Normal Vegetative Functions


Feeding Patterns
Most healthy, bottle-fed infants eat 2 to 4 ounces every 2 to 4 hours (six to nine feedings in 24 hours) by the end of the first week of life; breastfed infants prefer shorter intervals—feeding every 1 to 3 hours. Intake is adequate if the neonate is gaining weight appropriately and appears content between feedings. Feedings should be considered as having progressed satisfactorily if the infant is no longer losing weight by 5 to 7 days and is gaining weight by 12 to 14 days.
Parents usually need reassurance that their infant is obtaining adequate nutrition because of the wide variation in the intake of normal infants.
It is important to appreciate that infants cry for reasons other than hunger and that they need not be fed every time they cry.
  • Newborn - 110Kcal/kg/day
  • 12 Month - 10 Kcal/kg/day
  • q2-3h, monitor Urine output & wt. gain.
  • Max. overnight interval - 4 hr.
  • Signs of hunger: suckling of hand or fingers, arm movement towards mouth = feed baby now.

 
Weight Gain
Weigh the infant completely undressed. Normal newborns may lose up to 12% of their birth weight during the first 3 to 7 days of life with earlier and slightly more accentuated weight losses in exclusively breastfed newborns.
A weight loss of up to 10% is acceptable if the infant's examination, stooling, and voiding frequency and behavior are normal.
On average, infants gain between 20 and 30 grams (1 oz) per day in the first 3 months of life and between 15 and 20 grams per day for the next several months
 
Average Daily Weight gain
Age Ounce Grams
0-3 month 1 oz 26-31 g
3-6 month 1/2 oz 17-18 g
6-9 month 1/3 oz 12-13 g
9-12 month 1/4 oz 9 g
1-3 yr 1/4 oz 7-9 g
4-6 yr 1/8 - 1/4 oz 6 g
Average Monthly Weight Gain
Age Lb Kg
0-3 month 2.2 lb/mo 1 kg/mo
3-6 month 1.1 lb/mo 1/2 kg/mo
6-9 month 3/4 lb/mo 1/3 kg/mo
9-12 month 1/2 lb/mo 1/4 kg/mo

 
Stool Patterns
The number, color, and consistency of bowel movements can vary greatly in the same infant and between infants regardless of diet or environment.

An excessive intake of human milk or maternal use of laxatives further increases the water content of the infant's stool. Overfeeding or use of formula that is too concentrated or too high in sugar content also can produce loose stools. Occasionally, an infant may not have a bowel movement on a given day.

Stool color has no significance unless it is acholic or blood is present. The first stool, which consists of meconium, is usually passed within the first 24 hours after birth, and is thick, sticky, and black. Transitional stools, which are greenish brown, appear after initiation of milk feeding and are replaced by typical yellow, seedy milk stools 3 to 4 days later. Infrequent bowel movements do not necessarily mean constipation, because breastfed infants may occasionally go 5 to 7 days without a bowel movement.
Ask about the timing of the first stool, because failure to pass meconium in the first 48 hours of life may be suggestive of Hirschsprung disease or cystic fibrosis
Breathing Patterns
A normal respiratory rate for a neonate is from 30 - 60 breath/min. Periodic breathing (alternating episodes of rapid breathing with bried [<5-10s] pauses in respiration) is usually normal.
 
Sleeping Patterns
Normal newborns awaken at variable intervals that can range from about 20 min to 6 hr. Neonates & young infants tend to have no differentiation between day and night until appx. 3 months of age.