The child is bottle-fed. Formula-fed baby regimen

All young mothers are well aware that in the first months of life there is no more beneficial food than breast milk for a newborn baby. But sometimes a situation arises in which it is necessary to switch the child to a different diet (there is no breast milk or the mother cannot breastfeed). Artificial feeding of a newborn baby requires the right approach to both choosing a formula and following a new diet. Consultation with a pediatrician is mandatory before starting IV.

Indications for switching to IV

Feeding even the highest quality formulas will not be able to replenish the microelements that the baby receives with mother's milk. Therefore, the introduction of adapted nutrition should always be justified. Pediatricians identify several circumstances when artificial feeding is considered necessary:

Difficult childbirth, after which the mother must restore her strength;
Taking certain groups of vital medications by a woman;
Infectious diseases of the mother;
Lack of milk in the breast glands or its insufficiency. Lack of milk is determined by control weighing the baby after feeding;
Inability to feed the child due to temporary absence. This indication is justified when there are no conditions for storing expressed milk or the period of mother’s absence lasts for weeks.

Insufficient milk production must first be restored with the help of drugs that enhance lactation. Artificial feeding of the child begins only if these drugs do not bring the expected result. There is no need to introduce formula completely at once; even a few grams of breast milk are beneficial for the baby’s body and it is impossible to deprive him of this benefit.

Pros and cons of using artificial mixtures

Not all young mothers seriously think about what awaits them and their baby when switching to using infant formula. Often, just because of her convenience, a woman deprives her child of microelements necessary for his immunity and general health. Before deciding to switch to IV with a formula recommended by a pediatrician, you need to weigh all the advantages and disadvantages of the new diet. The obvious advantages of artificially feeding a child include:

Possibility of feeding the baby with other relatives. That is, the mother can calmly go away on her business and not worry that the baby will cry from hunger;
When feeding a baby from a bottle, the mother always knows how much he eats at one time and, if there are problems with his health, he immediately notices this by the amount of food remaining;
The appearance is always related to the type of mixture. In order to determine the allergen in a breastfed baby, a nursing mother has to completely review her diet;
The formula takes longer to digest than milk, so the number of times your baby eats is reduced.

These are some of the advantages of formula feeding, but there are many more disadvantages:

Artificial children are more likely to suffer from colds and allergies in subsequent years. This fact is explained by the lack of special enzymes in their body, which the baby can only get from mother’s milk;
The use of bottles requires that they be kept sterile at all times. If cleanliness is not maintained, then the development of dyspeptic disorders is possible;
Formula-fed babies often suffer from periodic regurgitation - a low-quality nipple contributes to the swallowing of air;
When traveling with a child, you have to take with you a separate bag with formula, bottles, sterilizers, that is, excess luggage;
It is often necessary to change several types of mixtures in order to find the most suitable one;
Artificial feeding of a child also involves certain financial costs. A good formula cannot be cheap, and as the child grows up, more and more of it is needed.

There are many more disadvantages of formula feeding than advantages, and therefore you should first try to restore hypolactation, and only then resort to such an extreme measure.

How to choose a mixture

The selection of the mixture must be coordinated with the pediatrician. The doctor knows the health characteristics of your child and will recommend the most gentle nutrition. It is necessary to independently show increased attention to the choice of mixtures and be sure to comply with the following criteria:

Best before date– the most important condition for the absence of unwanted reactions. Choose those boxes that have a reserve of several months of use;
The packaging must not be opened or deformed. The presence of dents and scratches indicates non-compliance with transportation conditions, and such a mixture may be spoiled;
Meals are provided according to age categories. A newborn baby should not be given formula intended for older children; the unformed stomach and intestines can react with serious illnesses;
You need to accustom your baby by introducing hypoallergenic mixtures;
If a child has certain health problems, then the food may contain additives that are useful to improve the functioning of the organs.

Mixtures may contain herbs to boost immunity, iron to treat anemia.

How to prepare food

When bottle-feeding a baby, his well-being will directly depend on how you prepare the formula. The instructions must be read and its points must be followed.
For dilution, it is best to use special bottled water; when boiling, some of the beneficial substances are lost. If water is taken from the tap, it must be boiled;
The dosage must be fully observed. Excessive amounts of dry mixture or lack of water can lead to oversaturation of the intestines with nutrients, and this is reflected in colic and dyspeptic disorders. The lack of a dry base leads to the fact that the baby is capricious and asks for a bottle at the wrong time;
The mixture is diluted directly in a bottle, into which water with a temperature of no higher than 50 degrees is first poured. Higher temperatures destroy beneficial bacteria;
After dilution, shake the mixture and make sure there are no lumps. Before feeding, check the temperature - it should not be higher than 37 degrees;

The hole in the nipple should be such that the baby makes some effort to suck. Flowing out in a thin stream leads to complete refusal of the breast and to the fact that the stomach begins to quickly stretch.

The mixture can be prepared in advance, but it should be stored in the refrigerator for no more than a day and heated in hot water.

