Bottle Feeding

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Bottlefeeding

A. Advantages

1. Provides an alternative to breastfeeding


2. Less restrictive than breastfeeding; may meet needs of working mothers
3. Allows a more accurate assessment of intake
4. May be indicated in the presence of a congenital anomaly such as cleft
palate
5. May be necessary for infants who require special formulas because of
allergies or inborn errors of metabolism

B. Types of formulas

1. Commercial liquid or powdered formulas


2. Special formulas
3. Unmodified regular cow's milk, liquid or reconstituted; not appropriate for
infants before 12 months of age; cow's milk contains more protein, more
calcium, less vitamin C, less iron, and less carbohydrate

C. Contraindications

1. Inadequate intelligence to prepare formula


2. Poor storage and refrigeration practices
3. Contaminated water supply
4. Cost of formula and equipment
5. Lack of equipment to adequately prepare bottles

Nursing Care of the Mother Who Is Bottlefeeding

A. Assessment

1. Desire to bottlefeed
2. Sucking ability of infant
3. Knowledge of formulas and formula preparation

B. Analysis/Nursing Diagnoses

1. Ineffective infant feeding pattern related to lack of knowledge


2. Knowledge deficit related to new experience of preparing formula and
feeding infant
3. Infant's altered nutrition: less than body requirements related to sucking
difficulties or formula that does not meet infant's needs
C. Planning Implementation

1. Teach preparation of formula


a. Calculation of formula to yield 110 to 130 calories and 130 to200 ml of
fluid per kilogram of body weight; caution regarding dangers of overdilution
(water intoxication) and underdilution (excess weight gain)
b. Proper sterilization of formula by terminal heat method and of feeding
utensils by a full 25 minutes of boiling if the water supply is not purified or
clear
c. Teach about commercial formulas
d. Proper refrigeration of formula

2. Teach feeding techniques


a. Always hold infant during feeding to provide warm body contact (bottle
propping may contribute to aspiration of formula)
b. Hold bottle so nipple is always filled with milk to prevent excessive air
ingestion
c. Adjust size of nipple hole to needs of baby (a premature infant needs a
larger hole that requires less sucking)
d. Burp during and after feeding; place on side to aid digestion

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