INFANT FORMULA

infant feeding infant feeding

infant feeding infant feeding

Infant feeding

Rotherham Paediatric Dietitians 2011Sarah Milnes BSc (Hons) RD

Whats in cow’s milkProtein composition

WheyAlpha -lactablumin Beta –lactaglobulinMost likely to cause production of IgE antibodies Heat sensitive - therefore may be able to tolerate evaporated, boiled or sterilised milk, UTH and milk powder

Casein Heat stable

SugarLactose

Iron

Additions to formula LCP (long chain Polyunsaturates)

Omega-3DHAOmega-6AABrain development, nervous system, eyesight

Prebiotic Also known as Oligosaccharides or polysaccharidesNon-digestible carbohydrates Nutrients for gut flora such as Bifidobacteria lactobacilliExamples as FOS( fructo-oligosaccharides), GOS (galacto-oligosaccarides), inulin, transgalacto-oligosaccharides and lactulose

Nucleotides Support Immune system Improve growthImprove gut bacteria

Alpha- Lactalbumin Whey proteinReduced beta proteins therefore more like breast milk

Cow & Gate Milupa Aptamil SMA

Breastmilk fortifer Nutriprem Breast milk fortifier

Breast milk Fortifier

Preterm – under 2000g

Nutriprem 1 Aptamil Preterm SMA Gold Prem 1

Preterm -above 2000g

Nutriprem 2 SMA Gold Prem 2

Ex-prems discharged from RFT SCBU that have not had catch up growth are discharged on Nutriprem 2, with progress monitored by Rotherham paediatric dietitians. It should only be

used until 26 weeks actual age.

Cow & Gate Milupa Aptamil SMA HIPP

First milk(whey

dominant)

First Infant Milk Aptamil First Milk

SMA First Infant milk

Hipp Organic First milk

First milks/Stage 1 used for the first year - no need for stage 2, stage 3 ……

Second Milks

“Hungry Baby”(Casein

Dominant)

Infant milk for the hungrier

babies

Hungry milk SMA Extra Hungry Infant

milk

Hipp Organic Hungry Infant

Cow & Gate Milupa Aptamil

SMA HIPP

Follow onFrom 6 months

onwards

Follow on milk Aptamil Follow on Milk

SMA Follow on Milk

Hipp organic follow on Milk

One year plus

When all you need is cow’s milk

Growing up milk for

toddlers / milk for 2-3 years

Aptamil Growing Up

milk +1 year / +2 years

SMA Toddler Milk

Hipp Organic Growing up

Cow & Gate Milupa Aptamil HIPP

Good night milk HiPP Organic Good night milk

Contains rice & buckwheat

High calorie100% whey milks Cow & Gate Comfort Aptamil Comfort

Other milks – all not recommend Soya infant formula only for

over 6 month of age but ideally not before 12 months therefore no need for soya

formula

Goats milkNEVER as banned in EU and

UK

Rice Milk

Not to be used in under 5’s due to high level of arsenic

Formula Feeding ProblemsConstipation Check it is constipation

Return to whey dominant formulaCheck feed concentration*Advise extra cooled boiled waterRefer to GP

Sugar should not be added to drinks or feedTake care not to compromise growth by giving too much cooled water

Colic Check bowelsCheck feeding positionCheck feed concentration*Check winding methodCheck over feeding

Check teat size observe a feed (HV or Midwife)Offer support/self help groupsFeeding diarySome parents find colic preparations helpful

Excessive possetting

Check for over feedingSupport and reassureObserve feedReview weight gain

Examine feeding positionFeeding DiaryRefer to GP if possetting is excessive and weight gain is inadequate

Poor weight gain

Check formula preparation*Check amount and frequency of feeds

Observe feedsRefer to GP/CMO if appropriate

* Care should be taken to ensure that a good standard of hygiene is maintained when making up feeds, and that manufacturers guidance is followed to ensure the correct concentration of feeds once reconstituted (usually 1 scoop of powder per 1 fluid ounce / 30mls water).

Kcal in 1/4 Kcal in ½ Kcal in an apple

Apple 15 kcal 30kcal 60kcalKcal in 2 teaspoon Kcal in 3 tblespoons Kcal in 6 tblespoons

Baby rice 15kcal 56kcal 112kcal

Kcal in 30ml Kcal in 90ml kcal in 120ml

Formula 20 kcal 60kcal 80kcal

Weaning updateExclusive breastfeeding from birth until weaning is the optimal way to feed young infants. Continuing breastfeeding throughout weaning may reduce the risk of coeliac disease and allergy, and gives ongoing protection against infection even with 2 feeds a day. Term infants should begin weaning around 6 months (26 weeks) but never before 4 months (17 weeks).

Baby – led weaning is popular with some parents.

Infants should all be considered individually as they develop at different rates.

Potentially high allergen foods such as egg, fish, milk used in foods and cooking, cheese, yoghurt, wheat and other gluten containing cereals do not need to be delayed until a certain age.

Preterm infants need special consideration and are not included in government weaning guidelines. Signs of readiness to start weaning are usually present between 5 and 7 months after their actual birth date (BLISS 2008).

2 years

6 months 1 year

wea

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Birth

Breast milk

Cow’s milk as a drink, 500 -600ml/dayFirst milk

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Vit D supplements for all– Abidec, Healthy start Vitamins, OTC till 5

3 meals & 3 snacksProgress on to

lumpier food faster when solids

introduced nearer 6/12

95% of infants should be 100% happy on the above

Preterm Formula till 26 wks actual age or stopped earlier if growth between 25-50th C

First milk can be used till 1 yr corrected

Cow’s milk as a drink, 500 -600ml/day