Video instruction:

How to feed your baby correctly

Formula-fed babies often weigh much more than their peers who drink their mother's milk. This is not as good as it seems, and with increased obesity comes a variety of health problems. To avoid this, you do not need to overfeed your baby; you must take into account how much he drinks and how long he can go without a bottle.
A teaspoon is used when the child feeds mainly from the breast, and receives the missing amount of food in the form of formulas;
Sometimes a child refuses both a bottle and a spoon, but he needs to be fed. In this case, the diluted mixture is poured through a syringe without a needle in small doses.

Feeding technique

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The baby should be in an almost vertical position, this is convenient for sucking and will not allow you to choke.
Make sure that the milk completely covers the nipple and air accumulates at the bottom of the bottle. This will prevent air from entering the stomach.
After feeding, the baby must be held in an upright position so that trapped air can escape.

We read:

If you feed your baby formula, this does not mean that he should be left alone. The baby may choke on milk or lose the bottle. The emotional contact between mother and baby is also important, so holding him in your arms you can calmly watch the baby’s concentrated face and take a break from household chores.

The nipple on the bottle needs to be changed periodically; it quickly becomes thinner, and the mixture flows through the hole in a continuous stream. You should always use the mixture after preparing it or store it in the refrigerator. The remaining food is poured out immediately.

The “artificial” baby needs more, this will make up for the deficiency of missing microelements.

How much formula should a baby eat:

A newborn baby in the first month of life eats from 700 to 800 ml of the adapted mixture 8-10 times. At 2-3 months of life, the amount of the mixture increases to 900 ml. When complementary foods are introduced, the volume of mixtures decreases.

It is believed that a child needs enough nutrition, which is 1/5 of his body weight per day. That is, if a baby weighs 4 kg, then he should drink 800 ml of milk per day. In the first days of life, the baby can drink 30–40 ml at a time, then up to 100 ml. In this regard, the frequency of feedings after the first month of life decreases. See material:

Frequency of sterilization of feeding bottles and nipples:

In the first month of life, all bottles and nipples should be sterilized after each feeding. First, the remaining mixture is removed with warm water and a brush, then all devices are boiled for 10 minutes. It is best to purchase a special sterilizer; using it, you will always be sure that the dishes are clean.

After the first month of life, it is enough to wash the nipple and bottle and rinse them with boiling water. But still make sure that the bottles are washed thoroughly; special attention should be paid to the threads, hard-to-reach places where bacteria can multiply in a few hours.

Is it possible to store the prepared mixture:

The prepared mixture is stored at room temperature for no more than 2 hours, in the refrigerator for no more than 12 hours. The remaining mixture after feeding is poured out; drinking such milk after an hour can lead to poisoning.

Video: Proper bottle feeding

Free IW

A baby's need for food at different times of the day is not the same. But you still need to adhere to a certain schedule with a deviation of half an hour in one direction or another. This way you will always know what time your baby usually eats and will be able to guess the time of a visit to the clinic or for a walk. If the regimen is followed, the baby falls asleep easier and is less susceptible to excessive weight gain,

Situations in which it is necessary to replace the mixture:

The mixture is not suitable, it causes diarrhea or constipation, allergic reactions;
Reaching a certain age. There is no point in giving a 6 month old baby formula for newborns;
The need to use special medicinal nutrition.

Problems with artificial feeding:

Artificial feeding of a child is considered in medicine as “metabolic stress” and therefore causes a wide variety of reactions. Allergies, problems with stool, colic occur in the first days in most babies. Some of them get used to it, others have to change mixtures.

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Feeding a child is a very responsible process. And it all starts with choosing a mixture. What to feed a newborn or one-month-old baby? For babies in the first half of life, it should be highly adapted, that is, as similar as possible to.

This mixture is called the "starter" and will have a 1 on the packaging. For children over six months of age, “follow-up” formulas are intended, the composition of which meets the needs of the growing body.

They contain more protein, fats and microelements. The packages are marked with the number “2”.

If the child burps frequently and more than expected, an anti-reflux mixture will help. If food digestion is disrupted, fermented milk mixtures and mixtures containing beneficial bacteria will come to the rescue.

When choosing a mixture, it is advisable to consult a doctor. When purchasing a mixture, you need to pay attention to the expiration date and integrity of the packaging.

There are also mixtures that contain special components that have a specific therapeutic effect. So, if someone in the family suffers from allergies, it is advisable to start with a hypoallergenic mixture.

Specially prepared dishes

Bottles used for feeding must be washed with a brush and sterilized in advance. This can be done by boiling them for 5 - 10 minutes or using a special sterilizer. The bottle in which the mixture is diluted must be dry.

The pacifier should be selected with the expectation that the mixture will flow out of it not in a stream, but drop by drop. This will ensure active sucking, and not just swallowing of the pouring mixture. Which is important for the development of the maxillofacial apparatus.

