Newborn Nutrition

Chapter 26

Newborn Nutrition

• Need protein, carbs, fat.

• Inability to concentrate urine, increase fluids if hot or ill

• Need vitamins and minerals

• Formula fed gain weight faster, need more formula to get necessary nutrients

• Breastfed babies gain weight more slowly

Stages of Human Milk

• Colostrum-2-4 days, yellow creamy, increase in pro., vit, min.and IgA

• Transition -until 2 wks PP, increase in fat and calories

• Mature-90% water

• Foremilk- H20, vit, protein

• Hindmilk-more fat

• Should BF 6-12 months

Advantages• Provide immunologic protection for up to 18

months• More easily and efficiently absorbed• BF+ sunlight= no supplements• BF promotes attachment• Contraindication-breast CA, HIV,

galactosemia, flagyl, jaundice, another pregnancy

Bottlefeeding

• Parents can share caring for newborn

• Higher incidence of allergic reaction(cow)

• Problem with powder concentration

• Cow milk not acceptable for infant feeding.

• Too much protein,calcium,phos, sodium potassium

Newborn Feeding

• Indications of newborn hunger?• Colostrum can be aspirated without irritation.• Benefits- oxytocin production, stimulates

peristalsis, decrease bilirubin, + attachment• Newborn may play with nipple, recognize odor of

mother• Assess for fistula or atresia• To R side for drainage and gastric emptying

Feeding Patterns

• Established by newborn

• Breastfed babies feed more frequently

• Newborn cues of hunger

• Newborns needs are better met with couplet care

• Support informed decision regarding type of breastfeeding

Breastfeeding Positions

• Football, lying, cradling, across lap.

• Use pillows for positioning

• Rub feet for sleepy baby

• May have to soothe upset newborn before feeding

• Explore cultural considerations of breastfeeding

Physiology of Breastfeeding

• Lobes-alveoli- small to larger lactating ducts flow toward nipples

• Breast development influenced by estrogen• Prolactin increases after birth and with sucking• Sucking stimulates post pituitary to release

oxytocin• Letdown-caused by stimulation of myoepithelial

cells

Teaching Breastfeeding• Good positioning, facing mom

• Use C or scissors

• Stimulate to open mouth

• Baby to breast

• Alternate breast

• Do not set restrictive time limits

• Mother and baby will become sleepy

Bottle/Breast Feeding

• May confuse newborn

• Use different muscles

• Mothers can use use pump (electric) or express manually.

• Can store milk in refrigerator or freezer

• Better to store in plastic

• Never microwave

Effects of Drugs on BF

• Avoid long acting drugs

• Give meds right after BF

• Observe infant for adverse effects

• Use drugs that metabolize quickly

• Weigh risks and benefits

Bottlefeeding Education

• Never prop up bottle

• Assess nipple for size of hole

• Point nipple directly into mouth

• Burp at intervals

• Regurgitation is normal

• Fat baby not necessarily healthy

• Discuss amt and frequency with client

Assess Weight Gain

• Assess growth and weight gain

• Six wet diapers/day

• Should not exceed 32 oz./day

• Can calculate needs and have parents keep records