Critical Pathway For Newborn Care

Category	First 4 Hours	4-8 Hours Past Birth	8-24 Hours Past Birth
Nutrition	Assist newborn to breastfeed as soon as mother/baby condition allows Supplement breast only when medically indicated or per agency policy Initiate bottle-feeding within first hour Gavage feed if necessary to prevent hypoglycemia	Breastfeed on demand, at least q3-4h Teach positions, observe/assist with feeding, breast/nipple care, establishing milk supply, breaking suction, feeding cues, latching on techniques, nutritive suck, burping Bottle feed on demand, at least q3-6h Determine readiness to feed and feeding tolerance	Continue breast/bottle feeding pattern Assess feeding tolerance q4h Discuss normal feeding requirements, signs of hunger and satiation, handling feeding problems, and when to seek help Expected Outcomes: Mother verbalizes knowledge of feeding information; breastfeeds on demand without supplement; bottle-tolerates formula feeding, nipples without problems