Today, I review, link to, and excerpt from The Cribsiders‘ “#14: Infant Nutrition: Digestible Pearls with Dr. Joan Meek, MD”. December 9, 2020 | By Justin Berk.
All that follows is from the above resource.
Summary
Tie on your bib and get ready for some serious knowledge food about infant nutrition with Dr. Joan Meek! We discuss normal newborn feeding and voiding patterns, the benefits of breastfeeding, and how to counsel families about their options for supplementation. Dr. Meek also tells us about some of the origins of and existing structures driving disparities in breastfeeding. And don’t miss our feeding frenzy rapid fire questions at the end. You’ll leave this episode like an infant who just finished eating–burping yet satisfied!
Credits
- Writer and Producer: Edward Corty, MPH
- Infographic: Edward Corty, MPH
- Cover Art: Chris Chiu, MD
- Hosts: Justin Berk, MD and Chris Chiu, MD
- Editor: Justin Berk MD; Clair Morgan of nodderly.com
- Guest(s): Joan Meek, MD
Time Stamps
- Picks of the Week 8:20
- Newborn Weight & Breastfeeding 10:23
- Newborn Feeding Red Flags 16:30
- Supplementing 20:00
- Benefits of Breastfeeding 22:30
- Disparities in breastfeeding 26:40
- Iron and Vitamin D for Newborns 35:35
- Types of Formula (Hydrolyzed and Soy) 39:20
- Formula Mixing 44:55
- Starting solids in infancy 48:08
- Feeding frenzy rapid fire questions (IDA, water, baby-led weaning, vegan toddlers) 56:13
- Take-Home points 1:01:00
Infant Nutrition Pearls
- Breastfeeding yields numerous benefits for mom (e.g. decreased risk of diabetes, HTN, breast and ovarian cancer) and baby (e.g. decreased risk of severe diarrhea, otitis media, obesity, lower respiratory tract infections).
- Some families will make an informed choice to use formula feeding; this decision should not be stigmatized. Instead, build trust through communication and support.
- Breastfeeding disparities are rooted in systemic racism including the reverberations from wet nursing and continued inadequate access to nutritional support.
- Try using demonstrations and the teach back method for mixing formula properly.
- When making formula with powder, emphasize the importance of putting the water in first, then adding the formula, in order to maintain the proper concentration.
- Drinking regular cow’s milk before one year of age can cause iron-deficiency anemia.
Newborn Nutrition
- Try to start the nutrition conversation prenatally!
- The first visit is important, AAP recommends within 2-3 days of hospital discharge and within 5th day of life
- Some mild jaundice is expected but not necessarily concerning
- Most babies will lose 8-10% of their initial birth weight–it’s good to emphasize this to the family so they know what to expect
- Sometimes after C-section, mother and baby can be separated which delays feeding past the desired first hour of life
- Immediately postpartum, the newborn should feed every 2-3 hours or approximately 8-12 times every 24 hours
- Also assess stooling and voiding of baby–we should expect 6-8 voids per day and fewer voids can be a concern for dehydration or not receiving enough calories
- Meconium will transition to green, seedy stools when calories are being adequately added
- Greater than 10% weight loss that is not turning around could be concerning, that baby may need supplementation of some sort. If mom has enough milk, expressing and feeding with a syringe or bottle works. If mom does not have enough milk, formula is next best choice