Diet and routine

This is a very important point. The baby receives his food on demand. How many times does a child need to eat on IV? The schedule depends on age. So, a newborn eats 7 - 9 times a day, a child 2 - 5 months old - 6 - 7 times, a six-month-old child needs to eat 5 - 6 times a day.

To do this, you first need to determine the daily amount of food. How much a baby should eat depends on his weight and age. So, up to two months, a child needs a volume of food in the amount of 1 - 5 of his body weight, at 2 - 4 months - 1 - 6, at 4 - 6 months 1 - 7 of his body weight, over six months - 1 - 8.

For example, a 1 month old baby weighs 4.5 kilograms, then he needs 900 milliliters of formula per day. It must be remembered that this volume should not exceed 1 liter.

To determine the volume of mixture required for one feeding, divide the daily amount by the required number of feedings. This will be 100 - 130 milliliters of the mixture.

It happens that a child eats a little less or more. A slight run-up is possible. Systematic overfeeding or underfeeding should not be allowed. For a child, this is fraught with obesity or...

The volumetric method described above is the simplest and most convenient to use. If necessary or if there are problems with weight, the doctor can calculate the volume of a certain mixture for a particular child using the caloric method and taking into account the age-related needs for proteins, fats and carbohydrates.

How to prepare the mixture?

Only boiled water should be used. The volume of water required for one feeding at a temperature of 50˚C is poured into the bottle and the prescribed amount of mixture is poured (indicated in detail on the packaging). Everything is thoroughly shaken and mixed.

How to feed formula?

How to feed a child correctly? Before feeding, you need to make sure that the prepared mixture is at the optimal temperature. To do this, drop it on your wrist (on the palmar surface). Its temperature should not be felt by the skin.

Wash your hands with soap. Find a comfortable position. Special pillows will help with this, using which you can comfortably position both yourself and the child. In this case, feeding will become a pleasant relaxation for the nursing mother and a source of necessary tactile contact for the baby.

Therefore, it is better to take it in your arms. If your baby is prone to excessive spitting, it is best to hold him upright. In other cases - semi-vertical.

Turn the bottle upside down so that the mixture completely fills the nipple and neck, and the air rushes to the bottom. This will prevent the baby from swallowing air and developing colic.

It is necessary to ensure that the mixture drips from the nipple and does not flow. Over time, nipples wear out and need to be replaced.

If there is any ready-made mixture left

According to the rules, the mixture remaining after feeding must be poured out. But it can still be stored for a little while. For one to two hours and no more than half a day in the refrigerator. Before feeding this mixture, it must be heated to an acceptable temperature.

Additional soldering

The child's artificial nutrition must be supplemented with liquid - water, weak infusions of rose hips and tea (not the regular one that you and I drink every day, but children's herbal tea).

In the heat and in a room with dry air, the amount drunk should be increased by 50 - 100 ml. It is also worth monitoring the child’s health.

Formula-fed babies begin to introduce complementary foods earlier than infants. From 4 - 4.5 months they begin to be given porridge, from 5 months.

How do you know if formula is not suitable for your baby?

Often it is not possible to select a mixture the first time. What will indicate this?

indigestion;

If after eating the child spits up a lot and or diarrhea or constipation begins, the formula is not suitable. When there are violations, but they are minor, it can be left for a week. If nothing changes during this time, the diet needs to be changed;

allergic manifestations.

The very first sign of an allergy is a rash (dermatitis). These can be either individual elements or merging spots throughout the body.

Reactions to formulas based on cow's milk develop more often. They can be replaced with mixtures based on protein hydroisolate and soy isolate or with mixtures prepared on the basis;

deficiency states.

The development of iron deficiency anemia, malnutrition, or another disease in a child associated with a lack of certain substances requires the selection of a special mixture with a therapeutic effect.

Complete and adequate nutrition is the key to the harmonious growth and development of your baby!

GBOU VPO TVER STATE MEDICAL

ACADEMY OF THE MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF RUSSIA

DEPARTMENT OF PEDIATRICS

FACULTY OF MEDICINE AND DENTISTRY

MIXED AND ARTIFICIAL FEEDING

Guidelines for independent work of students

4 courses of the Faculty of Medicine

Compiled by:

Doctor of Medical Sciences, Professor A.F. Vinogradov

Candidate of Medical Sciences, Associate Professor A.V. Koptseva

Tver, 2012

Title of training topic: Mixed and artificial feeding.

Nutrient mixtures used for mixed and artificial feeding.

Canned, adapted products. Features of feeding premature babies. Principles of nutrition for children over one year old. The role of the local pediatrician in organizing rational nutrition for children. Examination of children receiving various types of feeding. Development of the examination methodology. Drawing up a diet and menu layout for children of the first year of life on mixed and artificial feeding according to the instructions of the teacher.

The purpose of studying the educational topic:

To study modern aspects of mixed and artificial feeding of children of the first year of life at the level of knowledge and skills to draw up a nutrition map for children of the first year of life who are on mixed and artificial feeding, as well as solve situational problems on this topic. Master the concepts of supplementary feeding, canned and adapted foods. To familiarize students with the basic principles of feeding premature babies and children over one year old.

