NUR 81010: APPLIED NUTRITION AND DIET THERAPY (LABORATORY)

UST COLLEGE OF NURSING

PROFESSOR: MS. MENCHIE PAGDILAO, RN, MAN AND ASST. PROF. GERALYNNE MEDRANA, RN, MAN | 1ST
SEMESTER | A.Y. 2023 - 2024
LECTURE TRANSCRIPT # 2: BREAST FEEDING & PEDIATRIC NUTRITIONAL CONCERNS

BREAST FEEDING & PEDIATRIC NUTRITIONAL CONCERNS Table No. X Colostrum

PROPERTY IMPORTANCE
LACTATION Antibody rich Protects against allergy & infection
● Highlights of the advantages of breastfeeding Many white cells Protects against infection
○ Protects against infection Purgative - clears meconium
○ Decreases risk of Ca, DM, and postpartum - helps prevent jaundice
depression Growth factors - helps intestine to mature
○ Delays pregnancy - prevents allergy, intolerance
○ Promotes bonding Rich in Vitamin A - Reduces severity of infection
○ Economical
○ Always available
NUTRIENTS IN HUMAN AND ANIMAL MILKS
Table No. X Breastfeeding ● Although formula milk has been adjusted so that they are
ACRONYM MEANING more like human milk, they are still far from perfect for babies.
B Best for baby ● Animal milk is rich in protein that cannot be digested by the
R Reduced allergy baby yet
E Emotional bonding ● Casein – larger molecules that is hard to digest that cause
A Antibody present - IgA constipation to the infant
S Stool not so offensive ● Pa ss nito behhh
T Temperature always right
F Fresh always
E Economical
E Easy once established
D Digested well
I Immediately available
N Nutritious
- Due to colostrum
- Full of fats that is needed by
the baby in development
G Gastroentiritis prevented
- It cleanses the colon
- Normal poop consistency
- Emphasize the burping of the baby

RA 7600 of 1992
● Rooming-In/Breastfeeding Act
● Breastfeeding is the best feeding for all babies (must be done
at least 8x/day) ON DEMAND
● If with temporary contraindication, teach pumping and proper
storage

Composition of Breast Milk

● Colostrum
○ First few days
○ Thick and yellowish
○ More CHON than milk Table No. X Difference Between Breastmilk and Formula Milk
● Transitional Milk BREASTMILK FORMULA
○ Lactose, water-soluble vitamins, fat Higher in carbohydrate Higher in protein
○ Becoming whiter Higher in Fats, Vit. C Higher in minerals Vitamin D
● Mature milk Low in Iron Low in Iron
○ Fore milk - produced 1st; larger amounts, bluer, rich Adequate Vit A and B Adequate Vitamin A&B
in CHON (20cal/Fl. oz) (20 cal/fl. oz)
○ Hindmilk - produced last, whiter, rich in fat IgA (colostrum)

KITAO, LABAY, LAMORENA, LEGASPI | 2NUR3 1

 NUR 81010: APPLIED NUTRITION AND DIET THERAPY (LABORATORY)
UST COLLEGE OF NURSING
PROFESSOR: MS. MENCHIE PAGDILAO, RN, MAN AND ASST. PROF. GERALYNNE MEDRANA, RN, MAN | 1ST
SEMESTER | A.Y. 2023 - 2024
Nonconstipating, promotes Can cause constipation
brain growth and maturation
TYPES OF NIPPLE

INFANT HOLD
● Bond can be assessed
○ Lack of bond may indicate stress

● If the nipple is inverted, you can massage it outwards to ilabas

ang nipple

NIPPLE HOLD

COMMON BREASTFEEDING POSITIONS

● Laid-back Nursing Position
○ Used from first breastfeeding and great for anyone
○ Check if the baby can still breathe properly due to
their lack of head control
○ Mother lends back if sitting or reclines on any
supportive surface but not lying flat
● Cross-cradle Hold
○ Helpful for preemies, newborns, or babies with
trouble latching on
○ The mother holds the infant’s head with the hand
opposite the side on which the infant will feed while
her arms support the infant’s body across her lap
● Football Hold
○ Good for nursing twins, c-section recovery, large
breasts, and flat or inverted nipples
○ The mother supports the infant’s head and neck
inher hand with infant’s body resting on a pillow
● Cradle Hold
○ Comfortable once baby latches on ATTACHMENT
● Side-lying Position ● The 4 Key Points of Attachment:
○ Great for nighttime feedings and c-section recovery ○ More areola above baby’s top lip than below bottom
○ Mother is lying on her side with her lower arm lip
supporting her head or around the infant, with ○ Baby’s mouth wide open
pillows supporting her back and between her legs ○ Lower lip turned outwards
○ Baby’s chin touches breast

