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ARTIFICIAL FEEDING ARTIFICIAL FEEDING , , SUPPLEMENTED SUPPLEMENTED BREASTFEEDING, and BREASTFEEDING, and COMPLEMENTARY FEEDING COMPLEMENTARY FEEDING Prof. Dr. Emel Gür İÜ CTF Çocuk Sağ ve Hast ABD

ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

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ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING. Prof. Dr. Emel Gür İÜ CTF Çocuk Sağ ve Hast ABD. ARTIFICIAL FEEDING. A rtificial Feeding. In this type of feeding, the baby receives only non-breastmilk. - PowerPoint PPT Presentation

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Page 1: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

ARTIFICIAL FEEDINGARTIFICIAL FEEDING,,SUPPLEMENTED SUPPLEMENTED

BREASTFEEDING, and BREASTFEEDING, and COMPLEMENTARY FEEDINGCOMPLEMENTARY FEEDING

Prof. Dr. Emel Gür

İÜ CTF Çocuk Sağ ve Hast ABD

Page 2: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

ARTIFICIAL FEEDINGARTIFICIAL FEEDING

Page 3: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

AArtificial Feedingrtificial Feeding

In this type of feeding, the baby receives only non-breastmilk

Page 4: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

İf the family can afford it, it is İf the family can afford it, it is best to substitue breast-best to substitue breast-

feeding with industrial milk feeding with industrial milk formulae which all have formulae which all have composition similar to composition similar to

maternal milk.maternal milk.

Page 5: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

If cow’s milk must be used, the If cow’s milk must be used, the milk must be diluted with water in milk must be diluted with water in

proportions of 1:1 in the first proportions of 1:1 in the first month, 2:1 between 1 and 4 month, 2:1 between 1 and 4

months. No dilution is necessary months. No dilution is necessary after 4 months. To increase after 4 months. To increase

calorie content, 5g. (1 teaspoon) calorie content, 5g. (1 teaspoon) of sugar is added to each 100g. of sugar is added to each 100g.

diluted or nondiluted milk.diluted or nondiluted milk.

Page 6: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

AMOUNT OF MILK PER AMOUNT OF MILK PER MEALMEAL

1-2 week 60-90 ml3 wk - 2 mo. 120-150 ml2-3 mo. 150- 180 ml3-4 mo. 180-210 ml5-12 mo. 210-240 ml

Page 7: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

The number of feedings per The number of feedings per dayday

0-1 week 6-101 week-1 mo. 6- 81-3 mo. 5- 6 3-7 mo. 4- 5 4-9 mo. 3- 48- 12 mo. 3

Page 8: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Principles of Principles of artificial artificial feedingfeeding

Fruit juıces can be started after the first month. Artificially fed babies do not need solid foods,

such as milk pudding before 4 months It is best to prepare milk formulae fresh at each

feeding Adequate preparation of the food, cleanliness

of the water, and the containers and utensils is essential

Page 9: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Principles of Principles of artificial artificial feedingfeeding

Artificially fed babies do not need solid foods, such as milk pudding before 4 months

Page 10: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Principles of Principles of artificial artificial feedingfeeding

Bottles and nipples must first be washed with soap and water using a long brush, than sterilized in boiling water for 10 minutes and left to cool on upside down position

For the uneducated mothers, it is best to recommended spoon feeding, using cups or glasses even in very young babies.

The nipple hole must be checked for size by looking at milk flow

Page 11: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Adequacy of intake is Adequacy of intake is assessed by weight assessed by weight

monitoringmonitoring

Page 12: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

SSUPPLEMENTEDUPPLEMENTED BREAST-FEEDİNG BREAST-FEEDİNG

(MIXED FEEDING(MIXED FEEDING))

Page 13: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Supplemented BREAST-FEEDİNG Supplemented BREAST-FEEDİNG

(MIXED FEEDING(MIXED FEEDING))

An infant in his first 6 months is offered breast milk and in addition, other milks

and milk products as supplements.

Page 14: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

The main indication for The main indication for supplementing breast-supplementing breast-

feeding is an arrest weight feeding is an arrest weight gain in a healthy breastfed gain in a healthy breastfed

infant which is not corrected infant which is not corrected despite all efforts to despite all efforts to

increase the maternal milk increase the maternal milk supply.supply.

