Question 1

A pregnant patient in labor asks the nurse how soon the baby can be breastfed after delivery. What should the nurse respond to the patient?

Accepted Answer

Breastfeeding should begin as soon after birth as possible, ideally while the woman is still in the birthing room and while the infant is in the first reactivity period.
Breastfeeding should not wait until the baby rests. Twenty-four hours is too long to wait to begin breastfeeding. Mixing breastfeeding and formula feeding is not recommended.

Question 2

The nurse is explaining the process of breast milk production with a patient pregnant with her first child. What should the nurse include when providing this teaching? (Select all that apply.)

Accepted Answer

For the first 3 to 4 days after delivery, the breast milk is colostrum. The consistency changes to true breast milk by the 10th postpartum day. Colostrum is thin, yellow, and watery. Uterine cramping occurs as a result of oxytocin released during breastfeeding and is not a contraindication to breastfeeding but an expected occurrence. Most mothers do not have breast milk by the first day after giving birth.

Question 3

During a home visit, the nurse learns that a new mother is experiencing breast engorgement. What should the nurse recommend to help alleviate this problem?

Accepted Answer

A common suggestion to relieve breast engorgement is to empty the breasts of milk by having the infant suck more often or at least continue to suck as much as before.
Breastfeeding should not be discontinued. Applying cream to the breasts will not help with engorgement. The mother does not need to be placed on a fluid restriction.

Question 4

A new mother is ambivalent about breastfeeding and agrees to do it for at least 3 months. What response should the nurse provide to the patient at this time that would support the 2020 National Health Goals?

Accepted Answer

Six months to 1 year of age is one of the 2020 National Health Goals for breastfeeding. Although breastfeeding can help the mother return to prepregnancy weight, this is not a 2020 National Health Goal for breastfeeding. Three months is not the recommended time frame for the baby's nutrition. Breast milk can be donated; however, this is not a 2020 National Health Goal for breastfeeding.

Question 5

A new mother is concerned that the baby is not going to receive enough calories from breast milk to grow. What should the nurse instruct the mother as the daily caloric requirements per pound of weight for a newborn?

Accepted Answer

An infant up to 2 months of age requires 110 to 120 calories per kilogram of body weight or 50 to 55 kcal/lb every 24 hours to provide an adequate amount for maintenance and growth. The other choices are incorrect information.

Question 6

The nurse is teaching a pregnant patient about the nutritional value of breast milk. What information should the nurse include about the number of calories in a fluid ounce?

Accepted Answer

Breast milk contains 20 calories per fluid ounce, which is the same number of calories in commercially prepared infant formula. Breast milk does not contain 12, 24, or 30 calories per fluid ounce.

Question 7

A pregnant patient had decided to breastfeed the infant but, after delivery, tells the nurse that formula feeding would be the best choice for her now. What nursing diagnosis should the nurse use to plan this patient's care?

Accepted Answer

The mother has decided to forgo breastfeeding for formula feeding. This decision could place the mother at risk for impaired parenting because of the need to formula feed the infant. The mother's decision does not support the diagnoses of anxiety and ineffective coping. It is unlikely that the infant will have imbalanced nutrition related to formula feeding.

Question 8

The nurse is evaluating a new mother's ability to breastfeed her infant. Which criteria indicate that the mother is able to breastfeed independently? (Select all that apply.)

Accepted Answer

The LATCH breastfeeding charting system is used to measure a mother's ability to breastfeed independently. Criteria that indicate the mother can breastfeed independently include everted nipples, breasts are soft and nontender, and the baby swallows spontaneously and frequently. The mother having to hold the nipple in the baby's mouth and the nurse assisting with positioning indicate the mother is not independent in breastfeeding.

Question 9

The nurse is preparing a seminar on breastfeeding for a group of pregnant patients. Which information should the nurse include during this seminar?

Accepted Answer

Breastfeeding provides an excellent opportunity to enhance a true symbiotic bond between mother and child. Breastfeeding enhances uterine involution and reduces the risk of breast cancer. There is no information to support the impact of breastfeeding on thrombophlebitis.

