Chapter 22: Infant Feeding

Infant Feeding establishes human milk as the biological standard, detailing the three distinct stages of lactogenesis—from the immunoglobulin-rich colostrum ("liquid gold") to transitional and finally mature milk. The text explains the complex hormonal interplay where prolactin stimulates milk synthesis and oxytocin triggers the milk-ejection reflex (let-down) in response to infant suckling, following a fundamental supply-and-demand principle. Beyond macronutrients like proteins (whey and casein), carbohydrates (lactose), and essential fats for brain development (DHA/ARA), the chapter highlights the unique immunological components of breast milk, such as secretory IgA, lactoferrin, and leukocytes, which offer protection against respiratory and gastrointestinal illnesses. For families utilizing formula feeding, the chapter outlines various preparations—including modified cow’s milk and specialized soy or hydrolyzed protein options—while stressing the importance of sterile preparation and precise dilution to avoid dangerous electrolyte imbalances. Clinical nursing management is a core focus, introducing the LATCH assessment tool to evaluate positioning, audible swallowing, and nipple integrity. Furthermore, it provides evidence-based interventions for common challenges such as breast engorgement, mastitis, nipple trauma, and nipple confusion, alongside practical guidelines for milk expression, storage, and the nutritional requirements of preterm infants or multiple births.