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Chapter: 12th Nursing : Child Health Nursing

Artificial Feeding

When the infant is feed by any preparation other than breast milk is called artificial feeding.

FEEDING

The growth of the infants during the first 6 months of the life is greater and faster than any other period of life. Feeding plays an important role in it.

Principles

·           To provide sufficient fluid

·           To get adequate food

·           To provide balanced composition

·           To provide easily digestible food

 

Types of Feeding





ARTIFICIAL FEEDING

When the infant is feed by any preparation other than breast milk is called artificial feeding.

Factors contributing to rising incidence of artificial feeding in India


Indication

·           Contraindication of breast feeding either temporary or permanent reason.

·           Mother reluctant in breast feeding.

·           Inadequate of breast milk as evidenced by first feeding.

·           Changing life style of women or pressurized under socio economic condition.

Foods used

There is no perfect substitute for breast milk. In general boiled liquid cow’s milk various dried milk preparation and to a lessen event unsweetened or sweetened condensed milk are commonly used as artificial feeds. In some countries goat’s milk or buffalo milk are used.

Composition


 

Cup feeding

Various types of utensils are used for artificial feeding of infant. In some communities metal cups or container with a spout are used for this purpose. But cup feeding is more advisable for newborn than bottle feeding.


Advantages of Cup Feeding

Promotes tongue action  Heat confusion

Encourages the initial digestion of the milk in the mouth

Easy to sterilize than bottle and heat

Disadvantages

Addiction to the cup feed       

Aspiration may occur with an incorrect technique        

The length of the feed is longer        

Indication

As an interim measure for full term babies when breast feeding is not yet established e.g. maternal infant separation.

For the preterm infant without sufficient suck / swallow coordination.

Procedure

            Ensure the baby is alert and interested.

Gather equipment.

Expressed breast milk.

Sterilized cup (small, open, slightly shaped and made from polyethylene or similar)

Bib / napkin

Baby’s records

·           Wash and dry hands

·           Sit comfortably with the baby in an upright sitting position. Cuddled close to the parent’s body. Consider swaddling the top half of the baby (to prevent hands knocking the cup) and using a suitably placed bib. Choose to feed in skin-to-skin contact.

·           Place the cup (about half full, if possible) lightly on the baby’s bottom lip, reaching the corners of his mouth, with the level of milk touching his lips. Begin slowly.

·           Retain the cup in this position (throughout any pauses) allowing the baby to lap with tongue forwards. Avoid the temptation to pour the milk in.

·           The baby will determine the pace and cease feeding when no longer hungry.

·            Ensure that the feed time has been relaxed and pleasurable with lots of comfort and social interaction for the baby. Return the baby to a safe environment once finished.

·           Wash and sterilize the cup, wash and dry hands.

·           Complete documentation, note the volume of liquid ingested, the time taken and the effect for the baby.

When a baby is not being breast fed the midwife has an important role in facilitating safe and effective infant nutrition using formula milk.

Powdered infant formula milk is suitable for newborn babies are modified cow’s milk and are either whey or casein dominant whichever milk is chosen, it must be an age suitable formula. Equally where the manufacturers suggest preparation at a lower water temperature; this advice should be disregarded.

 

Storage of prepared Feeds

            Preparing a powdered feed and then storing it is strongly discouraged.

·           It should be prepared as near to the time to leave as possible.

·           If the feed is not used within 2 hours it should be discarded.

·           If reheating a feed, warm water can be used for upto 15 minute either by placing the bottle in the water or by holding it under a running tap.

·           Microwaves should not be used due to the inconsistent action of reheating.

 

Complementary Feeding

It’s a gradual addition of solid foods to the infant’s diet according to individual infant’s capacity and gradual withdrawal of breast / artificial feeding in frequency and quality.

Principles

·           Start weaning when child is free from any Gastrointestinal trouble.

·           One food item is introduced at interval of 4-7 days to allow for identification of food allergies and to allow the child to get used to it.

·           New foods are fed in small amounts from one teaspoon to few tablespoons.

·           Food should not be mixed in bottle and feed through nipple.

 

Methods of Complementary Feeding


 

Dietary need

Growth requirements combined with physical activity play a role in determining a child’s nutritional needs. Nutritional needs change with different life stages. It is important to take into account the extra demands placed on the body by these changes.


Food pyramid


Foods to be avoided for children

·           Fast food and junk food like chips, popcorn etc

·           Processed meats

·           Canned fruits and drinks

·           Honey

·           Dipping sauces

·            Raw milk and eggs

 

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