a. Human milk best option for infant nutrition up to 1 year of age (especially first 6 months); consist of number of micronutrients that are called bioavailable.
1) Effective in protecting newborns against respiratory tract infections, GI infections, otitis media, numerous allergies, type 2 diabetes, and atopy.
2) Contraindications to breastfeeding:
Maternal chemotherapy antimetabolites and certain antineoplastic drugs.
Active TB not under treatment in the mother
HIV in mother
Galactosemia in the infant
Maternal herpes simplex lesion on breast
Maternal substance abuse (i.e. cocaine, methamphetamine, and marijuana)
NOT contraindicated if on methadone treatment for substance abuse.
b. Bottle feeding: make sure to still promote bonding; keep baby close to body while rocking or cuddling them helps to ensure the emotional component of feeding.
1) Bottle fed infants still need to be rotated on alternate side of lap to expose them to different stimuli – do not HURRY feeding.
2) Infants need at least 2 hour of sucking a day. If 6 feedings a day, then about 20 minutes of sucking at each feeding provides for oral gratification.
DO NOT prop bottles please! denies bonding, aspiration risk, ear infection risk, teeth issues.
3) Commercially prepared formulas: Only iron-fortified formulas meet the requirements of infants.
Cow’s milk based – 20 kcal/fl oz. as liquid (ready to feed), power, or concentrated liquid (required dilution with water)
Soy based – 20 kcal/fl oz. power and concentrated liquid forms – lactose or cow’s milk protein intolerant
Casein or whey – hydrolysate formulas – available in ready to feed and power forms and are used when children cannot tolerate or digest cow’s milk or soy based formula
Amino Acid formulas.
Follow up formulas: Transitional formulas for infants older than 6 months of age who are also eating solid foods.
c. Preparation of Formula:
1) WASH YOUR HANDS! Wash all equipment.
2) Bottled water should not be considered sterile unless otherwise indicated; bottled water without fluoride should be avoided for mixing infant formula.
3) Cover and refrigerate any leftover formula
d. Feeding schedules:
1) Demand feedings – feeding infants when they signal readiness
2) Scheduled feedings – predetermined intervals. Bottle fed infants may be more on a 3-4 hour schedule but breastfed babies tend to be hungry every 2-3 hours so they should be fed on demand.
No supplements please. Especially before lactation is well established
No supplements of water (even in hot climates)
3) 3 weeks old Bottle fed infants consume about 2-3 oz. of formula at each feeding and are fed about 6 times a day. Breastfed infants may feed as frequently as 10-12 times a day.
Quantity of formula consumed is based on the calorie need of 108 kcal/kg/day.
e. Feeding behaviors: 5 stages
1) Pre-feeding behavior: crying, fussing, demonstrates infants level of arousal and degree of hunger. It is preferable to begin feeding during the quiet alert state before the faint becomes upset.
2) Approach behavior: sucking movements, rooting
3) Attachment behavior: Activities that occur form the time the faint receives the nipple and sucks
4) Consummatory behavior: consist of coordinated sucking and swallowing
5) Satiety behavior: observed when…