FORMULA FEEDING

Dr.sabah alatwani

Cow's Milk-Based Formulas

The alternative to human milk is iron-fortified
formula, which permits adequate growth of most
infants and is formulated to mimic human milk.
No vitamin or mineral supplements (other than
possibly fluoride after 6 months) are needed with
such formulas.
Cow's milk formulas are composed of
reconstituted, skimmed cow's milk or a mixture of
skimmed cow's milk and electrolyte-depleted cow's
milk whey or casein proteins.
The fat used in infant formulas is a mixture of
vegetable oils, commonly including soy, palm,
coconut, corn, oleo, or safflower oils.

 The caloric density of formulas is 20 kcal/oz (0.67

kcal/mL), similar to that of human milk.
Formula-fed infants often gain weight more rapidly
than breastfed infants, especially after the first 3 to
4 months of life. Formula-fed infants are at higher
risk for obesity later in childhood; this may be
related to differences in feeding practices for
formula-fed infants compared with breastfed
infants.
Cow's milk-based infant formulas are used as
substitutes for breast milk for infants whose
mothers choose not to or cannot breastfeed or as
supplements for breastfeeding.

Soy Formulas
Soy protein-based formulas provide an
alternative to cow's milk-based formula when
intolerance occurs from immune reactions to
cow's milk proteins.
A significant proportion of infants allergic to
cow's milk protein also are allergic to soy
protein, however. The soy formulas are
nutritionally safe alternatives to cow's milkbased formulas.
The soy protein is supplemented with
methionine to improve its nutritional qualities.
The carbohydrates in soy formulas are glucose
oligomers (smaller molecular weight corn
starches) and sometimes sucrose.

 Soy protein formulas do not prevent the

development of allergic disorders in later life,
and clinical intolerance to soy protein or
cow's milk protein occurs with similar
frequency.
Soy protein formulas can be recommended
for use by
1-Vegetarian families choosing not to serve
animal protein
formulas.
2-In the management of galactosemia.
3-Primary and secondary lactose intolerance.
Soy formulas should not be used
indiscriminately to "treat" poorly evaluated
patients with colic, formula intolerance, or
more serious diseases.

Therapeutic Formulas
The composition of specialized infant and
pediatric formulas is modified to meet
specific therapeutic requirements.
Therapeutic formulas are designed to treat
digestive and absorptive insufficiency or
protein hypersensitivity.
Semielemental formulas include protein
hydrolysate formulas.
The major nitrogen source of each of these
products is a casein or whey hydrolysate,
supplemented with selected amino acids.

 These formulas contain an abundance of essential

fatty acids from vegetable oil.
Certain brands also provide substantial amounts
(25% to 50% of total fat) of medium chain
triglycerides, which are water soluble and are more
easily absorbed than long chain fatty acids; this is
a useful feature for patients with malabsorption
resulting from such conditions as short gut
syndrome, intestinal mucosal atrophy or injury,
chronic diarrhea, or cholestasis.
Elemental formulas also are available that contain
synthetic free amino acids and varying quantities
and types of fat components. These are especially
designed for patients with protein allergy or
sensitivity.
The carbohydrate content of these specialized

Formula-Feeding: How Much, How Often,

How Long

Infant formula: 7 steps to prepare it safely

. Check the expiration date and condition of the container . 1
Wash your hands. 2.
Prepare your bottle. 3:
Sterilize bottles, nipples, caps and rings before using
them for the first time:
Boil the bottle and accessories in water for five minutes.
Use a pot that's large enough to hold all of the pieces
and cover them completely with water.
Remove the pieces from the water using a clean set of
tongs.
Allow the pieces to air-dry.
After the first use, there's no need to sterilize your
bottle and accessories. Simply wash these items with
soap and water and allow them to air-dry. Bottle and
nipple brushes can help you clean nooks and crannies .

Infant formula: 7 steps to prepare it safely

Add water to liquid-concentrate or powdered. 4
.formula
Measure the formula. 5.
.Warm the formula, if needed. 6
Store formula safely. 7.