Week 7 - newborn feeding

Question 1

how many months is exclusive breast milk recommended for?

Answer 1

6 months

Question 2

How much vitamin D should be given for all breast/human milk babies?

Answer 2

400 IU

Question 3

What mineral should be present in foods at six months?

Answer 3

Iron rich

Question 4

Why is human milk considered living tissue?

Answer 4

-because it contains almost as many live cells as blood
- baceriologically safe

Question 5

What are 4 benefits of human milk to babies?

Answer 5

1. Immunity
2. Decreased risk of many types of diseases
3. Anaglesic for NBs
4. Enhances brain development

Question 6

What are the benefits of breast/chest feeding to the birther?

Answer 6

1. decreased risk of many issues- namely PPH (helps uterine involution)
2. helps decrease weight after pregnancy
3. Helps with infant bonding
4. convenient and free

Question 7

Who is contraindicated to breast/chest feed?

Answer 7

1. HIV birthers
2. birthers undergoing cancer treatments
3. substance using birthers (gets to baby)
4. Herpes simplex lesion on breast

Question 8

Can birthers on methodone or subboxone breast/chest feed?

Answer 8

yes!
helps with withdrawl symptoms in babies also

Question 9

How long should we keep baby on birther’s chest/skin to skin?

Answer 9

start of birth (PP) until after the 1st feed

Question 10

how often should parents feed their baby?

Answer 10

8-12 x per day and PRN

Question 11

When does lactogenesis begin?

Answer 11

Stag 1 - in pregnency and ends with the start of increased milk production

Question 12

What is stage II lactogenesis?

Answer 12

starts with increased milk about 2-3 PP until day 8

Question 13

What is stage III of lactogenesis?

Answer 13

when mature milk is produced
usually 9+ days

Question 14

What are the 2 most important signs of good infant fluid intake during Post partum time?

Answer 14

1. gaining weight </= 7% weight loss
2. hydrated enough (no signs of dehydration

Question 15

what vitamin does breast milk not contain?

Answer 15

vitamin D

Question 16

what hormone produces milk during lactogenesis?

Answer 16

prolactin

Question 17

When are prolactin levels the most high?

Answer 17

first 10 days after birth

Question 18

How is prolactin produced?

Answer 18

-in response to infant suckling
- removal of milk from breast/chest

Question 19

What two hormones are involved in lactogenesis?

Answer 19

Oxytocin
Prolactin

Question 20

what does oxytocin do for breast feeding?

Answer 20

milk ejection reflex (the let down)

Question 21

what reflex is integral to lactation?

Answer 21

the nipple-erection reflex

Question 22

how is oxytocin stimulated during breastfeeding?

Answer 22

nipple is stimulated by infant
hypothalamus prompts the posterior pituitary to produce oxytocin

Question 23

What is the major immune globulin in human milk?

Answer 23

secretory immunoglobulin A

Question 24

what is colostrum rich in?

Answer 24

immunoglobulins

Question 25

what does colostrum have a higher consentration of than regular human milk?

Answer 25

protein fat-soluble vitamins minerals - less fat that mature milk

Question 26

What are the three stages of breast milk?

Answer 26

1. colostrum 2. transitional milk 3. mature milk

Question 27

what decreases in transitional milk?

Answer 27

- immunoglobulins - protein

Question 28

what increases in transitional milk?

Answer 28

lactose fat total calories

Question 29

what increases in mature milk?

Answer 29

fat lactose

Question 30

what decreases in mature milk?

Answer 30

protein

Question 31

what is the average duration of feedings per breast?

Answer 31

20 min per breast

Question 32

how often should baby be fed in 24 hours?

Answer 32

8-12 feedings and PRN (cues)

Question 33

how do we know breastfeeding is effective?

Answer 33

1. urine & stool (1=1 day, 2=2 days- etc up to 4-6 by day 4) 2. weight - once a day weights

Question 34

if ______ is still present in stools on day 3-4 we ned to reassess breast/chest feeding

Answer 34

meconium

Question 35

What are indications of a good latch?

Answer 35

* The mother feels a firm tugging sensation on the breast, but feels no pinching or pain. * The baby sucks with cheeks rounded, not dimpled. * The baby’s jaw glides smoothly with sucking. * Swallowing is usually audible * The baby cannot be easily removed from the breast. * The mother’s nipple is not distorted when the baby releases from the breast.

Question 36

What do we assess birther nipples for?

Answer 36

erythema cracks

Question 36

how often do we assess breasts using the LATCH-R acronym ?

Answer 36

Q8 hours

Question 37

how much should baby be gaining day 4 onward?

Answer 37

20-35g/day

Question 38

when should babies be back at birth weight?

Answer 38

10-14 days of age

Question 39

how often should babies be weighed in hospital?

Answer 39

after first feed Q24 hours

Question 40

what are the 6 feeding cues?

Answer 40

1. hand to mouth 2. sucking motions 3. rooting reflex 4. mouthing 5. flexed arms and legs with clenched fists 6. crying - late sign

Question 41

What are 4 newborn assessment findings we need to notify the provider about ?

Answer 41

1. not feeding well 2. not passing a void in 24 hours 3. excessive regurgitation or vomiting 4. masses in the abdomen

Question 42

what is the min amount of calories a birther should eat postpartum?

Answer 42

<1800 cal

Question 43

What should we not put on the breasts/nipples?

Answer 43

soap creams (except specific) no underwires plastic lined breast pads

Question 44

What are the 4 things breastfeeding birthers should focus on for their own health?

Answer 44

1. good nutrition 2. hydration 3. exercise 4. Rest

Question 45

If someone wants to use lactation as birth control, how often must they feed/express and what else is important for it to work?

Answer 45

- no period - q4-6 hours day /night - *can still ovulate before period

Question 46

what is a harm reduction approach with breastfeeding and smoking?

Answer 46

not within 2 hours

Question 47

When is engorgement normal?

Answer 47

2-5 days postpartum *bilateral lasts <24 hours *afebrile

Question 48

What are some problems when it comes to breastfeeding?

Answer 48

1. engorgement 2. sore nipples 3. Insufficient milk supply 4. Plugged milk ducts 5. Mastitis

Question 49

what are 3 reasons for sore nipples later in breastfeeding?

Answer 49

1. yeast infection 2. latch issues 3. monilial infections (fungus)

Question 50

if an infant is fed formula, do they require vitamin D?

Answer 50

no, its in the formula unless at high risk for deficiency (individual basis)

Question 51

What do we assess after hospital discharge regarding breast feeding?

Answer 51

1. infant feeding pattern 2. jaundice 3. breast discomfort reasons

Question 52

What 3 things do we need to educate parents about formula?

Answer 52

1. approved by health canada 2. cow's milk with iron is recommended 3. always check expiry

Question 53

What is the general formula feeding guideline for the first 24 hours of life?

Answer 53

5-10 mls per feed Q2-3 hours

Question 54

What is the general guidance for formula feeding for the first 24-48 hours of life?

Answer 54

10-15 mls per feed Q 2-3 hours