What is the only other option for feeding infants up to 6 months old?
Infant forumla - but it is inferior to breastmilk
Does infant formula provide against immunity to disease?
What are some of the reasons why infant formula is inferior to breastmilk?
- Infant formulas are synthetic foods that carry contamination risks, such as bacteria and toxins
- Formula-fed babies do not receive the immunological benefits of breast milk and are more likely to become ill and require hospitalisation
- The growth pattern of formula-fed infants is different to that of breast-fed babies. Formula-fed infants lose less weight in the first few days following birth but they gain weight more quickly from around 4-6 months, which may increase their risk of cardiovascular disease in the future
- Infant formulas are made to standard recipes and the composition does not vary with the differing needs of infants over time as breast milk does
What are the Do's and don't of formula feeding ?
- Feeds should be prepared one bottle at a time
- Eye contact and cuddling the infant - skin to skin when possible – helps to release oxytocin in both baby and carer
- Do not force a baby to finish his feed or push a bottle in his mouth as this can lead to over-feeding.
- Keep the bottle tilted and sit the baby upright so that the milk does not pool at the back of his mouth.
- Any leftover milk after a feed should be discarded within two hours.
How much/how often should formula fed babies be fed?
- They feed in small amounts but often follow the baby’s cues such as mouthing, rooting and fussing which are signs they are hungry to feed (this includes not making the baby finish milk, finish when they want to)
- The average formula intake from around day four to about 5-6 months of age is 150 ml/kg body weight in a 24 hour period.
What is recommended for extra-fluids for formula fed babies in hot weather?
Formula-fed infants can be offered drinks of plain, cooled, boiled water.
Why do breast fed babies not require extra fluids in hot weather ?
Breast milk composition changes in response to the baby’s needs for fluid, even in very hot weather.
What 3 things can infant formula only be based on ?
Cows’ milk, goats' milk or soya protein
What are the different types of infant formula?
Cows’ milk infant formulas:
- Whey-dominant formulas
- Casein-dominant formulas
- Modified formulas for minor digestive problems
Goats’ milk infant formulas
Soya based infant formulas - these arent recommended for infants under 6 months though
A range of specialised prescribable infant formulas for specific medical conditions such as food allergies, malabsorption syndromes and metabolic disorders. These should only be used under the supervision of a doctor or dietician. Only a doctor can prescribe them.
What is the main difference between whey dominant and caesin dominant cows milk infant formula ?
Simply the ratio of whey:caesin
In one whey is higher in the other caesin is higher
What do modified formulas designed for infants with minor digestive problems, such as colic consist of ?
Partially-hydrolysed protein, modified fat and thickeners.
Are follow on formulas suitable for infants under 6 months ?
No! remember only infant formula can be used for infants under 6 months
What are the 2 formats which infant formulas come in ?
- Dried powder which is not sterile
- Sterile UHT-treated ready to feed liquid that is more expensive
What is the problem with dry powered formula and what can happen because of this ?
- It is not sterile
- Therefore it may contain a range of organisms Salmonella and Enterobacter Sakazakii (now referred to as Cronobacter spp) are the most dangerous.
How can you reduce the risk of infection for bottle-fed babies?
- Use a liquid ready-to-feed formula for infants. (more expensive)
- Powdered formula should be added to water that has been freshly boiled and is above 70°C.
- Freshly boiled water should be left to cool in a lidded kettle for no more than 30 minutes
- The batch of formula used should be cultured if an infant presents with botulism
When parents do not follow the manufacture guidelines on making formula milk what are the potential problems which can arise ?
A risk of over- or under-nutrition.
- Over-concentration of feeds can result in constipation, hypernatraemia, vomiting and excess weight gain.
- Under-concentrating feeds may not provide the infant with sufficient calories or nutrients for growth and development.
Storing prepared infant formula is advised against - T or F?
True - it increases the risk of bacterial growth
If infant formula needs to be prepared in advance what it recommended for storage ?
- Keep them constantly at 5°C or below
- Use them within 24 hours
- Use a cool box with an ice brick to carry prepared feeds that need to be transported
- Refrigerated feeds should be warmed to room temperature by standing in a jug of hot water for a few minutes immediately before feeding. - do not use a microwave
Bottles, teats, milk expression and other equipment are difficult to clean thoroughly and must be sterilised before being used up to 12months old, what are the suitable methods for steralising ?
The recommended methods of sterilisation are:
- Microwave - with a special steamer
- Boiling water: equipment should be fully immersed in boiling water for ten minutes
Don't use Microwave ovens without a special steamer or Dishwashers
What are the risks of formula feeding?
- Increased illnesses in infancy and later life due to immune protection that is given in breastmilk
- Risks of contamination of the infant formula or the equipment used to feed baby
- Excessive weight gain in infancy through overfeeding when baby’s feeding cues are not followed
- Childhood obesity and associated diseases as a result of rapid weight gain in infancy
How long can infant formula be used for ?
Infant formula is suitable for infants up to 12 months of age and there is no advantage in changing to a follow on formula from 6 months of age.