Nursing Care Plan, Baby who spits up consistant amounts of formula.

[RNkeepLearning]

In my OB clinic last week. I cared for a newborn male child. For his first feeding he took 30ml!! And his mother reported him spitting up a lot of it, and at 12:30 a second feeding of 60 ML. YES TWO OUNCES! Naturally, the infant spit up all of that. During my assessment I had the child side-lying and held him facing downward slightly d/t his spitting up, and used a bulb syringe to evacuate the formula. I was worried he would asparate... The mother requested a formula change, she felt the babe was allergic to the formula, so he was switched to a sensitive formula. Gentle pt ed by the RN taking care of baby, while I shadowed, was done about the size of a one day old infant's stomach (size of a cherry), and the need for small feedings and frequent burps. I can understand, when a chlid cries everyone always wants to feed it thinking it's hungry. Sometimes, they just want to be hugged and patted or a pacee for soothing. At any rate. I have to do a nursing care plan for Baby, not mom. Other then the emesis he is a perfect beautiful baby boy, c-sec birth, 7#9oz!

Is Risk for imbalanced fluid volume r/t frequent emesis after feedings,

Or Risk for electrolyte imbalance r/t frequent emesis after feedings,

Or Risk for Aspiration r/t frequent emesis after feedings,

Or Risk for aspiration r/t mom not being receptive to patient education. (I AM JUST KIDDING!! THAT IS TOTALLY NOT A NU DX I WOULD USE! (however, it is truly frustrating to see that little baby vomiting so much. )

ARe there nursing care plan books for infants/OB/Peds? I am using my Ninth Ed. NDH by Ackley/Ladwig...

THANKS! CC

[JROregon, ASN, BSN, RN]

I wish I could help with more nursing dxs for baby but man, mom is feeding him too much. If she were breast feeding, the baby would be getting a few mls of colostrum per feeding for the first couple of days until the milk came in. So all this formula will just get spit up. I suppose you could add a dx for impaired tissue integrity because his skin could get some irritation if he is left in a sleeping position. I just cracked my ped nursing book. I'll take a peek.

[CrunchyMama, ASN, RN]

I agree with the previous poster. If he was eating what he's suppose to be eating (breastmilk), he most likely wouldn't be having these issues. Not only do formula fed babies/kids get fed too much, but a lot of the time there's issues with trying to digest it....hence the reason why there's so many different kinds of formula. Poor kid! :/

Anyway, I think all the nursing dx you have work pretty well....I would add risk for constipation (one of the problems formula fed babies have) and if there was such a dx as risk for acid reflux (another problem formula fed babies have). Good luck!

[BittyBabyGrower, MSN, RN]

I would do Alteration in Nutrition related to frequent emesis and Parental Teaching and Involvement related to feeding infant. That about covers it.

The reflux one, not so much....I see as many kids on breastmilk with reflux.

[RNkeepLearning]

To all three of you who took the time to post. THANKS so MUCH! Bitty Baby, that is great. THANKS! You gals are a great resourse, if you find anything else Oregon, in your peds, and you have time, post it! THANKS.

[JROregon, ASN, BSN, RN]

Our class starts peds in another week so I am learning just as much here. The book we got was huge compared to the time we have to learn about babies and kiddos.