Newborn Nutrition

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• 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 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• 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 time 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