1
Q
what is skin to skin contact
A
- uninterrupted SSC immediately following birth up to an hour to prevent hypothermia, promote breastfeeding
2
Q
what effect does SSC have on infants
A
- stabilizes HR, RR, and temp
- reduce infection
- improves sleep quality
- improves neurodevelopment
- enhances early breastfeeding
3
Q
maternal benefits from SSC
A
- bonding and attachment (oxytocin)
- may prevent maternal depression
- increases interactions
- improves bonding
4
Q
infant benefits if SSC
A
- supports transition
- brain development
- decreases pain during procedures
- strengthens immunity
5
Q
consequences of disturbing SSC
A
- poorer feed
- increased salivary cortisol
- increased crying
- do not get SSC benefits
6
Q
benefits of SSC for preterm infants
A
- better state organization and autonomic system functioning
- physiological stability
- biologic co-regulation and synchrony
- better quality of sleep
7
Q
principles for safe sleep are:
A
- back to sleep
- firm mattress
- crib/bassinet
- sharing room
- smoke free
- breastfeeding
8
Q
what is the important part of effective feeding
A
- reflexes and the suck-swallow-breathe cycle
9
Q
what is an effective latch
A
- nipple aligned with baby’s nose
- wait for wide mouth
- aim nipple high in mouth
10
Q
what can help support breastfeeding for moms
A
- comfortable positions
- supportive pillows
- lumbar support
- relax neck and shoulders
11
Q
what can help support breastfeeding for infants
A
- torso against moms
- tucked in close tummy and chin on the breast
- hand on base of neck
- prone positions
12
Q
breastfeeding positions
A
- cradle hold
- cross-cradle hold
- football hold (ceasarean)
- side-laying position (cesarean)
- Australian hold
13
Q
signs of effective feeding for the mom:
A
- feel infant tug
- leak milk from breast milk
- feel warm gush/tingling
- uterine contractions occur
- feel relaxed at end of feed
- nipple elongated and round
- no cracks or blisters
- feel milk coming in days 3-4
- increased thirst
14
Q
Signs of Effective Feeding for the Infant
A
- chin to breast with nose slightly away
- sucks rapidly at first
- sucks rhythmically
- ocasional pauses, temple move
- lips flanged out
- audible swallows (ca)
- relaxes
- milk in/around mouth
- satisfied
- urine/stool output
15
Q
what is the appropriate amount of urine and stool at day 4
A
- 3 BM
- 6-8 wet diapers every 24 hours
16
Q
Signs of Effective Feeding for the Infant
A
- fall asleep at the breast
- spurring or pulls off
- dimples in cheek and tight pursed lips
- mom feels pain
- cracked, scabbed nipples
- weight loss
17
Q
what does LATCH stand for
A
- Latch
- Audible swallowing
- type of nipple
- Comfort
- Hold (position)
18
Q
what is the best stage for feeding
A
- quiet alert stage
19
Q
deep/quit sleep
A
- closed eyes, no eye movement
- reg breathing
- no body movements
20
Q
light/active sleep
A
closed eyes
- rapid eye movements
- irregular breathing
- sucking, smiling, grimacing, yawning
- slight twitching
- where most sleep is
21
Q
drowsy state
A
- may have eyes open
- irregular breathing
- variable body movements
- relaxed
22
Q
quiet alert phase
A
- eyes bright and wide
- responsive to stimuli
- minimal body activity
23
Q
active alert phase
A
- eyes open
- rapid and irregular breathing
- sensitive to stimuli
- active
24
Q
what moms can do when their infant is crying
A
- do not fight
- try consoling (cuddling, rocking, SSC)
- follow continuous SSC
- patience
25
what does crying do to the infant?
- valsulva maneuver
- increases HR, BP
- ICP
- salivary cortisol
26
when does crying increase?
- increases at about 2 weeks then continues to increase weekly until 3-4 months
27
what does PURPLE stand for
- Peak of crying
- Unexpected
- Resistant to soothe
- Pain-like face
- Long lasting
- Evening
28
soothing methods for a crying infant
- repspond fast
- feed
- interact
- carry the infant
- change infants position
- move around
- white noise
29
what is the frequency of feeds for on demand feeding
- 8 or more times within 24 hours
30
what infant conditions may not be able to show signs of hunger?
- late preterm, jaundice, infants of difficult deliveries
31
infants who struggle with feeding cues parents should feed:
- provided SSC
- attempt feed every 2-3 hours
32
feeding freq is determined by
- infants hunger
- moms breast fullness
33
newborns breastfeed
- every 1-3 hours in the first week
- 8 or more times in 24 hours
- watch feeding cues (sleep/wake stages)
34
how to support milk supply
- night feeds - prolactin levels are high (good for producing milk)
- cluster feeds
35
what does feeding duration depend on?
- gestational age
- ability to suck
- state of consciousness
- position/latch
36
how to tell if the infant is full?
- sucking/swallowing stops
- push away from the breast
- relaxed after feed
37
average feeding time is
- 30-40 minutes or 15-20 minutes per breast
38
how many voids should an infant have on day 1-4
- correspond to the number of days
- 1-3 may be pink and rusty
- 4 pale yellow
39
how many voids should occur 5-7 day
- 5 wet diapers
40
how many voids after day 7
- 6 or more diapers
41
how many stools on days 1-2
- meconium at least once or twice a day
42
stools on days 3-4
- transitional stool at least 2-3 times per day
43
how many stools on day 5 and beyond
- golden yellow
- 3 or more in a day
- then after a month its once every few days
44
what is the size of a newborns stomach on day 1-2
- 5-7ml size of a cherry
45
what is the size of a newborn stomach on days 3-4
walnut
- 30mls
46
what is the size of a newborns stomach on days 5-6
- apricot
- 60mls
47
when should an infant return to birth weight?
- by day 7-10
48
other factors to watch how the infant is feeding is by assessing for:
- alertness
- visor with feeding
- colostrum availability
- jaundice
- output
49
what does responsive feeding mean?
- reciprocal relationship between infants and mom
- infant giving cues and moms responding
50
signs of readiness for solid foods
- teething, salivation
- extrusion reflex
- hand-mouth coordination
- shows interest in food
- breastfeeding fails to satisfy
- hold head up straight
- opens mouth when food approaches
51
what supplements should be given to babies
- iron-rich foods (meat, fish, egg yolk
- vitamine D supplementation (prevent rickets)
52
what does iron rich food help prevent
- iron deficiency, impaired learning, poor growth, neuromotor, physical, and mental delays
53
how to wean
- slowly and begin to introduce foods instead of bread milk every 5-7 days
NSPN 7150
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