Week 12- Newborn Nutrition/ Immediate Post Birth Care

Question 1

Colostrum is high in ___ and lasts how long ____.

Answer 1

High in protein

Lasts up to day 5

Question 2

Transitional milk is higher in ____ and lasts until ____.

Answer 2

Protein and carbs

Lasts until 2 weeks

Question 3

Mature milk is composed of what?

Answer 3

Foremilk- carb rich

Hindmilk- protein/fat rich

Question 4

Contraindications to breastfeeding:

Answer 4

1. Certain maternal meds
2. Maternal substance abuse
3. Cytotoxic and immunosuppressive drugs
4. Active TB
5. HSV lesion on breast
6. Active varicella infection
7. HIV infection in developed countries
8. Neonatal galactosemia

Question 5

Breast milk may be stored at room temp for:

Answer 5

4-6 hours

Question 6

Breast milk may be stored with cooler with ice for:

Answer 6

Up to 24 hours

Question 7

Breast milk may be stored in fridge up to:

Answer 7

3-8 days

Question 8

Breast milk may be stored in the freezer ____ and deep freezer ___.

Answer 8

Freezer- 4-6 months

Deep freezer- 6-12 months

Question 9

Formula prep:

Answer 9

I scoop per 2 ounces

Question 10

Hydrolyzed formula is:

Answer 10

Partially broken down

Question 11

Amino acid formula is good for-

Answer 11

Soy/dairy intolerance

Question 12

3 or more hours a day of crying for 3 or more days a week for more than 3 weeks in a row is?

Answer 12

Colic

Question 13

When does colic typically start and resolve?

Answer 13

3w

3 m

Question 14

How much are newborns expected to lose in the first days of life?

Answer 14

5-8% of body weight in bottle fed

10% in breastfed babies

Question 15

When should newborns return to birth weight?

Answer 15

By 2 weeks of life

Question 16

When do newborns double birth weight?

Answer 16

5-6 months

Question 17

When do infants normally triple their birth weight?

Answer 17

1 year

Question 18

Infant weight below the 3rd percentile requires-

Answer 18

Frequent follow up

Question 19

Complications of poor weight gain in the infant?

Answer 19

Developmental delay
Poor bonding
Severe dehydration

Question 20

All states require what on newborn screening?

Answer 20

Congenital hypothyroidism
Cystic fibrosis
Sickle cell
PKU

Question 21

Any referred metabolic screening should be retested by:

Answer 21

3m of age

Question 22

When should metabolic screen be done?

Answer 22

As close to hospital discharge as possible.

If born at home- within 1-2 days

Question 23

2 types of newborn hearing tests:

Answer 23

1. Auditory- brain response

2. Otoacoustic- emissions testing- most common and measures ciliary movement

Question 24

When are you most concerned with jaundice?

Answer 24

If visible within 1st 24 hours of life or if it appears excessive

Question 25

Glucose may fall how low in newborns?

Answer 25

May fall as low as 25-35 in first hour of life

Question 26

Who gets vitamin K?

Answer 26

Infants greater than 1.5 kg get 1mg vitamin K

Question 27

Who should get hep B?

Answer 27

Medically stable infants over 2kg should receive within 1st 24 hours of life

Question 28

What do green stools indicate?

Answer 28

More foremilk than hindmilk

Question 29

Blood in stool may indicate-

Answer 29

Protein allergy

Question 30

Bilirubin is the:

Answer 30

End product of heme metabolism

Question 31

This is bound to glucuronic acid and is water soluble (more easily secreted):

Answer 31

Conjugated bili

Question 32

This is inbound and not water soluble (difficult to excrete)

Answer 32

Unconjugated bili

Question 33

What is the peak level of bilirubin in newborns?

Answer 33

6mg/dl which occurs between 2-4 days of life

Question 34

What causes hyperbilirubinemia?

Answer 34

Hepatic immaturity Decrease ability to conjugate bili Decreased rate of excretion Mild dehydration/ low caloric intake

Question 35

Screening for hyperbili?

Answer 35

Transcutaneous bilicheck- 5 measurements and get average | Can’t be used on infants less than 37w

Question 36

What infants are at higher risk of hyperbili?

Answer 36

Less than 38w gestation and breastfed infants

Question 37

Other major risk factors of hyperbili?

Answer 37

``` Jaundice within first 24 hours A sibling who had jaundice Unrecognized hemolysis Non-optimal sucking/nursing Deficiency in G6PD Infection Cephalohematoma East Asian Or Mediterranean descent ```

Question 38

Pathologic jaundice caused by:

Answer 38

``` Isoimmunization Erythrocyte biochemical defects Structural abnormalities Infection Sequestered blood ```