Determine the role of the local pediatrician in organizing rational nutrition for children.

Key terms:

1) Mixed feeding

2) The concept of “supplementary feeding”

3) Artificial feeding

4) Adapted milk formula

Topic study plan:

Definition and principles of mixed feeding

Definition and principles of artificial feeding

Classification of adapted milk formulas

Features of nutrition of premature babies

Principles of nutrition for children over one year old

Presentation of educational material:

Under mixed feeding understand breastfeeding with forced (non-physiological) introduction of supplementary feeding in the form of cow's milk (animal and plant milk) or its dilutions (mixtures) in the amount of 1/5 to 4/5 of daily needs.

Mixed feeding is a type of feeding when, along with human milk, children are given milk formula, since due to the child’s age, he cannot yet be given complementary foods. Additional nutrition with artificial milk formulas is called supplementary feeding

Indications for mixed feeding are a lack of milk in the mother (hypogalactia) or some diseases of the mother. Clinical symptoms of a child's fasting include a flattening or falling of the weight curve, restlessness, infrequent urination and changes in bowel movements. The stool is usually initially reduced or, conversely, increased.

In order to find out whether the mother has a sufficient amount of milk, it is necessary to weigh the baby in the early hours before and after feeding, i.e. conduct check weighing child. By the difference in weight you can judge how much milk the baby sucked. By calculating the required amount of milk using formulas, and knowing the amount of milk the child receives from the mother, you can calculate the required amount of supplementary feeding.

When mixed. During breastfeeding, food is prescribed depending on the amount of milk in the mother, that is, after each feeding, or some of them, or by alternating full feedings with breast milk and formula. Adapted milk formulas used in artificial feeding are used as supplementary feeding in modern diets and are described in the corresponding section.

Principles of mixed feeding:

Introduction of supplementary feeding no earlier than 4-7 days of the fight against hypogalactia.

The choice of supplementary feeding takes into account age and appetite.

Supplementary feeding is prescribed after breastfeeding.

The number of feedings remains the same as with natural feeding, but if the milk deficiency is more than 50%, then the number of feedings is reduced by 1.

Supplementary feeding can not be introduced into all feedings if the milk deficiency is 50% or less.

Do not change the supplementary food.

Conduct weekly control feedings (2-3 times a day, 2-3 days a week at different times of the day).

Change in the need for food ingredients when using non-adapted mixtures to 3.5-4.0 g/kg per day of protein.

Supplementary feeding is administered in a spoon or through a small hole in the nipple.

Taking into account modern views (National Program for Optimizing the Feeding of Children in the First Year of Life, 2010), the timing of introducing complementary foods during mixed and artificial feeding does not change.

Artificial feeding - this is feeding a child in the first months of life with animal or plant milk (soy, almond) when there is a deficiency of breast milk, amounting to 4/5 or more of the daily ration.

Principles of artificial feeding:

The frequency of feedings when prescribing adapted formulas can be the same as with natural feeding; when prescribing non-adapted formulas, the number of feedings is reduced by 1 and you can switch to 5 feedings a day from 3-4 months.

The volumes of nutrition during artificial feeding are calculated in the same way as during natural feeding (the volumes depend not on the type of feeding, but on the capabilities of the gastrointestinal tract).

Complementary foods are introduced at the same time as during natural feeding.

The need for protein increases when feeding with non-adapted mixtures to 4-4.5 g/kg; when receiving adapted mixtures, the amount of protein is the same as with natural ones.

Calorie content increases by 10% when using non-adapted mixtures.

Any attempt to transition to mixed and natural feeding is encouraged.

Transferring a child to artificial feeding is “metabolic stress” and in this regard, doctors should pay great attention to the correct choice of “substitutes” for human milk, taking into account individual characteristics of health, physical development and even appetite.

The basis of most “substitutes” or mixtures is cow's milk, which differs significantly from human milk in its composition and properties. Cow's milk has a significantly higher content of protein, calcium, potassium, sodium and other mineral salts than human milk. At the same time, the level of carbohydrates, a number of fatty acids and vitamins, on the contrary, is lower than in human milk. In order to bring the composition of cow's milk closer to the composition of women's milk (or otherwise “adapt” its composition to the characteristics of the child’s immature body, hence the name “adapted infant formula”), it is necessary to reduce the content in cow’s milk. protein and salts, but increase the level of carbohydrates (lactose), some vitamins and fatty acids. Currently, various human milk substitutes, both domestic and imported, are widely represented on the Russian market. “Substitutes” for human milk can be dry or liquid (ready-to-drink), fresh or sour.

Milk formulas are divided into 2 large groups - adapted and non-adapted, in turn, mixtures in each of these groups are sweet and fermented milk.

