REAL/Authentic Proctored Exam Complete 3 Versions
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what do we know about breastfed babies who become
dangerously undernourished? - ANSWER-report by cooper &
colleagues identified a significant increase in the incidence of
malnutrition and hypernatremia in breastfed infants
- 5 sentinel cases in ohio began a chart review of the prior 4
years
- chart review babes were 23% below birth weight on average
on readmission and showed clinical signs of dehydration and
hypernatremia
- babies were: not d/c early, nursing q 3-4 or 4-6 hrs, scheduled,
both breasts,
5-10. min a side, SLEEPY
- researchers found: the class was inadequate, inadequate
follow up in the community post-partum
how do you know about breastfeeding adequacy? -
ANSWER-fewer than 4
,soiled diapers on day 4 when used in conjunction with
delayed onset of
lactation may indicate breastfeeding
inadequacy
- four on four... and each
day after
cooper findings re: weight loss findings - ANSWER-- babies
were not identified
before 10% weight
loss
- a "contented" (sleepy) baby is NOT a well-fed baby
(calorically deprived
babies are
sleepy)
breastfeeding associated hypernatremia - ANSWER-
hypernatremia is a common complication of inadequate milk
transfer during breastfeeding
- completely preventable complication that seems to be
relatively common
hypernatremia weight loss difference - ANSWER-1.6% in
healthy infants vs.
16.2% in hypernatremic
addmited infants
, hypernatremia frequency of feeds difference - ANSWER-10.2 for
healthy infants
vs. 7.6 in the NHD admitted
infants
how has the AAP responded to hypernatremia? - ANSWER--
ensure formal evaluation and documentation of breastfeeding
by trained caregivers (including position, latch, milk transfer,
examination) at least for each nursing shift - all breastfeeding
newborn infants should be seen by a pediatrician at 3-5 days of
age, which is within 48-72 hours after discharge from hospital
- evaluate: hydration (elimination patterns), body weight gain
(body weight loss no more than 7% from birth and no further
weight loss by day 5), discuss maternal/infant issues
- observe feeding
what increases gastrin and decreases somatostatin in babies? -
ANSWER-- sucking babies have cutaneous (touch) receptors in
their mouths that respond to sucking starting at 27 weeks
gestation
- species own milk
- decreased stress
- touch
- wellness
when the infant suckles from the breast... - ANSWER-there is
an outpouring of
19 different GI hormones in both the mother and the
infant, including