Term
| Definition of Preterm Infant |
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Definition
| Born prior to 37 weeks gestation |
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Term
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Definition
Low Birth Weight
<2500 grams/ 5lb 8oz |
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Term
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Definition
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Term
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Definition
Extremely Low Birth Weight
<1250 grams/ 2lb 3oz
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Term
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Definition
| birthweight < 750 grams/ 1lb 6oz |
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Term
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Definition
Necrotizing Enterocolitis
where portions of the bowel undergo necrosis (tissue death) |
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Term
Problems related to prematurity
Immature GI system |
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Definition
NEC
slow weight gain
decreased gastric mobility |
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Term
Problems related to prematurity
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Definition
| a condition in which the blood is deficient in red blood cells, in hemoglobin, or in total volume |
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Term
Problems related to prematurity
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Definition
Patent Ductus Arterosis
a congenital disorder in the heart wherein a neonate's ductus arteriosus fails to close after birth |
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Term
Problems related to prematurity
Retinopathy of Prematurity
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Definition
| disease in which retinal blood vessels develop abnormally in the eyes of premature infants. |
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Term
Problems related to prematurity
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Definition
| temporary suspension of breathing |
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Term
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Definition
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Term
Problems related to prematurity
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Definition
| usually congenital condition in which an abnormal accumulation of fluid in the cerebral ventricles causes enlargement of the skull and compression of the brain, destroying much of the neural tissue. |
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Term
Problems related to prematurity
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Definition
| abnormally low level of calcium in the blood |
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Term
Problems related to prematurity
Hypoglycemia |
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Definition
| an abnormally low level of glucose in the blood. |
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Term
Problems related to prematurity
Hypertension
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Definition
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Term
Problems related to prematurity
Hyperbilirubinemia |
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Definition
elevated levels of bilirubin
clinical sign is jaundice |
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Term
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Definition
Total Parenteral Nutrition
intravenous administration of a solution of essential nutrients to patients unable to ingest food |
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Term
| breastfed infants discharged... |
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Definition
| 2 weeks earlier than non-breastfed infants |
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Term
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Definition
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Term
| 5 needs of preterm infant to facilitate normal growth and development |
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Definition
-normal respiratory rate
-blood sugar > 2.5 mM/L (40 mg/dL)
-maintain body temp
-adequate nutrition (varies per infant)
-regular skin to skin care |
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Term
| desired blood sugar level |
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Definition
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Term
| range of preterm caloric needs |
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Definition
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Term
| 9 components elevated in preterm milk |
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Definition
-calories
-lipids
-nitrogen protein
-sodium
-chloride
-potassium
-iron
-magnesium
-immunoglobulins |
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Term
| common lacking macrominerals in preterm milk |
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Definition
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Term
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Definition
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Term
| time preterm milk matures to term milk |
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Definition
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Term
Incidence of NEC
-infants fed mother's milk |
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Definition
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Term
Incidence of NEC
-infants mix-fed mother's milk and preterm formula
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Definition
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Term
Incidence of NEC
-infants fed preterm formula
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Definition
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Term
| Enteromammary Immune System |
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Definition
| Mother colonized to NICU organisms via skin to skin contact, makes antibodies that are transferred to breastmilk, protects baby |
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Term
Problems related to prematurity
limited renal function
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Definition
due to immature kidneys
breastmilk contains low solute load which is easier on kidneys |
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Term
Problems related to prematurity
Respiratory distress syndrome |
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Definition
severe breathing impairment
caused by prematurity of lungs |
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Term
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Definition
| 6X greater in formula fed infants |
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Term
Problems related to prematurity
Intracranial hemorrhage |
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Definition
| Bleeding within (under) the skull. Can occur within brain tissue (common with preemies) or between brain tissue and skull |
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Term
Problems related to prematurity
Bronchopulmonary dysplasia |
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Definition
BPD
scarring and inflammation in the infants lungs due to prolonged positive pressure ventilation |
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Term
| Incidence of retinopathy of prematurity |
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Definition
| Formula fed babies are 2.3 times more likely to have ROP |
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Term
| optimal premature growth baed on |
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Definition
| growth curve baby would have followed if still in utero |
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Term
| uses for early enteral feedings of breastmilk |
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Definition
prime the gut
trickle feeds
trophic feeds
.5-1 ml by nasogastric tube every 3 or six hours |
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Term
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Definition
tailoring breastmilk to the specific needs of a baby
ie. separating hindmilk for preterm infant for greater caloric and fat intake at low volume |
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Term
| purpose of breastmilk fortification |
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Definition
| supplementing essential nutrients |
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Term
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Definition
| simple clinical technique for estimating fat and calorie concentration in human milk |
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Term
| Fortifiers that can be added to human milk |
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Definition
cow's milk based protein
electrolytes
vitamins and minerals |
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Term
| Issues associated with fortification of human milk |
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Definition
lower gastric emptying times- feeding intolerance
incomplete absorption of additives
neutralizing the effects of lactoferrin
increased risk of infection
no longterm benefits shown |
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Term
Issues with powdered fortifiers
liquid |
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Definition
powder- not sterile, US FDA recommends against use in preterm infants
liquid- given 1:1 ratio, reduced milk intake |
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Term
| less stressful feeding method |
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Definition
early breastfeeding has been shown to be less stressful than bottle feeding.
