A nurse is reviewing home care with a client who has multiple sclerosis. Which of the following precautions should the nurse recommend to promote client safety?

Choice A reason: Supplementing breastfeedings with water every 12 hours is not advised for newborns, as breast milk provides complete hydration and nutrition. Water can reduce milk intake, decreasing supply due to reduced demand. It risks electrolyte imbalances, like hyponatremia, in infants with immature kidneys. Exclusive breastfeeding for six months supports optimal growth, immune function, and maternal-infant bonding, making this recommendation inappropriate.
Choice B reason: Offering the breast at hunger cues, such as rooting or hand-sucking, supports demand-driven breastfeeding, which stimulates prolactin and oxytocin for milk production. This ensures adequate supply, promotes healthy weight gain, and aligns with the infant’s natural feeding rhythm. It prevents over- or under-feeding, fostering neonatal development and strengthening the maternal-infant bond, making this the correct advice.
Choice C reason: Limiting feeding to 10 minutes per breast can prevent adequate hindmilk transfer, which is high in fat and calories, essential for growth. Short sessions may reduce milk supply due to insufficient stimulation. Infants need variable feeding times to meet nutritional needs. This restriction risks poor weight gain and inadequate nutrition, indicating it’s not a suitable recommendation.
Choice D reason: Starting each feeding with the same breast can cause imbalanced milk production, as one breast may be understimulated, reducing overall supply. Alternating breasts ensures both are drained, supporting balanced lactation and preventing engorgement or mastitis. This practice maintains milk supply via prolactin release, making this advice incorrect for optimal breastfeeding.

Choice A reason: Giving 2 ounces of water before newborn genetic screening is unnecessary and inappropriate, as the test involves a heel stick blood sample, not oral intake. Water may disrupt feeding or hydration balance in newborns, making this statement incorrect and irrelevant.
Choice B reason: Newborn genetic screening is typically a one-time test shortly after birth, not repeated at 2 months unless specific conditions warrant follow-up. Routine repetition is not standard, making this statement inaccurate for general teaching about the screening process.
Choice C reason: Blood for newborn genetic screening is collected via a heel stick, not the inner elbow, to minimize discomfort and obtain sufficient capillary blood. Drawing from the elbow is incorrect and impractical for newborns, making this statement inaccurate.
Choice D reason: Performing genetic screening after 24 hours ensures accurate detection of metabolic disorders, as newborns need time to metabolize nutrients. This timing aligns with national guidelines (e.g., AAP), making it essential and correct information for parents about the screening process.