Adapted milk formula(AMC) - a food product in liquid or powder form, made on the basis of cow's milk, milk of other farm animals, intended for use as a substitute for human milk and as close as possible to it in chemical composition in order to satisfy the physiological needs of children of the first year of life for nutrients and energy. The content of protein, fats, carbohydrates, minerals and vitamins in mixtures must comply with domestic and international standards for adapted milk formulas. There is a modern classification of infant adapted milk formulas (Fig. 1). This mainly concerns the division of formulas depending on the age of children into “initial” (from 0 to 6 months), “subsequent” (from 6 to 12 months) and for children from 0 to 12 months.

Particular attention is paid to “initial” formulas, the composition of which is maximally adapted to the physiological needs and metabolic characteristics of children in the first six months of life. Recently, there has been a tendency to reduce the level of protein in modern dairy products in order to bring it closer quantitatively to human milk. Thus, in most “initial” mixtures the amount of protein is 1.4-1.6 g/100 ml, and the minimum level is 1.2 g/100 ml; the ratio of whey proteins to casein is 60:40, 50:50, in some mixtures 70:30. Almost all modern mixtures contain taurine, α-lactalbumin, and some - nucleotides.

To adapt the fat component of the “initial” mixtures, vegetable oils (sunflower, corn, soybean, rapeseed, coconut, palm) rich in polyunsaturated fatty acids (PUFAs) are introduced into their composition. To improve the emulsification of fats, a small amount of natural emulsifiers lecithin, mono- and diglycerides are introduced into the mixtures. Almost all mixtures contain L-carnitine, which promotes the assimilation of fatty acids at the cellular level. The current trend is the enrichment of mixtures of DSHIFAs (arachidonic and docosahexaenoic acid), which are precursors of prostaglandins, thromboxanes and leukotrienes,

The carbohydrate components used are mainly lactose and maltodextrin. A number of mixtures contain galacto- and fructo-oligosaccharides, which have a prebiotic effect and promote the selective growth of bifidobacteria. Some formulas contain lactulose, which is also a prebiotic.

All mixtures include the necessary set of vitamins and minerals in accordance with the physiological needs of children in the first months of life. This is primarily iron, copper, zinc, iodine. Selenium, which has antioxidant properties, was introduced into a number of mixtures. The calcium to phosphorus ratio is in the range of 1.5:1 - 2.0:1.

The level of vitamins in AMS exceeds that in human milk by an average of 15-20%, because their digestibility is lower than that of human milk. In this case, much attention is paid to vitamin D. Its content in 100 ml of the finished mixture should be 40-50 MB according to the standards. B vitamins, vitamin A, and β-carotene are added to all mixtures.

“Subsequent” mixtures, unlike the initial one, contain a higher amount of protein (up to 2.1 g/100 ml). The predominance of whey proteins over casein is no longer mandatory. Products for children of this age group have a higher content of iron, calcium, and zinc.

Formulas “from 0 to 12 months” can be used in the nutrition of children throughout the first year of life. However, this group of products is not numerous and in modern conditions is used to a limited extent due to the wide range of initial and subsequent formulas.

A number of dry fresh mixtures contain probiotics: bifidobacteria and lactobacilli. Modern technologies make it possible to ensure the safety of microorganisms in the product throughout the entire shelf life.

Criteria for selecting adapted milk formulas (AMC):

child's age;

socio-economic conditions of the family;

allergy history;

individual intolerance to the product.

The criterion for choosing the right mixture is the child’s good tolerance to this product.

As a result of all of these changes, a fairly good breast milk substitute is obtained, but it is necessary to strive to minimize the risk of sensitization to foreign protein by using protein hydrolysates and providing the child with nonspecific protection against intestinal infections by adding substances such as lactoferrin, lactoperoxidase, lysozyme, etc.

Adapted human milk substitutes include domestic liquid ones - "Agu-1" (Lianozovsky baby food plant, Russia), "Baby Milk" (Lianozovsky dairy plant, Russia) and dry formulas - "Mikamilk" (Kofranleit / Rosdetspetspetsprodukt, France / Russia ), as well as imported ones - “Nan” (Nestlé, Switzerland), Nutrilon (Nutricia, Holland), “Efamil-G” (Mid Johnson Division of Bristol Mayer Squibb), “Pre-HiPP” and “HiPP” (HiPP, Austria ), Humana-1 – taurine-containing mixture for children from the first days of life to 3-6 months, whey protein/casein ratio 60:40, does not contain glucose, sucrose and gluten, Humana-2 – from 3-4 months to 1 year, Humana-Baby-fit - from 6 to 12 months, gluten-free, enriched with iron, protein component 80:20, good content of vegetable oils, banana pectins in combination with starch increase the viscosity of the mixture and have an anti-dyspeptic effect, Frisolak - from 0 to 12 months , has a good ratio of linoleic and linolenic acids, a protein component of 60:40, fermented milk mixtures - “Gallia” and “Lactofidus” (Danone, France).