Baby needn't be able to tolerate bottle feeding before trying at the breast. |
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Term
| Undesirable effects of bottle feeding in small infants |
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Definition
hypoxia- low oxygen
apnea- stop breathing
bradycardia- slow heart rate
oxygen desaturation
hypercarbia- high carbon dioxide
hypothermia- low body temp
irregular breathing |
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Term
| ability of infant to breastfeed depends on... |
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Definition
suck, swallow, breathing coordination
(innate reflexes) |
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Term
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Definition
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Term
| earliest fetal swallowing observed |
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Definition
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Term
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Definition
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Term
| fetal gag reflex observed |
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Definition
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Term
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Definition
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Term
| time coordination of suck, swallow, and breathe actions are typically observed |
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Definition
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Term
earliest some oral feeding at the breast may be possible
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Definition
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Term
| time some infants might be able to take a complete feed at the breast 1-2 times per day |
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Definition
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Term
| time that efficient breastfeeding that maintains growth is possible |
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Definition
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Term
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Definition
3-5 sucks per burst
pause of equal duration- often detaching |
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Term
| transitional suck pattern |
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Definition
-6-10 sucks per burst
-a pause of equal duration
-occasional detaching
-secession of breathing can follow longer suck bursts |
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Term
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Definition
-10-30 sucks per burst
-brief pauses
-suck:swallow = 1:1 |
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Term
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Definition
| lack of rhythm of sucking activity |
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Term
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Definition
| interruption of feeding process by abnormal tongue or jaw movements |
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Term
| time non-nutritive sucking can be observed from |
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Definition
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Term
| characteristics of non-nutritive sucking |
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Definition
2 sucks per second
weak, uncoordinated
no swallow |
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Term
| When kangaroo care can start |
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Definition
| when infant is stable, but still has tubes |
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Term
| 9 benefits of kangaroo care for baby |
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Definition
1. stable heart rate
2. improved oxygen saturation
3. stable temps
4. better weight gain
5. longer periods of sleep/ alertness
6. less waisted activity
7. rapid brain development
8. more successful breastfeeding
9. less crying |
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Term
| benefits of kangaroo care for parents |
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Definition
more confidence
better bonding
earlier hospital discharge- save $
increased milk production |
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Term
| positions for breastfeeding preterm infant |
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Definition
cross-cradle hold and football hold
positions that provide extra support to the head and torso |
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Term
| position helpful for neurologically impaired infants |
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Definition
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Term
| % of decrease in apneic episodes when using kangaroo care |
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Definition
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Term
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Definition
| gentle pressure on infants back or chest with open hand helps infant to organize himself |
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Term
| how mother should support her breast to feed a preterm infant |
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Definition
| U hold pressing into the breast, not pinching fingers together |
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Term
| When to infants display "cue" based feeding patterns |
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Definition
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Term
| 5 indications for use of tube feeding devise at the breast |
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Definition
1. infant who latches but has low sucking pressures
2. lack of sucking rhythm
3. mother's request
4. limited milk supply
5. impaired MER |
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Term
| can be used if baby is unable to latch onto mother's nipple due to size |
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Definition
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Term
| recommended over supply to provide a cusion |
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Definition
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Term
Establishing full breastfeeding
Stage One |
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Definition
| establish lactation by expressing and collecting milk |
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Term
times per day a mother of a preterm infant should pump
amount of milk it should yield |
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Definition
8-12 times in 24 hrs for first 7-10 days
should yield 800-1000 ml per day by day 7-10 |
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Term
| when should pumped breastmilk be fed to infant |
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Definition
immediately if possible- fresh breastmilk is preffered
-if frozen can be thawed and given in chronological order |
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Term
| time fresh breastmilk can be refrigerated before being given to preterm infant |
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Definition
48 hours max
(term infant 3-5 days) |
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Term
Establishing full breastfeeding
Phase Two |
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Definition
| Introduction of infant to breast |
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Term
Establishing full breastfeeding
Phase Three
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Definition
Optimizing early feedings
-working on possitioning and attachment
-continue kangaroo care |
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Term
Establishing full breastfeeding
Phase Four
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Definition
Transition to full cue-basd breastfeeding
-often happens at term |
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Term
| What LC should teach parents before discharge |
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Definition
1. signs baby is getting enough
2. expected feeding patterns
3. continued use of the breast pump
4. use of supplemental feeders |
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