  

Page 15: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

The decision for The decision for supplementation is taken supplementation is taken

only after one or two weeks only after one or two weeks of monitoring. of monitoring.

Page 16: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Principles of supplemented Principles of supplemented feeding feeding

When the need for supplementation is established, this is done gradually

At first, the supplement is given once a day preferably in the evening (6.00-7.00 pm.), a time when the mother’s milk supply is usually the lowest.

The baby is breast-fed for 5-10 minutes and the supplement (milk formula and cow’s milk) is offered by spoon. İf the baby is not satisfied by one supplementation, two or more meals may be supplemented.

Page 17: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Principles of supplemented Principles of supplemented feedingfeeding

Spoon feeding must be preferred to bottle feeding. This is important for the continuation of breast-feeding and prevention of infections.

Fruit juices are started at 4 weeks and milk pudding at 4 months in babies on supplemented feedings

Page 18: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

COMPLEMENTARY COMPLEMENTARY FEEDINGFEEDING

Page 19: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

FEEDING BETWEEN 6-12 FEEDING BETWEEN 6-12 MONTHSMONTHS

Page 20: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Breastfeeding will not meet Breastfeeding will not meet the requirements of the the requirements of the babies over 6 monthsbabies over 6 months

Page 21: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

After 6 months, breast-After 6 months, breast-feeding is supplemented with feeding is supplemented with

more concentrated foods.more concentrated foods.  

Page 22: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Time of introduction of Time of introduction of supplemental foods supplemental foods

(6 months or earlier) (6 months or earlier) should be decided by weight should be decided by weight

monitoringmonitoring

Page 23: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Until 9th month breast-milk Until 9th month breast-milk is the primary diet of the is the primary diet of the

baby.baby.Foods initially supplement Foods initially supplement breast-feeding gradually breast-feeding gradually

replace breast-feeding and replace breast-feeding and at 9-12 months become the at 9-12 months become the

primary diet of the babyprimary diet of the baby

Page 24: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

RESULTS OF EARLY AND LATE RESULTS OF EARLY AND LATE INTRODUCTION OF THE SUPPLEMENTAL INTRODUCTION OF THE SUPPLEMENTAL

FOODSFOODS

EARLY Decreasing of breast-

milk Gastroenteritis Allergy Malnutrition Obesity

LATE Growth retardation Infection Gastroenteritis Malnutriion Vitamin ve mineral

deficiency

Page 25: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

REQUIREMENT OF ENERGY ACCORDING TO REQUIREMENT OF ENERGY ACCORDING TO AGEAGE

Age Energy (kcal/kg/day)

<3 mo. 120

3-6 mo. 115

6-8 mo. 110

9-1 mo. 105

1-3 mo. 100

4-6 mo. 85

7-10 mo. 85

11-14 yr. E 60

K 50

15-18 yr. E 45

K 40

Page 26: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Supplementary foods must Supplementary foods must be foods of high energy be foods of high energy

content, easy to digest, low content, easy to digest, low in fiber, in puree in fiber, in puree

consistency, easy to consistency, easy to prepare and free of spices.prepare and free of spices.

Page 27: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Supplementary foods are Supplementary foods are best given by cup and best given by cup and

spoon, and introduced one spoon, and introduced one at a time and in small at a time and in small

amounts (1-2 teaspoons), amounts (1-2 teaspoons), and the amount increased and the amount increased

every dayevery day

Page 28: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Fruit juice and fruit puree Fruit juice and fruit puree (apples or peaches) and (apples or peaches) and

milk pudding prepared with milk pudding prepared with rice flour are the first rice flour are the first

supplementary foods to be supplementary foods to be started. Vegetable purees, started. Vegetable purees, yoghurt, eggs, meats are yoghurt, eggs, meats are

gradually introducesgradually introduces

Page 29: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

The nitrat content of The nitrat content of spinach must be given as spinach must be given as soon as prepared. Fava soon as prepared. Fava

beans are not beans are not recommended becouse of recommended becouse of favism, eggplants are not favism, eggplants are not

recommended because they recommended because they are poor in minerals and are poor in minerals and

vitaminsvitamins

Page 30: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Points to remember when Points to remember when starting supplementsstarting supplements