KITAO, LABAY, LAMORENA, LEGASPI | 2NUR3 2

 NUR 81010: APPLIED NUTRITION AND DIET THERAPY (LABORATORY)
UST COLLEGE OF NURSING
PROFESSOR: MS. MENCHIE PAGDILAO, RN, MAN AND ASST. PROF. GERALYNNE MEDRANA, RN, MAN | 1ST
SEMESTER | A.Y. 2023 - 2024
■ Apply cold packs to the breast betrween
breastfeeding
● Nipple Pain
○ Proper position, washing and warm/cold compress
● Blocked Ducts
○ Usually results to breast engorgement (localized
edema and tenderness, palpable hard lumps)
○ Breast Massage, Non Constricitve Bra, Frequent
Breastfeeding
○ Assess progression to Mastitis

FREQUENCY OF BREASTFEEDING
● 10-12x per day (every 2 hours)
● Atleast 20 mins per breast

DETERENTS TO LETDOWN REFLEX

● Fatigue
● Stress
● Alcohol
● Smoking
● Some prescription medications
● Prevention: SKILLED HELP to position and attach the baby.
Babies should not be given feeding bottles, especially before CONTRAINDICATION TO BREASTFEEDING
breastfeeding is established. ● Active TB
● HIV/AIDS
● Herpes simplex lesions on maternal breast
● Maternal alcoholism or drug addiction
● Malaria, Maternal Chickenpox
● Maternal breast cancer requiring treatment

BREASTMILK STORAGE
● Ss na lang

SUCKLING PROBLEMS
● Assess if infant manifests the following:
○ Dimpling of the cheeks
○ Smacking or clicking sound
● Insert a gloved finger into the infant’s mouth
● If infant tends to place the tongue on top of the nipple, insert a
finger in the mouth and press the infant’s tongue down just
before latch-on

COMMON BREAST PROBLEMS

● Swelling
○ Peaks at 72-96 hours after giving birth may occur
○ Temporary
■ Encourage mother to begin breastfeeding
early and to feed frequently
■ Discourage mother from using water or
formula to feed

KITAO, LABAY, LAMORENA, LEGASPI | 2NUR3 3

 NUR 81010: APPLIED NUTRITION AND DIET THERAPY (LABORATORY)
UST COLLEGE OF NURSING
PROFESSOR: MS. MENCHIE PAGDILAO, RN, MAN AND ASST. PROF. GERALYNNE MEDRANA, RN, MAN | 1ST
SEMESTER | A.Y. 2023 - 2024

OVERVIEW OF HIVE AND INFANT FEEDING

● HIV can pass from an infected woman to her child during
pregnancy. At the time of birth or through breastfeeding
called mother-to-child transmission
● Baby needs breast milk through milk donation or wet nursing

INFANT FEEDING COUNSELLING FOR HIV-POSITIVE

● Before a woman is pregnant
● During her pregnancy
● Soon after her baby is born

KITAO, LABAY, LAMORENA, LEGASPI | 2NUR3 4

 NUR 81010: APPLIED NUTRITION AND DIET THERAPY (LABORATORY)
UST COLLEGE OF NURSING
PROFESSOR: MS. MENCHIE PAGDILAO, RN, MAN AND ASST. PROF. GERALYNNE MEDRANA, RN, MAN | 1ST
SEMESTER | A.Y. 2023 - 2024
● When her baby is older
● When a woman fosters a baby whose mother is very ill or has
died

BREASTFEEDING AND BREAST-MILK OPTION FOR

HIV-INFECTED WOMEN
● Exclusive breastfeeding for the 1st few months followed by
early cessation
● Expressing and heat-treating breast milk
● Wet-nursing

PEDIATRICS NUTRITIONAL CONCERNS??

● Baby Bottle Tooth Decay
○ Nursing Bottle Caries, Nursing Bottle Mouth
Nursing Bottle Syndrome
○ Commonly affects incisors
○ Occurs in infants allowed to sleep with bottle of milk
or juice
○ Prevention:
■ Weaning, Oral hygiene
■ Water instead of sweet juices
● Premature Infants
○ Underdeveloped body systems
■ Increased nutritional needs
■ Breast milk + “human milk fortifier”
○ Risk for feeding problems, developmental delays,
and growth retardation
● Failure to Thrive
○ Very minimal weight gain for the course of:
■ A. 2 months (
■ B. 3 months (
○ Causes:
■ Organic FTT: Growth failure is due to an
acute or chronic disorder that interferes
with nutrient intake, absoprtion,
metabolism, or excretion or that increases
energy requirements
■ Non-Organic FTT: Up to 80% of children
with growth failure do not have an
apparent organic disorder; growth failure
occurs because of ??
● Inborn errors of Metabolism
○ Phenylketonuria
■ Inability to breakdown phenylalalnine
■ Mental retardation
■ Known via newborn screening test
○ Galactosemia
■ Autosomal recessive disorder
■ Lactose Intolerance
■ Growth and mental retardation

KITAO, LABAY, LAMORENA, LEGASPI | 2NUR3 5