Somewhat less adapted mixtures are the so-called “casein formulas”. Their name comes from the fact that they are made from powdered cow's milk, the main protein of which is casein, without the addition of demineralized whey. As a result, such mixtures are less close to the protein composition of human milk. At the same time, for all other components (carbohydrate, fat, vitamin, mineral, etc.), these mixtures, as well as the adapted ones described above, are as close as possible to the composition of human milk. “Casein” formulas include such well-known mixtures as “Similak” (Abbot Laboratories, USA), “Nestozhen” (Nestlé, Switzerland), etc.

Finally, partially adapted mixtures. Their composition is only partially close to the composition of human milk - they lack demineralized whey, the fatty acid composition is not fully balanced, and not only lactose, but also sucrose and starch are used as a carbohydrate component. Such mixtures include “Aptamil”, “Milumil” (Milupa, Germany). These substitutes can be used in the nutrition of children in the first year of life, starting from 2-3 months.

All modern breast milk substitutes and “follow-up” formulas are instant (instant) products. To use them in children's nutrition, you only need to mix a strictly defined amount of dry powder with pre-boiled warm (50-60°C) water and mix thoroughly, avoiding the presence of lumps.

Advantages of fermented milk mixtures:

improve digestion processes;

have partially split protein, which loses its allergic properties;

vitamins produced by bacteria;

they partially destroy lactose, which some children do not tolerate well;

displace pathogenic flora;

there is no more ethyl alcohol in them than in bread, juice, breast milk; it is necessary for metabolic processes taking place in the body.

Disadvantages of fermented milk mixtures:

have a high calcium content;

whey protein to casein ratio 20:80;

when they are used, the acid base shifts to the acidic side.

Thus, infant formula is considered good if:

Protein 1.2 - 1.5 g/dl;

The ratio of whey protein to casein is 60:40;

Contains taurine;

Vegetable fat - 1%;

Carbohydrates – dextrine maltose;

Vitamins A, D, E;

Osmolarity = 280 mOsm/L.

Currently, in the diet of patients with food allergies, dairy-free mixtures prepared on the basis of soy protein isolates produced abroad are widely used: Humana SL (Germany), Nutrisoya and Frisosoy (Holland), Prosoby (USA), Alsooy (Sweden), as well as domestic product – Nutrilak-soy. The protein component of these products is represented by soy protein isolate; fatty – formed from vegetable oils; carbohydrate – represented by dextrin maltose, which has a positive effect on the intestinal microbiocenosis. The products are enriched with a complex of vitamins and minerals in accordance with the requirements of young children. The mixtures do not contain milk protein, lactose or gluten.

Children who are bottle-fed, just like their peers, need complementary feeding. Considering that modern adapted milk formulas contain the necessary set of vitamins and minerals, there is no need to make corrections for these substances with complementary feeding products earlier than when breastfeeding.

Consequences of artificial feeding

Shortening the average life expectancy by 10 years (min);

Sensitization in 75% of children;

Dysbacteriosis 100% of children;

Chronic diseases of the gastrointestinal tract – 45-55%;

Development of early sclerosis (no activator of cholesterol utilization enzymes);

Early hypertension;

Early ischemic heart disease, strokes, etc.;

Children are at risk for oncology and hemonology (leukemia);

The ratio of diseases of children on natural: mixed: artificial feeding is 1: 3: 6. The BBD group is 2-3 times larger;

Children who are “artificial” are prone to mechanical, uncreative work, nihilism and aggression.

Features of nutrition of premature babies

A premature baby should arrive at the pediatric site with a stable sucking reflex and feeding regimen. Usually these are 7 feedings with a 6-hour night break. Feeding is switched to 6 times a day when the body weight reaches 3,000 g.

The most optimal type of feeding for a premature baby is breastfeeding. You should strictly monitor the amount of milk your baby absorbs. Therefore, a premature baby should be provided with scales, which the clinic should provide to him. In cases of insufficient absorption of breast milk, supplementary feeding with a spoon is required. You should tell your mother about this and teach her about it. In this case, special dry adapted mixtures for premature infants are used. The peculiarity of these mixtures is their higher protein and carbohydrate content, and, accordingly, calorie content, compared to conventional adapted mixtures. Special adapted formulas for premature infants should be used until they reach a weight of 4 kg, and then switch to regular adapted formulas.

Types of feeding premature babies

Women's milk after premature birth has a special composition that is more consistent with the nutritional needs of premature babies and is consistent with their ability to digest and assimilate. Compared to the milk of women who gave birth at term, it contains more protein (1.2-1.6 g per 100 ml), especially in the first month of lactation, slightly more fat and sodium and less lactose with the same total level of carbohydrates. The milk of women after premature birth is also characterized by a higher content of a number of protective factors, in particular lysozyme. Human milk is easily digestible and well tolerated by premature babies.

Despite its special composition, the milk of women who gave birth prematurely can satisfy the nutritional needs of only premature babies with a relatively large body weight - more than 1800-2000 g, while premature babies with a lower body weight after the end of the early neonatal period gradually begin to experience a deficiency in protein, a number of minerals (calcium, phosphorus, magnesium, sodium, copper, zinc, etc.) and vitamins (B 2, B 6, C, D, E, K, folic acid, etc.).

