infant feeding
infant feeding
infant feeding
infant feeding
INFANT FORMULA
Infant feeding
Rotherham Paediatric Dietitians 2011
Sarah Milnes BSc (Hons) RD
Whats in cow’s milk
Protein composition
Whey
Alpha -lactablumin
Beta –lactaglobulin
Most 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
Sugar
Lactose
Iron
Additions to formula
LCP (long chain
Polyunsaturates)
Omega-3
DHA
Omega-6
AA
Brain development, nervous system, eyesight
Prebiotic
Also known as Oligosaccharides or polysaccharides
Non-digestible carbohydrates
Nutrients for gut flora such as Bifidobacteria lactobacilli
Examples as FOS( fructo-oligosaccharides), GOS (galactooligosaccarides), inulin, transgalacto-oligosaccharides
and lactulose
Nucleotides
Support Immune system
Improve growth
Improve gut bacteria
Alpha- Lactalbumin
Whey protein
Reduced beta proteins therefore more like breast milk
Cow & Gate
Breastmilk fortifer
Nutriprem Breast
milk fortifier
Preterm – under
2000g
Nutriprem 1
Preterm -above
2000g
Nutriprem 2
Milupa Aptamil
SMA
Breast milk Fortifier
Aptamil Preterm
SMA Gold Prem 1
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 Infant Milk
Aptamil First
Milk
SMA First Infant
milk
Hipp Organic
First milk
First milk
(whey
dominant)
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 on
From 6 months
onwards
Follow on milk
Aptamil Follow
on Milk
SMA Follow on
Milk
Hipp organic
follow on Milk
One year plus
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
When all you
need is cow’s
milk
Cow & Gate
Milupa Aptamil
Good night milk
HIPP
HiPP Organic Good
night milk
Contains rice &
buckwheat
High calorie
100% 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 milk
NEVER as banned in EU and
UK
Rice Milk
Not to be used in under 5’s
due to high level of arsenic
Formula Feeding Problems
Constipation
Check it is constipation
Return to whey dominant formula
Check feed concentration*
Advise extra cooled boiled water
Refer to GP
Sugar should not be added to drinks or
feed
Take care not to compromise growth by
giving too much cooled water
Colic
Check bowels
Check feeding position
Check feed concentration*
Check winding method
Check over feeding
Check teat size observe a feed (HV or
Midwife)
Offer support/self help groups
Feeding diary
Some parents find colic preparations
helpful
Excessive
possetting
Check for over feeding
Support and reassure
Observe feed
Review weight gain
Examine feeding position
Feeding Diary
Refer to GP if possetting is excessive and
weight gain is inadequate
Poor weight
gain
Check formula preparation*
Check amount and frequency of
feeds
Observe feeds
Refer 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).
Apple
Kcal in 1/4
Kcal in ½
Kcal in an apple
15 kcal
30kcal
60kcal
Kcal in 2 teaspoon
Baby rice
Formula
Kcal in 3 tblespoons Kcal in 6 tblespoons
15kcal
56kcal
112kcal
Kcal in 30ml
Kcal in 90ml
kcal in 120ml
20 kcal
60kcal
80kcal
Weaning update
Exclusive 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).
Breast milk
2 years
Fe rich foods
7/12
weaning
17 weeks the
earliest for
weaning
6 months
‘Sour ‘ veg and finger
foods around 8- 9/12
Birth
1 year
Family food
3 meals & 3 snacks
Progress on to
lumpier food faster
when solids
introduced nearer
6/12
First milk
Preterm Formula till 26 wks actual
age or stopped earlier if growth
between 25-50th C
Cow’s milk as a drink, 500 -600ml/day
First milk can be used till 1 yr
corrected
Cow’s milk as a drink, 500 600ml/day
Vit D supplements for all– Abidec, Healthy start Vitamins, OTC till 5
95% of infants should be 100% happy on the above