They must be prepared fresh, kept in a cool place away from insects

Some babies prefer a salty taste, while others like sweet taste. The choice of the food must be done with some flexibility to suit the baby’s preference

The baby must not be forced . İf the baby refuses the food, that particular food is withheld for a few days

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Points to remember when Points to remember when starting supplementsstarting supplements

Water given to babies younger than 12 months must always be boiled. Water used in the preparation of supplemental foods must also be clean

In preparing the foods, attention must be paid to measure the right amounts

(1 teaspoon=5ml; 1 tablespoon =15ml; 1 cup or 1 water glass=200ml; 1 tea glass=100ml)

Page 32: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

AMOUNT OF SUPPLEMANTARY AMOUNT OF SUPPLEMANTARY FOODS PER MEALFOODS PER MEAL

Age (month) Tablespoon

6 6

7 7

8 8

9 9

10 10

11 11

12-24 at least 10

Page 33: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Time of introduction of Time of introduction of supplemental foodssupplemental foods

6th-7th months

7th-8th months

Fruit juice and puree Vegetable purees Milk pudding Yoghurt

Meat, chicken, fish Lentile, chickpea, bean Egg yolk (It ıs initially is given hard boiled and started in small amount)

Page 34: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Time of introduction of Time of introduction of supplemental foodssupplemental foods

8th-9th months

9th-12th months

Cereals (rice, wheat, macaroni, bread )

Children can be introduced to the family table

Page 35: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

FEEDİNG BETWEEN 1-5 FEEDİNG BETWEEN 1-5 YEARS YEARS 

Page 36: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

After 9 months, breast-After 9 months, breast-feeding ceases to be the feeding ceases to be the

basic diet of the baby. The basic diet of the baby. The baby should be completely baby should be completely

weaned at 2 yearsweaned at 2 years

Page 37: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Children can be trained to Children can be trained to self feed by spoon starting self feed by spoon starting at age at age 12 months 12 months and can and can

be introduced to the family be introduced to the family table table

The child must have his/her The child must have his/her own separate plate and own separate plate and

must be carefully observed must be carefully observed to note what he/she eats to note what he/she eats

and how muchand how much

Page 38: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Between 1 and 5 years, Between 1 and 5 years, children need to have children need to have fourfour

meals a day meals a day The diet should include The diet should include

basic foodstuffs which are; basic foodstuffs which are; milk and milk foods, meats milk and milk foods, meats

and eggs, fruits andand eggs, fruits and vegetablesvegetables, starchy foods, starchy foods

Page 39: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

A child of this age must A child of this age must receivereceive

500g milk dailyTwo servings of either meatsAn egg every day (on alternate days if

eating meats regularly)Vegetables once or twice a dayFruits once or twice a dayOne or two servings of starchy food and 3

slices of bread

Page 40: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Food requirements are Food requirements are different in induvidual different in induvidual

children and children must children and children must never be forced to eatnever be forced to eat

Page 41: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

Children should not eat Children should not eat candies and other sweet candies and other sweet

frequentlyfrequentlyTea and coffee are Tea and coffee are

stimulants which should stimulants which should not be given to young not be given to young

childrenchildren

Page 42: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

All children should have their All children should have their own tooth-brush starting at own tooth-brush starting at

age 18 monthage 18 month

Page 43: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

FEEDING AT SCHOOL AGEFEEDING AT SCHOOL AGE

Page 44: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

FEEDING AT SCHOOL AGEFEEDING AT SCHOOL AGE

Breakfast is an important meal Usually the reason for this is faulty family eating

habits and neglect of meeting around the breakfast table regularly

Parents should abstain from negative comments on the food at meals

Serving should not be too large and each member of the family must try to finish his serving

Page 45: ARTIFICIAL FEEDING , SUPPLEMENTED BREASTFEEDING, and COMPLEMENTARY FEEDING

FEEDING AT SCHOOL AGEFEEDING AT SCHOOL AGE

It must be remembered that a child under 5 can eat only half the amount of an adult, and a 12 year old boy only 2/3 the amount of the teenager

The child is encouraged to finish his plate by educating him about changing food requirements by age, sex, size and physical activity

School age children also need to have a balanced diet including the basic foods