Week 5 - Breastfeeding/Formula Feeding

Disadvantages of formula feeding

-Has no antibodies -Not as nutritious as breastmilk -Involves a lot of "work" (in terms of preparation) -Formulas are also expensive

To help stimulate the infant to open up its mouth wide in preparation for breastfeeding , the nurse knows that the mother can...

Stroke the nipple against the baby's cheek, which will activate the rooting reflex and cause the baby to open its mouth wide in preparation for nipple latching

A new mother is asking the nurse how her newborn son should be positioned in relation to her body when breastfeeding. The nurse is correct in instructing the mother to position the baby...

"tummy to tummy" w/ mouth in front of the nipple and the head in alignment w/ the body

A new mother asks the nurse why breastfeeding is better than simply just using formula. The nurse is correct in saying that...

Breast milk is a lot more nutritious than formula. It's high in protein, fats, and amino acids; has a higher Fe concentration than milk formula; AND also gives the baby antibodies (specifically IgA) to help out the baby's immune system

The nurse is correct in teaching a new mother that generally, babies breastfeed how often?

Every 2-3 hrs (for a total of 8 to 12 times a day) while spending around 15-20 min on each breast during each breastfeeding session

The nurse knows that women who formula feed typically feed their babies how often?

Every 3-4 hours, with the initial feed being no more than 1/2 oz (or about 15 mL)

The nurse knows that early breastfeeding in the postpartum period is advantageous to the mother because...

Not only does the "tummy to tummy" time during breastfeeding facilitate bonding between mother-baby, breastfeeding also releases a lot of oxytocin → which stimulates uterine contractions → helps involute the uterus and clamp down on any potentially broken/damaged uterine BVs → thereby reducing the risk for postpartum hemorrhage

The nurse is teaching the mother how to unlatch the baby properly once a breastfeeding session is over. The mother demonstrates proper technique when...

She breaks the suction by inserting a clean finger into the baby's mouth in order to release the mouth from the nipple

When observing a new mother that is breastfeeding, the nurse notices that a proper latch has been achieved by the infant. Knowing this, the nurse can expect for the mother's nipple to be where in the baby's mouth?

at the junction of the hard and soft palate

A mother complains of sore nipples after breastfeeding. The nurse knows that proper teaching points for this patient include...

-Reminding the patient of ways to facilitate proper latching of the breast -Exposing the nipples to air between feedings

A mother with an active CMV infection is preparing to formula feed. She tells the nurse that instead of formula feeding, she plans on just giving her baby cow milk. The nurse knows that this is incorrect and that the mother should be corrected because...

Cow milk is NOT nutritious enough for the baby. It also may overload the baby with way too much protein, sodium, and other minerals that its renal system/kidneys can't handle

A mother 1 day postpartum has been breastfeeding and reports to the nurse that she has been experiencing some cramps in her uterine area. An appropriate response to the patient is to...

Explain that this is a common occurrence after birth once women are nursing because a specific hormone called oxytocin is being released in the mom's body while she is breastfeeding, resulting in contractions that help bring the uterus down back to where it was prior to pregnancy

For breast engorgement pain and discomfort, the nurse knows that a mother can take which pain medications to alleviate this pain?

acetaminophen OR ibuprofen

The nurse knows that breast milk is considered "tissue" because...

it contains almost as many live cells as human blood.

Prior to breastfeeding, the nurse knows that women are encouraged to use warm soaks or take a warm shower. The nurse knows that the rationale in doing so is that...

warmth encourages some milk to be released (which improves engorgement) AND allows breast to soften (makes latching easier)

Prior to breastfeeding, the nurse knows that it is important that a mother should...

wash her hands. The breasts don't necessarily need to be washed before a feed

The nurse knows that breasts become engorged after birth because...

of the increase in prolactin (which is caused by the decrease in estrogen and progesterone) that stimulates the production of more breastmilk. Usually breasts become engorged on day 4 postpartum and resolve 1 to 1.5 days after it begins.

The nurse knows that in regards to breastfeeding, how to babies make it known that they want to be fed?

Babies exhibit hunger cues (e.g. sucking, rooting reflex). Babies breastfeed "on demand" and will generally develop their own feeding schedule.

The nurse knows that during a single breastfeeding session, the mother can expect to feed the infant for how long on each of her breasts?

