A nurse is providing teaching to the parent of a newborn who has gastroesophageal reflux (GER). Which of the following instructions should the nurse include?

Choice A reason: Tuna can is not a safe food choice for a client who has food allergies because it may contain traces of other fish or shellfish that can trigger an allergic reaction. Tuna can should be avoided or checked for allergen labels before consuming.

Choice B reason: Gravy beef is not a safe food choice for a client who has food allergies because it may contain gluten, soy, or dairy products that can trigger an allergic reaction. Gravy beef should be avoided or checked for allergen labels before consuming.

Choice C reason: Apple pie is a safe food choice for a client who has food allergies because it is unlikely to contain common allergens, such as nuts, eggs, or milk. Apple pie is made from cooked apples, sugar, flour, and butter, which are low-risk ingredients for food allergies. Apple pie should be stored in the refrigerator or freezer after cooling to prevent spoilage.

Choice D reason: Bread is not a safe food choice for a client who has food allergies because it may contain gluten, wheat, or sesame seeds that can trigger an allergic reaction. Bread should be avoided or checked for allergen labels before consuming.

Choice A reason: Feedings should not be accompanied by nonnutritive sucking. Nonnutritive sucking is the act of sucking on a pacifier, finger, or other object without getting any nutrition. Nonnutritive sucking can interfere with the establishment of breastfeeding, cause nipple confusion, and reduce milk supply.

Choice B reason: Feedings should be on demand. On demand feeding means feeding the newborn whenever they show signs of hunger, such as rooting, sucking, or crying. On demand feeding helps the newborn regulate their appetite, meet their nutritional needs, and bond with their caregiver.

Choice C reason: Feedings should not begin within 1 hr after birth. This instruction is applicable for breastfeeding, not bottle feeding. Breastfeeding should begin within 1 hr after birth to initiate milk production, stimulate uterine contractions, and transfer colostrum to the newborn. Bottle feeding can be delayed until the newborn is stable and alert.

Choice D reason: Feedings may not occur in clusters. Cluster feeding means feeding the newborn more frequently and for longer periods of time during certain times of the day or night. Cluster feeding is common in breastfed newborns, especially during growth spurts or developmental leaps. Bottle fed newborns may not exhibit cluster feeding, as they tend to have more consistent and predictable feeding patterns.