore nipples
• plugged milk ducts
• mastitis

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Formula feeding education

• readiness for feeding
• feeding patterns
• feeding techniques
• bottles and nipples
• infant formulas
• formula preparation

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Types of formula

• read to feed ( nothing added in )
• liquid concentrate ( need to add sterile water
• powdered ( sterile water )
  • to sterilize water, need to boil for 2 minuets, then let cool
  • do not head bottles in microwave, can cause uneven heating and burn baby

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