Breast Milk and Infant Formulas.ppt

Breast Milk and Infant Formulas Lori S. Brizee MS, RD, CSP Clinical Dietitian Children’s Hospital and Regional Medical Center Human Milk and Infant Formulas: Breast milk Standard Infant Formulas Premature Infant Formulas Specialty Infant Formulas Modular Additives Breast Milk Characteristics First choice feeding for MOST infants Immunologic factors Protective against diarrhea causing infections and otitis in infants Trophic to GI tract Well tolerated by infants with short bowel Fatty acids important to brain/visual development Breast Milk vs Standard Milk Based Formulas Energy: slightly higher Protein: Lower, but higher quality (whey and casein) Renal Solute load: Lower Carbohydrate: Mainly lactose Fats: Long chain; DHA/AA (lipases increase absorption) Common Challenges with Breast Feeding Baby sided problems Illness preventing/interfering with early feeding Anatomic malformations Sleepy baby Thrush Common Challenges with Breast Feeding Sleepy Baby Sleep cycles REM sleep-----deep sleep (15 min +/-) ----wake (quiet alert) If cannot wake, in deep sleep, try again in 15+/- minutes Watch for hunger cues e.g., sucking on hands Common Challenges with Breast Feeding Sleepy Baby Waking techniques Hold by armpits and dangle Put feet on hard surface Spin around Last resort: stroke palate with finger until sucking, then take finger out and put nipple in. Common Challenges with Breast Feeding Mom sided problems Low milk supply Frequent feeding, pump after feeding Medications: Reglan, Domperidone Fenugreek Sore Nipples Clogged ducts Mastitis Yeast Infection Breast Feeding: Is baby getting enough? Regain birthweight by 1 week Newborn to 2 months gain 1 ounce per day Newborn to 4-6 weeks: 2-10 bowel movements per day Bowel movements are better clue than wet diapers. Formula Brands Ross Similac/Isomil/Alimentum Mead Johnson Enfamil/Prosobee/Enfacare Nestle Good Start Wyeth Generic in USA; Gold Brands; SMA SHS NeoCate, DuoCal Milk Based Formulas Standard 0-12 months Simil