Newborn Nutrition Chapter 11 Copyright 2008 Wolters Kluwer

Factors Influencing a Woman’s Choice to Breast-Feed or Bottle-Feed • Culture • Age • Prior experience with, or exposure to, breast-feeding • Intent or need to return to work or schoo Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Advantages of Breast-Feeding • Maternal benefits – More rapid uterine involution – Less bleeding in the postpartum period – A quicker return to pre-pregnancy weight level – Decreased incidence of ovarian and premenopausal breast cancers Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Advantages of Breast-Feeding (cont. ) • Infant benefits – Provides immunologic properties from the woman – Provides unique experience for maternal– newborn bonding – Decreases the risk in overfeeding of the newborn – Decreases incidences of otitis media, diarrhea, and lower respiratory tract infections – Possibly protects against certain conditions or diseases such as SIDS, insulin-dependent diabetes, and allergic diseases Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Contraindications to Breast-Feeding • Illegal drug use • Active untreated TB • HIV infection • Chemotherapy treatment • Herpetic lesions on the breast • Insufficient production of breast milk • Galactosemia or phenylketonuria in the infant Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Newborn Features Facilitating Breast-Feeding • Uniquely shaped nose and mouth • The rooting reflex

Factors Controlling Lactation • Physical control of lactation • Hormonal control of lactation •

Composition of Breast Milk • Colostrum – Produced during the second trimester – A thick, yellowish-gold substance higher in antibodies and protein than breast milk, but lower in fat • Foremilk – Very watery and thin, may have a bluish tint; what the infant first receives during the nursing session • Hind milk – Thicker and whiter with a higher quantity of fat and caloric content than foremilk Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Nursing Care for the Breast-Feeding Woman • Assessing breast-feeding readiness • Assisting with breast-feeding technique • Assessing the breast-feeding session • Ending the breast-feeding session • Assessing newborn fluid intake • Teaching about breast-feeding special concerns • Relieving common maternal breast-feeding problems Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Positions for Breast-Feeding • Cradle hold – The newborn’s abdomen is facing and touching the woman’s abdomen • Football hold – The newborn is held with its head under the woman’s breast • Side-lying position – Both the woman and the newborn are on their sides facing each other while lying in bed Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Common Maternal Breast-Feeding Problems • Sore nipples • Engorgement • Plugged milk ducts •

Signs a Newborn Is Not Feeding Well • Dry mouth • Not enough wet diapers per day • Difficulty rousing the newborn for a feeding • Not enough feedings per day • Difficulty with latching and/or sucking Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Teaching Topics for the Breast-Feeding Woman • Signs newborn is not feeding well • Growth spurts • Available resources • Using supplements • Breast-feeding amenorrhea • Contraception while breast-feeding • Pumping and storing breast milk Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Advantages of Formula Feeding • Feeding infants who are adopted • Feeding infants in cases where breast-feeding would be harmful • Quantifying the amount of formula consumed • Perceived ease of formula feeding vs. breast-feeding • Involvement of others in feeding infant Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Disadvantages of Formula Feeding • It is inferior nutrition • It has no immunologic properties • It is harder for the newborn to digest • There is a higher correlation between infants who are formula fed and some illnesses like otitis media and allergies • It is expensive Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

3 Main Types of Formula • Milk-based • Soy-based • Hypoallergenic Copyright © 2008

Nursing Care of the Formula-Feeding Woman • Assisting with formula-feeding technique • Assessing the formula-feeding woman and newborn • Teaching about formula-feeding concerns – Preparing bottles of formula – Adding supplements – Maternal breast care – Common problems in the formula-fed newborn Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins