Nutrition Through the Life Cycle (...

6th Edition
Judith E. Brown
ISBN: 9781305628007



Nutrition Through the Life Cycle (...

6th Edition
Judith E. Brown
ISBN: 9781305628007
Textbook Problem

Breastfeeding Premature Infants


Thirty-five-year-old Stacey delivers twin boys at 30 weeks’ gestation: baby Andrew is 2 pounds, 9 ounces, and 13.5 inches long; baby Mark is 1 pound, 13 ounces, and 14 inches long. Stacey had a difficult pregnancy that included severe nausea and vomiting, heartburn, preeclampsia, and preterm labor.

Stacey is very committed to breastfeeding and was able to use a hospital-grade electronic breast pump approximately 6 hours after delivery. She pumps every 2–3 hours or 8–9 times daily in order to establish her milk supply. At the end of the first week, Stacey is pumping about 14–16 ounces/day per baby, and by 3½ weeks she is pumping 4–5 ounces per breast at each pumping. Stacey wakes at night to pump when she is full. She has placed the pumping equipment by the bed and become adept at pumping, getting out of bed only to put the milk in the refrigerator. At 2 weeks postpartum, Stacey experiences a plugged duct and has difficulty emptying the right breast for 2 days.

The twin boys have suffered the usual preterm difficulties with breathing, apnea, and bradycardia. Initially the twins are tube-fed. As their condition improves, baby Andrew is first put to breast 3 weeks after his birth, and baby Mark several weeks later. Baby Mark has more difficulty learning to latch on and suck and is growing more slowly than is his brother. Multiple interventions are used to achieve breastfeeding success. On advice from a lactation consultant, Stacey uses a nipple shield to help baby Mark latch on. In response to slow weight gain in baby Mark, the lactation consultant recommends that the baby receive hindmilk, which is often higher in fat and calories.

Mark and Andrew are released from the hospital a day after their due date. Stacey continues using the nipple shield for several weeks with Mark, trying without the nipple shield every few days. After 3 weeks at home, baby Mark is able to latch on without the nipple shield. The twins are breastfed and also receive up to 3 bottles of fortified expressed breast milk or premature infant formula per day for the first 2 months at home. The babies take feedings equally well from bottle or breast.


List at least two possible nutrition diagnoses for this case.

Summary Introduction

To list: Two possible nutrition diagnoses for the given case.

Introduction: Infants who born in between 34 and 37 weeks of the pregnancy is considered as late-preterm infant. Breast feeding is an important phase in the life of both the mother and the infant. Breast milk provides the necessary nutrients, immunological functions, and psychological support to the growing infant in his early stages of development.


Person S is 35 years-old who and delivered two premature boys at 30 weeks’ gestation. Person A (baby) is 2 pounds, 9 ounces, and 13.5 in long. Person M (baby) is 1 lb, 13 ounces, and 14 in long. Person S had various difficulties during her pregnancy. Person S used a hospital-grade electronic breast pump after six-hours of delivery. In every 2-3 hours and 8-9 times daily, she pumped in order to create her milk supply. After 6-7 days, person S was able to pump about 14-16 ounces/day per baby and by 312 weeks of delivery the amount of milk pumping became 4-5 ounces per breast at each pumping. At two weeks of postpartum, Person S experienced a plugged duct and faced difficulty while emptying her right breast for two days.

Two boys have suffered from various preterm difficulties with other symptoms like breathing, apnea, and bradycardia

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