2. How would you know if Noah’s nutritional intake is sufficient? Noah's Cardiac ConditionNoah is a former late pretermmale born at 38 weeks gestation.He weighed 2100 grams andwas small for gestational age.His mother's medical historyincluded chronic hypertension, obesity, and gestationaldiabetes. Noah was diagnosed prenatally with a cardiacThe family perceives this recommendation as underminingNoah's mother's effort to nurse him, and is unsure aboutimplementing this change. Noah likes to nurse, howeverfeedings are brief and Noah is not able to obtain the higherfat/higher calorie hindmilk. Over time, his family starts tointroduce baby foods from a spoon and his mom continuesto breastfeed. Noah's weight gain is progressing slowly; hislength and head circumference are progressing along the10th percentile. Because of his slow weight gain his weight-for-length percentile has fallen to the 3rd percentile.Noah's family enjoys the interactions during feedingsand feels that Noah is doing well for an infant with a car-diac problem. They have not contacted the WIC Programor the Children with Special Health Needs Program. Somepeople they meet assume that Noah was a prematurebaby, but his small size is not of concern to his parents.Cheryl E. Davis/Shutterstock.comcondition that could affect his ability to feed.His mother planned to breastfeed Noah and has beensuccessful at expressing her milk and maintaining her breastmilk supply. Noah has a weak suck and tires easily at thebreast. He is able to drink small volumes, 1 to 1½ ouncesfrom a bottle. The feedings can last 30 minutes or longer.At discharge, the family is referred to the WICprogram, Supplemental Social Insurance (SSI), and thestate Children with Special Health Needs program.Specialty cardiac clinic and local follow-up appointmentsare made. Feeding difficulties concern the family, andboth a lactation consultant and a registered dietitian areQuestions1. How do breastfeeding and feeds of breasts milkbenefit Noah?involved prior to and after discharge.Noah nurses frequently, but briefly, due to fatigue.Growth is slower than expected, but the cardiologistdoes not think Noah's slow weight gain is a result of hiscardiac condition. Noah continues to nipple small volumeseven after his family implements the recommendationsfrom the lactation consultant. The registered dietitianrecommends increasing the caloric density of expressedbreast milk with the addition of infant formula powder.2. How would you know if Noah's nutritional intake issufficient?3. Why might the family not desire services and benefitsfrom the WIC program or Children with SpecialHealth Needs program?4. What next steps would you recommend to help Noahwith his weight gain?

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Breastfed newborns have passive immunity. It is said to be a temporary and short-lived immunity as…