Summary OB NURS 306 Week 4 Study Guide For 2023 Exam (Score 100%)

OB NURS 306 Week 4 Study Guide For 2023 Exam (Score 100%) Newborn nutrition and feeding o Breastfeeding  Direct/Nipple  Expressed Milk  Hand expression  Breast Pump o Bottle Feeding (Formula feeding) o Nutritional needs of the newborn - Breastfeeding promotion o To enable mothers to establish and sustain exclusive breastfeeding for 6 months (only breast milk, nothing else inside of it) WHO and UNICEF recommend: o Initiation of breastfeeding within the first hour of life  Exclusive breastfeeding – that is the infant only receives breast milk without any additional food or drink, not even water  Breastfeeding on demand – that is as often as the child wants, day and night  No use of bottles, teats or pacifiers - Contraindications to breastfeeding o Illicit Drug Use o Active and untreated tuberculosis o Receiving diagnostic or therapeutic radioactive isotopes o Receiving antimetabolites or chemotherapy o Active herpes lesions on the breast o HIV Positive  Developed countries only o Infants with galactosemia o Infants with PKU  **Change in recommendation is now to encourage breastfeeding as human milk has lower levels of phenylalanine than cow’s milk.  Primary care interventions to promote breastfeeding o Formal breastfeeding for mother and families o Direct support of mothers during breastfeed o Training of primary care staff in breastfeeding techniques and support o Peer support - Alcohol use and breastfeeding o For 1 serving: wait 2-3 hours o For 2 serving: wait 4-5 hours o For 3 serving: wait 6-7 hours and when you no longer feel the symptom o For 4 serving: wait 8-9 hours and when you no longer feel the symptom - Medications contraindicated in breastfeeding o Only a few drugs pose a clinically significant risk to breastfed babies. TETRAGONS  B Bromocriptine, Benzodiazepines  R Radioactive isotopes/Rizatriptan  E Ergotamine/Ethosuximide  A Amiodarone/Amphetamines  S Stimulant Laxative/Sex hormones  T Tetracyclines/Tretinoin o A lot of anti-seizure medication o Retin A and Accutane - Drug and medication safety in breastfeeding o Dr. Hale’s Lactation Risk o Categories  L1 Safest  L2 Safer  L3 Moderately Safe  L4 Potentially Hazardous  L5 Contraindicated - Maternal advantages of breastfeeding o Helps the uterus after birth to control postpartum bleeding (releases oxytocin) o It’s available whenever your baby needs feeding o Naturally uses 500 calories o Reduces the risk for depression o Saves money o Right temperature o Stimulates maternal instincts o Reduces risk of osteoporosis o Reduces risk of breast and ovarian cancer o Strong bond with baby - Infant advantages to breastfeeding o Decreased risk of infant diarrhea o Decreased risk of respiratory infections o Decreased risk of being hospitalized for respiratory syncytial virus o Decreased risk of otitis media o Decreased risk of necrotizing enterocolitis (infant’s intestine) o Decreased risk of childhood obesity o Decreased cost - Disadvantages to breastfeeding o Mother must be available for feeding or to provide pumped milk if she is absent o Mother must pump if feeding is missed o Early breastfeeding may be uncomfortable o Certain medications can interrupt breastfeeding - Composition and stages of human milk o *Made up of proteins, carbohydrates and fats that are synthesized in the alveolar glands of the breast.  Protein is easier to digest than in formula.  Lactose is the main carbohydrate.  Cholesterol is essential for brain development o Contains other vitamins and minerals o Contains antibodies which decreases the risk for neonatal infections o Stages 1  Colostrum  A yellowish breast fluid that is present for 2-3 days after birth o Higher levels of protein and lower levels of fat, carbs, and calories than mature human milk o High in immunoglobulin G and A o Acts as a laxative and assists in the passage of meconium o Stage 2  Transitional milk – consists of colostrum and milk  Stage lasts from day 3 to day 10 o Decreasing levels of protein and increasing levels of fats, carbs, and calories o Stage 3  Mature milk  After day 10  Content of carbohydrate, protein, and fat changes due to babies saliva giving feedback o Thick and creamy mixture o High in fat and calories o Fore milk  Quenches baby’s thirst – higher levels of water content  Contains lactose and protein  Not high in calories and fat o Hind milk- gets released after foremilk  Milk produced during the feeding session and released at the end of the session  Higher level of fat content