Question 10

A new mother asks the nurse to explain the difference between breastfeeding and formula when feeding a newborn. What should the nurse respond as an advantage of breastfeeding for the infant?

Accepted Answer

Breast milk contains secretory immunoglobulin A (IgA), which binds large molecules of foreign proteins, including viruses and bacteria, keeping them from being absorbed from the gastrointestinal tract. Breast milk does not cause firmer stools. It takes more effort for the infant to suck at a breast than at a bottle. Breast milk is less difficult for the baby to digest.

Question 11

A new mother is concerned that she will not have enough breast milk because of small breasts. What should the nurse respond to the mother?

Accepted Answer

Breast milk is formed in the acinar cells of the mammary glands and begins production after the delivery of the placenta. When the progesterone level falls, the production of prolactin is stimulated, which cause breast milk to be made. The nurse can discuss the patient's concern; it does not need to be discussed with the physician. Supplementing a breastfeeding baby with formula is not recommended. The nurse's comment about milk production and the frequency of feeding does not address the mother's concern.

Question 12

The nurse is assisting a new mother begin breastfeeding. Which action is the most appropriate for the nurse to take at this time?

Accepted Answer

When a mother is first attempting to breastfeed, lying on the side with a pillow under the head is a good position to use because it relieves fatigue and allows the infant to rest on the bed and not on the mother. Stroking the cheek will cause the infant to turn away from the breast. Infants should grasp the nipple areola with the mouth. Most new mothers need some instruction and help.

Question 13

During a home visit, a new mother tells the nurse that her nipples are sore from breastfeeding. What should the nurse instruct the mother at this time? (Select all that apply.)

Accepted Answer

To help with sore nipples from breastfeeding, the nurse should instruct the mother to apply lanolin to nipples after air exposure, expose the nipples to air so the nipple dries, position the baby differently for each feeding, and massage a few drops of breast milk to the areola. The mother should be discouraged from inserting plastic liners into the nursing bra because these prevent air from circulating around the breast.

Question 14

A new mother asks the nurse how to determine if the baby is receiving enough breast milk. What response should the nurse make to the mother?

Accepted Answer

Acceptable criteria during the first week of life are wetting six to eight diapers within 24 hours or losing no more than 10% of birth weight. After the first week, weight gain and voiding six to eight times each 24 hours are good criteria to use. The infant will not become constipated when ingesting breast milk. Sleeping is individual for each baby and cannot be used to determine an adequate nutritional intake. Weighing the infant before and after feedings is not recommended.

Question 15

A new mother asks the nurse what medications she can and cannot take into her body because it might affect breast milk. What should the nurse respond to this mother's request?

Accepted Answer

Almost any drug may cross into the acinar cells and be secreted in breast milk. As a general rule, the mother should take no drug unless prescribed or approved by her primary care provider while breastfeeding. Halting breastfeeding could impact the mother's ability to continue at a later time.

Question 16

During a routine health visit, the mother of a 6-month-old baby mentions that she would like to begin weaning the baby from breastfeeding. What teaching should the nurse provide to the mother at this time?

Accepted Answer

When weaning, breastfeeding should be discontinued gradually by first omitting one breastfeeding a day and substituting a formula feeding. Heat to the breasts does not suppress milk production. Pumping the breasts will continue milk production. If weaning before 12 months, the baby should be weaned to formula and not whole milk.

Question 17

The nurse is teaching new parents how to calculate the amount of formula to feed their newborn each day. The baby weighs 8 lb. How much formula should the nurse teach the parents to provide each day?

Accepted Answer

The total fluid ingested for 24 hours must be sufficient to meet the infant's fluid needs and is calculated by determining 75 to 90 ml or 2.5 to 3.0 oz of fluid per pound of body weight per day. Because the infant weighs 8 lb, the amount of formula would be between 8.0 × 2.5 or 20 oz and 8.0 × 3.0 or 24 oz. The other choices are inaccurate calculations for the amount of formula to provide to an infant weighing 8 lb.

Quiz 19: Nutritional Needs of a Newborn