Wednesday, December 28, 2011

Indications For Use of Infant Formula

!±8± Indications For Use of Infant Formula

Infant food manufacturers and health care professionals are united in recommending breast milk as the best way to feed a baby during the first six months of life. However, because a woman cannot, or chooses not to breast feed, then the infant formula is used. There are clinical or pathological cases, which permits only the infant formula to be used and this is a very good reason why the infant food industry makes an essential contribution to infant and young child health by offering safe and nutritious alternatives to breast milk.

These problems are as follows:
• Allergy to cow or soy protein (or colic). Suggested recommended formula to be used in this case is Mutramigen Neocate. They are Casein hydrolysate and hypoallergenic formulas.
• Cardiac or renal diseases. Suggested recommended formula to be used in this case is Similac PM 60/40. They have lower amounts of Ca/Phosphorus and potassium.
• Necrotizing Enterocolitis. Suggested recommended formula or is the premature Formula or in severe cases, Pregestimil. They are partially elemental and with Ca/P pregestimil: elemental/lactose-free
• Constipation- A good start or Routine formula with increased Sugar is highly recommended. Such good start formula should be 100% whey protein, produces "soft breast milk-like stools"
• Cystic Fibrosis- Portagen or Pregestimil/ Alimentum is a good formula for this case. Such a formula is an increase MCT fat concentration.
• Diarrhea- A Routine or Isomil DF, Lacto-free, pregestimil formula. Isomil DF consists of w/water-soluble fiber and lactose-free, others: lactose free, elemental formula.

Premature Infant formulas
Characteristics
• Designed for premature infants with birth weight less than 1800g.
• Major nutrient composition is partially elemental for easier digestion.
• Vitamin and mineral content is approximately 3 times that of standard formulas to meet the increased needs premature infants.
• Available only in ready to feed in 20 or 24 calorie/ounce.

Composition
• Protein: 60% casein and 40% whey
• Carbohydrate:50% lactose and 50% glucose polymers
• Fat: 50% medium chain and 50% long chain triglycerides.

Available brands
1. Enfamil Premature with Iron
2. Similac special Care with Iron
3. Similac Natural care (breast milk fortifier)
4. Similac Neocare
• Designed for premature infants greater than 1800g who require increased calories, protein, vitamins and minerals.
• 22 calories/ounce standard dilution.
• Available in powder commercially. Ready to feed in the hospital setting.
• Appropriate for the first year of feeding.

Using Bottle
Allow the infant to tell the adult when feeding is over. Babies have a natural ability to obtain the right amount of food if the adult will allow them that privilege. Babies will change from day to day in the amount of formulas they want and need. Allow them to communicate that to the feeder. When a baby closes its mouth, turns her head away, fusses and refuses to have the nipple replaced, consider the feeding ended and discard any formula remaining in the bottle. Formula left over after feeding can harbor bacteria, which will grow and then be consumed by the infant if the bottle is reused.

Always hold an infant when feeding. Never prop a bottle. Infants need to be able to see the face of the person feeding them, they need to be able to communicate and enjoy the feeding and they need to be able to get the bottle out of their mouth if they are choking or gagging, none of this is possible with a propped bottle.

Never offer an infant honey or corn syrup. There have been several incidents of serious food poisoning resulting from honey and corn syrup given to infants with immature digestive systems.


Indications For Use of Infant Formula

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Tuesday, December 6, 2011

The Nutritional Value and Essence of Different Milk Formula Substitutes

!±8± The Nutritional Value and Essence of Different Milk Formula Substitutes

Last 50 years have brought about the most substantial progress in improving the composition of mother's milk substitutes ever made in history. In this 21st century, infant formula manufacturers have continued to carry out efforts to develop better breast milk than ever before. Efforts to identify and replicate helpful trace elements, and to conduct important research regarding the addition of immune active ingredients and enzymes that will make formula products even better, are currently under way. But for the main time, here are some already existent formulas which have good nutritive values.

Cow Milk Based Formulas
Characteristics

• Standard formula used when breast feeding is not adopted or is stopped before one year of age.
• Designed to mimic breast milk composition. Breast milk is approximately 60% whey and 40% casein, Cow's milk is 8% casein and 20% whey.
• Formulas contain at least 50% more protein/dL than breast milk (1.5g/100cc).
• Formulas provide appropriate intake of essential nutrients: iron and linoleic acid.
• Carnitine and taurine are added to most standard formulas
• Nucleotides are added to Enfamil and Similac.

Cow-Milk Based Composition
• 20 calories/ounce standard dilution
• Protein is ideally whey-predominantly (similar to breast milk).
• Carbohydrate is lactose (except in Lacto-free Formula).
• Fat is a mixture of vegetable Oil (LCT)
• Approximately 32 ounces of standard formula per day will meet 100% of RDA for vitamins and minerals for term infants.
• If Infants are only fed ready to feed dormula, fluoride supplement of 0.25mg/day is necessary to meet the RDA based on American Academy of Pediatric guidelines.

Available Brands of Cow Milk Based Formulas
• Enfamil with Iron (or low-iron) (Mead Johnsom)
• Similac with Iron (or low-iron) (Ross)
• Gerber
• Good start (Carnation formula with 100% whey as protein).
• Similac PM 60/40 (has decreased calcium, phosphorus and potassium content: Often used in renal patients). (Ross).
• Lactose-free (Mead Johnson) Cow-Milk protein, but lactose-free.

Soy-Based Formulas
Indication for use
• Vegetarians
• IgE mediated reaction to cow's milk protein
• Lactose Intolerance or Galactosemia
• Refeeding after chronic diarrhea (lactose-free)

Characteristics:
• Increased proteins content than cow milk based formulas, since using plant source for protein (2.2g/dL).
• Increased vitamin and mineral content to compensate for mineral antagonists, such as phytates.
• Additional methionine added to formula to ensure a "complete" protein.
• Taurine and cystein added.
• Sweeter taste than cow-milk based and lower cost.

Composition
• 20 calories/ounce standard dilution
• Protein: soy protein with added methionine
• Carbohydrate:Sucrose, corn syrup solids, tapioca starch
• Fat: Blend of vegetable oils

Available Brands of Soy Formulas
• Prosobee
• Isomil
• Isoyalac

Casein Hydrolysate Formulas
Indication for use
• Milk protein or soy protein allergy
• Complicated gastrointestinal disorders
• Colic
• Feeding intolerance to cow milk or soy formulas

Characteristics
• Poor taste and expensive
• Not recommended for long term use in preterm infants due to inadequate vitamin and mineral content and protein source may be difficult to metabolize
• Alimentum is only available in ready to feed.
• Pregestimil is only available as a powder for the sonsumer, but is available in some hospitals as 20 X 24 calorie/oz ready to feed.
• Nutramigen is available in liquid concentrate and powder to the consumer, but is available as ready to feed in the hospital setting.

Available Brands
• Nutramigen
• Pregestimil
• Alimentum

Composition
• Protein: Casein hydrolysate (small peptide considered to be hypoallergenic)
• Carbohydrate: Modified tapioca starch and glucose Oligosaccharides.
• Fat: approximately 50% of fat is MCT oil in Alimantum and pregestimil, and 100% of fat is corn oil in Nutramigen.


The Nutritional Value and Essence of Different Milk Formula Substitutes

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