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Paediatric Neonatology > Feeding > Flashcards

Flashcards in Feeding Deck (18)
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1

What is good weight gain in a neonate?

25g/an ounce a day with a day off on Sunday

2

What are indications for NG tube feeding in neonates?

Any sick infant who is too ill of too young to feed normally
Expressed breast milk or formula milk is fed by NG/OG tube

3

What is trophic feeding

Minimal enteric feeding, gut priming
This is to maintain normal GI structure and function

4

What are indications for parental nutrition?

Via central vein
Post-op
Trauma
Burns
If oral nutrition is poor
Gut rest - necrotising enterocolitis

5

What are complications of parenteral nutrition?

Infection
Acidosis
Metabolic imbalances
Thromboembolic
Hepatobiliary stenosis
Cholelithiasis
Osteopenia

Stop in stages to avoid hypoglycaemia

6

What are reflexes associated with breastfeeding

Rooting
Suckling - jaw goes up and down while the tongue compresses the areola against the palate
Swallowing - larynx rises, epiglottis falls

7

What are signs of correct attachment?

Mouth wide open, chin touching breast
Baby should be seen to be drawing in the breast not just the nipple
Lower lip curled back, maximally gobbling areola
Slow, rhythmic deep jaw movements as well as suckling movement

8

When is expressing breast milk valuable?

To relieve painful breast engorgement between feeds
To keep milk production going when it is necessary to give nipples a rest
o aid nutrition if sucking is reduced - cleft lip, prematurity
If the mother is going to be separated from baby

9

How long can breast milk be kept?

5 days in the fridge
Frozen milk should be used within 6 months

10

What are symptoms of mastitis?

Tender, hot, red breast
Fever

11

What is treatment of mastitis?

Flucloxacillin
Ibuprofen
Continue breastfeeding
Express if too painful

12

What are factors that make breastfeeding harder?

If mother and baby are separated at night
Unfriendly working environment
Cultural reframing of breasts as sex objects

13

what are advantages of breast feeding?

Sucking promotes uttering contractions so avoiding some PPHs
Breastfeeding induced oxytocin surges promote trust and diminish fear
Less insulin resistance, hypertension, obesity due to long chain polyunsaturated fatty acids
Breast milk is free and clean and gives baby attractive smell
Colostrum has good endorphins
IgA, macrophages, lymphocytes protect from infection

14

Why is feeding on demand encouraged?

Keeps baby happy and enhances milk production
Fewer breast problems - engorgement, abscesses

15

What are CI to breastfeeding?

HIV +ve
Amiodarone
Antimetabolitses
Antithyroid drugs
Opiates

16

What milk is given in cows milk allergy?

Hydrolized formula - protein hydrolysed into short peptides

17

How much milk do babies need?

150ml/kg/24h over 4-6 feeds

18

What drugs are contraindicated in breastfeeding?

Lithium
Amiodarone
Methotrexate
Benzos
Aspirin
Sulphonamides
Tetracyclines

Carbimazole, Cipro, Chloramphenicol, Cytoxics