Newborn Nutrition Dr. Twila Brown

Newborns’ Nutritional Needs Calorie requirements 105 to 108 kcal/kg/day Fluid requirements 140 to 160 mL/kg/day Weight Breast fed gain birth weight by 14 days Gain 15 grams or 0.5 ounce per day Formula fed gain birth weight by 10 days Gain 30 grams or 1 ounce per day

Stages of Breast Milk Colostrum More protein, fat-soluble vitamins, and minerals Immunoglobulins for passive immunity Transitional milk More fat, lactose, water-soluble vitamins, calories Mature milk Foremilk: high in water, vitamins, protein Hindmilk: higher fat concentration

Breast Milk Advantages and Disadvantages Recommended for first 6 to 12 months Immunologic Inhibit growth of bacteria and viruses Decreases incidences of allergies Nutritional Facilitates digestion and absorption Composition varies with gestational age Iron better absorbed and adequate until 6 mos Lower renal solute level

Breast Milk Advantages and Disadvantages Psychosocial Maternal/infant bonding Less expensive than formula Pumping when mother is not available Storage concerns: Room air, 6 hrs; refrigerator, 24 hrs; freezer, 6 mos Contraindications Breast cancer, HIV, AIDS, Medications

Formula No cow’s milk until after 1 st year Types Cow’s milk protein or soy-protein 20 kcal/oz (24 kcal/oz) Preparation Ready to feed, liquid concentrate, powder Dilution Storage

Feeding Schedule Initial Feeding Signs of feeding readiness Assess suck/swallow/breathing pattern Assess for gagging and respiratory distress Colostrum is not irritating if aspirated On demand schedule Feeding cues Breast feed 8-12 times per 24 hrs Formula feed 6-8 times per 24 hrs

Breastfeeding Techniques Physiology Supply and demand Oxytocin stimulates let-down reflex Position baby Baby’s body facing mom Nose at breast with body in alignment Latching on Stimulate wide open mouth Take in entire nipple with areola at gums Prevent sore nipples

Breastfeeding Techniques Feeding Hear swallowing, see milk at mouth Empty each breast Break suction Alternate breast and change baby’s position Warm stored milk with warm water Avoid supplemental feedings Avoid pacifiers/different nipples Elimination 6-8 wet diapers and several stools per day

Bottle feeding Hold baby for all feedings Head elevated Formula/milk in nipple Newborn: 1-3 oz every 3-4 hrs Birth to 2 mos: 2-4 oz at 6-8 a day Preparation and storage Clean bottles and water Fresh bottle for each feeding Use within 1 hour if not refrigerated Prepare enough for only 24 hours