NEWBORN NUTRITION

Fatikhu Yatuni Asmara

Goals

Ensure continuation of growth by

giving enough calories
Provide balance in fluid homeostasis
Keep electrolytes normal range
Avoid imbalance in macro-nutrients
Provide micro-nutrients and vitamins
General facts about neonatal fluid
and nutrition
Last trimester of pregnancy
Fat and glycogen storing
Iron reserves
Calcium and phosphoruos deposits
Premature babies more fluid (85%-
95%), 10% protein, 0.1% fat. No
glycogen stores
Insufficient protein and calories is life
threatening to the sick
Stages of Human Milk
Colostrum-2-4 days, yellow creamy,
increase in pro., vit, min.and IgA
Transition -until 2 wks PP, increase in
fat and calories
Mature-90% water
Foremilk- H20, vit, protein
Hindmilk-more fat
Advantages
Provide immunologic
protection for up to 18
months
More easily and
efficiently absorbed
BF promotes attachment
Contraindication-breast
CA, HIV, another
pregnancy
Bottlefeeding
Parents can share caring for newborn
Higher incidence of allergic
reaction(cow)
Problem with powder concentration
Cow milk not acceptable for infant
feeding.
Too much protein,calcium,phosphat,
sodium potassium
Newborn Feeding
Indications of newborn
hunger?
Colostrum can be aspirated
without irritation.
Benefits- oxytocin production,
stimulates peristalsis, decrease
bilirubin, + attachment
Newborn may play with nipple,
recognize odor of mother
Assess for fistula or atresia
Breastfeeding Positions
Football, lying, cradling, across lap.
Use pillows for positioning
Rub feet for sleepy baby
May have to soothe upset newborn
before feeding
Explore cultural considerations of
breastfeeding
Physiology of Breastfeeding
 Lobes-alveoli- small to larger lactating
ducts flow toward nipples
Breast development influenced by estrogen
Prolactin increases after birth and with
sucking
Sucking stimulates post pituitary to release
oxytocin
Letdown-caused by stimulation of
myoepithelial cells
Is my milk enough???
8-12 feeds per day to 6-8 weeks of age
Frequent swallowing
Adequate urine output (2-6 times/day)
Adequate stooling
Yellow stools
Weight loss no greater than 8% of BW
Weight gain 15-30 grams/day
Good skin turger, moist mucous
membranes
Contentment 1.5-2 hours after feed
Enough milk
Breasts feel full before and
softer after feeds
Milk leaks from contralateral
breast during suckling
Sensation of milk ejection
pins and needles
Absent nipple trauma and
pain
Profound state of relaxation
in mom during suckling
Standard infant formula
100% lactose
Fat is all long chain triglyceride
Protein is whey 60%, casein 40%
Iron fortified 12mg/liter and low iron
versus low 1.5mg/liter (should not
give it)
Ready to feed or prepare from
powder
Soy formulas
Lactose free
Carbohydrate is sucrose or corn syrup
Fat is vegetable oil such as coconut
oil
Not recommended in very low birth
weight infant related to weight gain
and osteopenia.
Remember

A baby dies
every 30 seconds
from unsafe
bottle feeding.
One & a half
million babies die
every year in
poor countries
because they are
not breastfed.
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BREASTFEEDING

Best for baby

Reduces incidence of allergies
Economical - no waste
Antibodies - greater immunity to infections
Stool inoffensive - never constipated
Temperature always correct and constant
Fresh milk - never goes sour in the breast
Emotionally bonding
Easy once established
Digested easily within two to three hours
Immediately available
Nutritionally balanced
Gastroenteritis greatly reduced
Thank You!
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