For 15-20 minutes on EACH BREAST or whenever the newborn appears satisfied

The nurse knows that between and after feeds, babies should be "burped" in order to release gas trapped in the baby's stomach that occurs after a baby feeds. The nurse knows that proper burping technique involves...

Gently patting the back of the baby w/ cupped hands. Can be done in several different positions: -Holding baby against chest -Holding baby while sitting on parent's lap or knee -Burping baby while baby's head is across the shoulder

Proper unlatching occurs when a mother breaks the suction by inserting a clean finger into the baby's mouth in order to release the mouth from the nipple. The nurse knows that proper unlatching is key because...

It prevents the pulling of the nipple that could lead to uncomfortable breast soreness and cracking of the nipple

The nurse can teach the patient that a breastfeeding baby will likely produce what kinds of stools?

Seedy and yellow stools

The nurse knows that it is important to teach a breastfeeding mom to avoid taking unprescribed or over the counter meds without speaking with their doctor first because...

Some meds could secrete into breastmilk, which could go into the baby

Unlike stools for breast-fed babies, the nurse knows that BOTTLE FED babies have what kinds of stools?

Yellow-light brown stools

While breastfeeding is beneficial for both mother and baby, some women are not able to breastfeed. The nurse knows that mothers who can't breastfeed and are likely to use formula instead include...

-Mothers w/ infants that have galactosemia (rare metabolic disorder that affects how the body metabolizes the sugar galactose) -Moms w/ active TB that isn't getting tx -HIV (+) status -CMV infection -Moms undergoing cancer tx w/ chemo, radiation, etc... -Moms that have had a mastectomy -Maternal substance abuse -The use of certain medications that can be secreted into breastmilk

When introducing the nipple into the baby's mouth, a proper latch is key. The nurse knows that a proper latch to the nipple occurs when...

-The baby's mouth grasps ALL OF the nipple and MOST of the areola -The baby's lower lip is turned outward against the breast -The baby's chin & nose are basically right up against the breast -The baby's tongue is "massaging" the bottom half of the nipple (as reported by mom)

If a mother decides to formula feed/needs to formula feed because she is unable to breastfeed, the nurse should teach the mother (and partner) to do what?

-To only use formulas fortified with iron -to always provide the same type of formula constantly to the baby -to NEVER add cereal to a formula

The nurse knows that if an infant is weaned off of breastfeeding, the nurse should anticipate teaching the parent about...

Giving the infant iron fortified formula

The nurse knows that current infant feeding recommendations suggest that...

Infants should be exclusively breastfed for the first 6 mo. of life and then should continue on for at least 12 mo.

The nurse knows that hormonal contraceptives, especially estrogen containing contraceptives, are not recommended for breastfeeding mothers because they decrease milk supply. Therefore, they should be avoided for the first 6 wks after birth. The nurse recognizes which of the following as an alternative to estrogen contraceptives?

Progestin-only pills (POPs). This form of contraception is less likely to interfere with milk supply. Condoms should also be used too

A nurse is taking care of a patient who has been breastfeeding and reports extreme dryness and cracking of the nipples. She tells the nurse she has been using soap in the shower while cleaning her breasts. The nurse should teach the patient that...

Soap shouldn't be used to clean breasts because it removes natural body oils → makes nipples more likely to crack. Should just wash with water when showering and then patted dry

A new mother asks the nurse what kinds of bras she should wear to help facilitate breastfeeding. The nurse is correct in teaching the patient that...

Soft BUT well-fitted and supportive bras should be worn. It's important for bras to be soft so that milk flow isn't obstructed in anyway

The nurse knows that women often stop breastfeeding because...

They experience sore nipples and/or pain while breastfeeding.

A nurse notices that a woman day 5 postpartum who has been breastfeeding has very swollen breasts. The patient reports 5/10 breast pain bilaterally. She tells the nurse that she will stop breastfeeding temporarily to "give her breasts a break". The nurse should correct this patient because...

With breast engorgement, frequent breastfeeding of BOTH breasts should be continued to ensure adequate, equal drainage of milk ducts occurs. The pt should also be reminded to breastfeed for an equal amount of time on both breasts (15-20 min/breast) to ensure that one breast isn't more clogged with milk than the other breast

A mother skeptical about breastfeeding asks the nurse if breast milk is safe for the infant. The nurse is correct in saying that...

YES, breastmilk IS safe for the infant and is always fresh. (Human milk is literally made for humans)