Preserving the main advantages of natural feeding and, at the same time, meeting the high nutritional needs of a premature baby becomes possible by enriching human milk with “enhancers” or fortifiers (for example, “Pre-Semp”, Samper, Sweden, “Breast milk fortifier”, Friesland Foods, Holland, etc.). They are specialized protein-mineral or protein-vitamin-mineral supplements, the addition of which to freshly expressed or pasteurized human milk can eliminate nutritional deficiencies.

Indications for artificial feeding of premature babies are only the complete absence of mother's or donor milk, as well as intolerance to human milk. In the nutrition of children born prematurely, only specialized formulas intended for feeding premature infants should be used, the nutritional value of which is increased compared to standard adapted products (Pre-NAN, Pre-Nutrilak, Pre-Nutrilon with prebiotics, Humana-O-G A, Friso-pre, Enfamil premature).

Complementary feeding products are prescribed to premature babies starting at 4-5 months of age. The introduction of complementary foods before 4 months is unacceptable due to the immaturity of both the digestive system and metabolic processes. Later (from 6 months) the administration of complementary feeding products is also inadmissible, since the supply of nutrients (minerals and individual vitamins) in children born prematurely is sharply limited.

The introduction of complementary foods is carried out slowly and gradually. Until children reach 7-8 months of age, each feeding should end with the baby being put to the breast or using formula milk.

Organization of rational nutrition and the role of the local pediatrician

The organization of breastfeeding in primary health care is given exceptional importance, since:

preservation of natural feeding is the protection of the child’s rights to health; this is the official policy of WHO and the government of the Russian Federation and, finally, this is the main positive factor determining health;

the leading organizer in this process is the KZR (healthy child’s office);

in a children's clinic, one of the leading criteria for a doctor's qualifications and the effectiveness of his work is the proportion of natural feeding.

Local pediatrician:

carries out constant preventive work to maintain a high proportion of natural feeding (at least 75% of all nursing mothers of children under one year old) at all stages: before pregnancy, before childbirth, intranatal and postnatal.

identifies risk groups for hypogalactia;

uses all components of the diagnosis of hypogalactia: anamnestic, clinical, control feeding;

if there is a threat of hypogalactia, it immediately takes action (algorithm for combating hypogalactia);

informs the head of the pediatric department in advance about the reasons for the possible transfer of each child to mixed and artificial feeding in order to make a collegial decision;

plans centralized or decentralized provision of breast donor milk to mothers with hypogalactia (a breast donor milk bank, a circle of lactating mothers for mutual assistance);

organizes increased medical literacy (medical “education”) of parents through various forms of education: “health universities”, “school of young parents” (there is also a “school of young father”), where they teach, among other things, the basics of feeding.

The doctor must convey to the mother the importance of following the following regimens:

daily routine;

work and rest;

sleep and wakefulness;

loads (from general sports to strict bed);

nutrition (especially in terms of frequency of feeding, volume of food, timing of introduction of complementary foods and duration of breastfeeding).

Nutrition for children over one year old:

Each period of childhood is characterized by its own characteristics of growth and development, the degree of morphological and functional maturity of individual organs and systems, and the specifics of physiological and metabolic processes.

Principles of nutrition for children over one year old:

Adequate energy value of daily diets corresponding to the energy consumption of children.

A balanced diet for all replaceable and essential food factors, including proteins, amino acids, dietary fats and fatty acids, vitamins, mineral salts and trace elements, as well as minor food components (flavonoids, nucleotides, etc.).

Maximum variety of diet, which is the main condition for ensuring its balance.

Rational diet.

Optimal technological and culinary processing of products and dishes, ensuring their high taste and preservation of the original nutritional value.

Taking into account the individual characteristics of children (including their intolerance to certain foods and dishes).

Ensuring sanitary and hygienic food safety, including compliance with sanitary requirements for the state of the catering unit, supplied food products, their transportation, storage, preparation and distribution of dishes.

Educational and methodological material:

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Sometimes a child is forced to be bottle-fed instead of mother's milk. Of course, such a diet will not have a beneficial effect on the baby’s health, because store-bought formulas do not contain many elements and vitamins that strengthen the immune system. So, let's try to figure out how breastfeeding differs from artificial feeding? And how to properly feed an artificial baby?

A formula-fed baby cannot be fed with formula alone for a long time. Within a few months after birth, the baby will begin to reach for the plates of adults, which means that it is time to introduce new products into his diet. How to correctly calculate the daily intake of the mixture and when should you start the first artificial complementary feeding?

Artificial feeding from birth to 3 months

Whether or not to breastfeed a baby is a personal matter for each mother, but there are also cases when indications for artificial feeding are given by a specialist. Typically these include:

Prematurity of the child.
Difficult birth (recovery time is needed).
Insufficient lactation or its complete absence.
Inability to breastfeed the baby (mother works a lot) and lack of expressed milk.
Chronic or infectious diseases in the mother.

