Newborn Nutrition Neonatal Nursing Care Part 4 Developed by D. Ann Currie , RN, MSN

Nutritional Comparison: Breast Milk 90% water Same weight gain or greater during first 3-4 months Fat is variable Primary carbohydrate is lactose, trace amounts of other carbohydrates

Components of Breast Milk Whey/Casein ratio changes according to infant needs Whey components include alpha-lactalbumin, serum albumin, lactoferrin, immunoglobulins, and lysozyme Low in vitamin D, adequate vitamin C & B complex Mineral content similar Iron absorption: 50-60%

Advantages of Breastfeeding Species specific Cholesterol in breast milk plays a role in myelination and neurologic development More efficient metabolism of cholesterol Composition varies according to gestational age Iron is more readily absorbed

Infant Benefits Reduced risk of Protection from Type I or type II diabetes mellitus Lymphoma, leukemia, & Hodgkin’s disease Obesity Hypercholesterolemia Asthma Protection from Respiratory tract and gastrointestinal tract infections Necrotizing enterocolitis Urinary tract infections Otitis media Bacterial meningitis

Maternal Physical Benefits Decreased postpartum bleeding More rapid uterine involution Burns additional calories Decreased risk of developing Breast and ovarian cancer Postmenopausal osteoporosis

Maternal Psychosocial Benefits Improved maternal-infant attachment Skin-to-skin contact Tactile communication Learn behavioral cues and needs Prolactin increases feelings of relaxation and euphoria Oxytocin heightens responsiveness and receptivity toward infant

Disadvantages to Breastfeeding Pain due to nipple tenderness Leaking milk when breasts are full Embarrassment about breastfeeding Feeling tied down to the demands of breastfeeding Unequal feeding responsibilities/fathers left out Perceptions about diet restrictions Limited birth control options Vaginal dryness Concerns about the safety of medications and breastfeeding

Feeding Interventions: Birthing Room Assess for signs of readiness to feed Place newborn on mother’s chest Breastfeeding may begin in birthing room Assess infant physiologic status during feeding

Feeding Interventions Monitor progress Education Anticipatory guidance Evaluate the need for follow-up after discharge

Infant Feeding Education On Demand” feeding pattern Infant feeding cues Normal feeding/sleeping patterns Satiety behaviors Growth patterns

Breastfeeding Education Positioning Latching Breast milk pumping and storage Supplementation

Nutritional Comparison: Formula 90% water Greater weight gain after 3-4 months Lactose is only carbohydrate

Components of Formula Whey/Casein ratio is 60:40 Whey components are beta-lactoglobulin and alpha-lactalbumin Adequate amounts of vitamins Mineral content similar

Formula Feeding Education Intake and output expectations Preparation and storage of formula Feeding technique Equipment Safety precautions

Growth Rates Both breastfed and formula-fed infants experience growth spurts requiring increased feedings Breastfeeding mother should nurse more frequently Formula feeding mother should slightly increase amount of feeding

Influence of Culture on Infant Feeding Perception of breasts as sexual organ Perceptions of colostrum Language

The End of Part IV