View
228
Download
1
Category
Tags:
Preview:
Citation preview
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
ning
Birth
Breast milk
Cow’s milk as a drink, 500 -600ml/dayFirst milk
Family food17
wee
ks th
e ea
rlies
t for
w
eani
ng
Fe ri
ch fo
ods
7/12
‘Sou
r ‘ v
eg a
nd fi
nger
fo
ods
arou
nd 8
- 9/1
2
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
Recommended