Parents have been asked by the neonatologist to provide breast milk for their newborn son, who was born prematurely at 32 weeks of gestation.
The nurse who instructs them about pumping, storing, and transporting the milk needs to assess their knowledge of lactation.
What statement is valid?
The mother should pump every 4 to 6 hours, including during the night.
A premature infant more easily digests breast milk than formula.
A glass of wine just before pumping will help reduce stress and anxiety.
The mother should only pump as much as the infant can drink.
The Correct Answer is B
Choice A rationale
Frequent and consistent breast pumping is essential to establish and maintain an adequate milk supply, particularly for mothers of preterm infants. Pumping approximately every 2 to 3 hours, or 8 to 12 times in a 24-hour period, better mimics a newborn's feeding frequency and is crucial for stimulating prolactin release and milk synthesis, more so than the 4 to 6 hour interval which risks decreasing supply.
Choice B rationale
Breast milk contains high concentrations of whey protein, which forms a soft, easily digestible curd in the infant's stomach, facilitating gastric emptying. Furthermore, human milk contains lipase, which aids in fat digestion, and human milk oligosaccharides (HMOs), which act as prebiotics to promote beneficial gut flora, all making it superior to formula.
Choice C rationale
Alcohol, including that consumed in wine, passes readily into breast milk. Although the concentration in milk mirrors that in the mother's blood, the alcohol can impair the infant's motor development, disrupt sleep patterns, and potentially inhibit the milk ejection reflex (let-down), thereby reducing the volume of milk obtained during the pumping session.
Choice D rationale
Mothers of preterm infants should pump to establish a full milk supply, which often exceeds the initial small volumes the premature infant can tolerate. Pumping frequently to empty the breasts fully signals the body to produce more milk, supporting the ultimate goal of providing a full volume of human milk as the infant matures and increases intake.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Heat loss by convection occurs when body heat is transferred to cooler ambient air that is moving across the newborn's body surface. The fan blowing directly on the unwrapped infant creates a flow of cooler air, which accelerates heat loss from the infant's skin to the surrounding air. Keeping the baby wrapped and preventing air currents minimizes this mechanism to help maintain a neutral thermal environment.
Choice B rationale
Heat loss by conduction involves the transfer of heat from the newborn's body to a cooler solid surface with which the infant is in direct contact, such as a cold mattress or scale. The situation described (fan blowing on the unwrapped baby) does not involve direct contact with a cooler surface, so conduction is not the primary mechanism of heat loss here.
Choice C rationale
Heat loss by evaporation involves the vaporization of water from the newborn's moist skin or respiratory tract, such as from amniotic fluid immediately after birth or from sweat or insensible water loss. While some insensible loss occurs, the fan's action is primarily convection, as it moves cooler air over the infant, making evaporation an indirect or secondary concern.
Choice D rationale
While it is true that a newborn needs to be bundled to maintain a neutral thermal environment (NTE), stating this general fact does not answer the mother's "why" question regarding the specific mechanism of heat loss caused by the fan. The NTE is the range of ambient temperatures where metabolic rate and oxygen consumption are minimal to maintain a normal body temperature (36.5°C to 37.5°C). —.
Correct Answer is D
Explanation
Choice A rationale
While drying does remove blood and amniotic fluid, the primary scientific rationale is thermoregulation. Removing superficial contaminants is secondary to preventing cold stress. Allowing the wet skin to air dry would cause rapid, dangerous cooling, a more significant threat than the mere presence of maternal blood.
Choice B rationale
The drying and vigorous stimulation do not specifically increase blood flow to the distal extremities (hands and feet). The initial drying is the first step in preventing evaporative heat loss, which is paramount to maintaining the infant's core body temperature and promoting stable transition to extrauterine life.
Choice C rationale
Stimulating the infant by rubbing the back or soles of the feet does encourage crying, which helps expand the lungs and clear fluid. However, the most immediate and critical scientific reason for thorough drying is to prevent significant evaporative heat loss, which accounts for a large percentage of neonatal heat loss.
Choice D rationale
Water on the skin surface rapidly evaporates, and because a significant amount of heat is required to change water from liquid to vapor (latent heat of vaporization), this evaporation causes rapid and significant body heat loss. Thorough, immediate drying eliminates the largest source of cold stress for a newborn, preventing a drop in core temperature.
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