VI. GI adaptation A. Digestion -lack pancreatic amylase -can digest simple CHO, fat, and protein (NOT starch) -immature salivary glands (2-3 months) B. Excretion -meconium first couple days -breastfeed babies are yellow and seedy VII. Urinary adaptations -have short tubules, decreased concentration and dilution of urine OB Notes 55
-void within first 24 hours of birth -bladder can hold 6-44 mLs of urine -void 2-6 times a day -girls may have pseudomenstruation -brick dust spots (orange tinge d/t uric crystals) VII. Immunologic Adaptation 3 groups 1. IgG= bacterial toxins (transferred during 3 rd trimester) 2. IgM= baby produces (if increased= exposure to virus or infection in utero) 3. IgA= colostrum (baby produces after 1 month of age) IX. Neurologic and Sensory Perception A. Observe -eye movements, focus 9-12 inches -tone of cry (cri du chat= immaturity/neurological problem) -muscle tone -reflexes -hand to mouth -behavioral states (breastfeed within first hour, sleep vs. alert) B. Behavioral capacities 1. habituation 2. orientation 3. self-quieting ability 4. visual fixation Ch. 29- Lab Day Newborn Nutrition- Ch. 31 I. Nutritional Needs of the Newborn A. Breastmilk 1. colostrum (thick and sticky, yellow, rich in nutrients, first 3-4 days after birth) 2. transitional (mixture of colostrum and mature) 3. mature milk (more water content, nutrients that babies need) Advantages -Immunologic (antibodies) -Nutritional (the best for babies) -Psychosocial (allows for bonding) Composition : nutrients, antibodies, less iron than formula but the iron in breastmilk is more readily absorbed (will not need supplementation until 4-6 months), no loss of vitamins, may need supplements of Vit. D and fluoride Disadvantages : meds excreted through breastmilk, discomfort when learning, mom’s desire B. Formula 1. Types: Similac, Goodstart, soy-based, lacto-free, 2. Advantages: double birth weight quicker (breastfed infants double weight by 6 months, triple in one year; formula fed double by 3.5 months, triple by 9-12 months), more involvement of father 3. Disadvantages: contains more calcium, iron, chloride, and sodium, contain saturated fatty acids (vs. unsaturated in breastmilk), therefore harder on kidneys, greater risk of allergies 4. Wait one year before feeding cow’s milk to a child!!! C. Breastfeeding 1. called lactation 2. Hormones: a. estrogen- increased ductal system in the breast b. prolactin- promotes milk production c. oxytocin- let-down reflex (may cause afterpains) 3. Education OB Notes 56
a. hearing baby cry may cause let-down reflex b. fear, pain, lack of confidence, embarrassment, can all inhibit let-down reflex 4. Objectives a. baby receives adequate nutrition (mom with fluid, nutrients, prenatal vitamin) b. adequate milk supply- mom needs AT LEAST 8-10 glasses a day c. how to not cause trauma to nipples 5. Feeding tips a. alternate breasts (safety pin on bra strap) b. alternate positions (helps prevent nipple soreness) c. how to break suction d. prevent nipple confusion (only breastfeed, no pacifiers or bottles) 6. Potential Problems a. Nipple soreness- correct position b. Cracked nipples- baby in wrong position, suction broken wrong, may lead to infection
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- Fall '12
- progesterone, A., Late pregnancy, OB Notes