The composition of store-bought formulas is as close as possible to breast milk, but they still lack the antibodies produced in the body of a nursing woman. Therefore, you will have to monitor the health of the artificial child until his immunity is fully strengthened.

Approximate diet for a baby from birth to 3 months:

For a baby up to ten days old, it is recommended to prepare a mixture, the daily norm of which is calculated by the formula: 70 ml (80 ml if the birth weight was more than 3200 g) * P (baby’s age in days). For example, the baby is 6 days old, which means the daily amount of formula for him will be 480 ml (80 * 6).
After ten days of life, up to 2 months of age, the amount of formula per day will depend on the baby’s weight (1/5th of body weight or 600-850 ml).
From two to four months, the rate of formula feeding per day will be 1/6th of the child’s body weight (or 750-900 ml).

Also, do not forget to give your baby boiled water.

It's time to introduce complementary foods. Nutrition from 3 to 6 months

If the first complementary foods during breastfeeding are introduced when the baby is six months old, then the artificial baby will need additional food already at 3 months. Such an early change in the baby’s diet occurs because mother’s milk differs greatly in composition from store-bought milk. So, What is the difference between breast milk and formula?

Breast milk is produced exactly in the amount that the baby needs.
Biologically active water is the main component of mother's milk (88%). Thanks to this component, a breastfeeding baby does not need to be given additional water.
Carbohydrates (7%), fats (4%), proteins (1%), iron, minerals, vitamins, growth hormones, white blood cells and antibodies for immune protection (0.2%) are presented in the ideal ratio necessary for the baby. Such a composition is difficult to find in mixtures.

But your baby artificial, so your diet will have to be balanced on your own. It's time to introduce complementary foods, where to start? Doctors usually recommend giving your baby fruit juice as a new product. First, it is better to offer him half a teaspoon so that the baby gets a taste. Then the portion can be gradually increased, of course, if the child has not developed an allergy and he willingly drinks a new drink.

A good helper in how to introduce baby's first complementary foods, tables for calculating portions and products according to the baby's age. There are quite a lot of them on the Internet, but they are all different. Therefore, it is better to draw up a menu for an artificial baby with the help of a doctor or take a complementary feeding table from your pediatrician.

If the child is gaining weight well, then the next new product in the diet may be vegetable puree. The main rule is not to add salt. his. Spices, salt and sugar are not recommended for a baby at this age, but this does not mean that boiled vegetables will seem tasteless to the baby. The child’s receptors have not yet been spoiled by adult food, and he will happily eat everything that is given to him. As the first vegetables, you can give your baby zucchini, pumpkin, cauliflower and broccoli.

Another good product for first complementary feeding can be cereal porridges, for example, buckwheat or rice. They are recommended for those children who are not gaining weight well.

Diet for 6 to 8 months

Products for artificial babies at 6-8 months are not very different from the same diet for infants, so the daily regimen will look something like this:

6 a.m. 180-200 ml of mixture with milk or water.
10 hours. 150 g of milk porridge, 4 g of butter (can be added to the porridge) and 60 g of fruit puree.
14 hours. 150 g vegetable puree, 0.5 tsp. olive or sunflower oil (can be added to puree), one fourth of the yolk and 30 ml of fruit juice.
18 hours. 150 g of milk mixture, 40 g of cottage cheese, 30 ml of fruit juice and 3 g of crushed biscuits.
22 hours. 180-200 g of mixture with water or fermented milk products.

If parents introduce complementary foods from 6 months, you can already select recipes for dishes for the baby yourself.

Approximate menu for a year old

At this age, babies should switch to more solid foods, which means that the one-year-old’s menu will become much more varied.

Breakfast. Any milk porridge at the discretion of the parents (oatmeal, rice, semolina), cottage cheese casserole or omelet.
Dinner. The first and second courses must be present. This could be meat soup and vegetable puree with a cutlet (steamed), borscht and fish (boneless) with cauliflower and much more.
Afternoon snack. Time to please your baby with something tasty. Offer him cookies with kefir or yogurt. Don't forget about fruits.
Dinner. This is the easiest meal, so it is best to feed him porridge with milk or vegetable puree.

Regardless of whether the baby is artificial or is on breastfeeding, do not rush to give him adult food (sausages or exotic fruits), because such products can only cause allergies and poisoning.

Choosing a formula-feeding diet for your baby is not just about deciding on your favorite brand of infant formula. For bottle-fed babies, everything is different, from the frequency of their meals to the color of the contents of their diaper. What do young parents need to know in order to correctly create a formula-fed baby’s regimen?

The routine of a bottle-fed baby is different from that of a baby.
breastfed. Strictly speaking, the everyday life of an “artificialist” is largely
degrees are subject to an hourly schedule, while the days of true
the baby is formed more by the will of his instincts and natural
his mother's desire to put the baby to her breast...

Babies digest breast milk and formula differently

Differences in the regimens of bottle-fed babies and breastfed babies are primarily due to the way in which newborns and older babies absorb breast milk and formula.

A question that young mothers often ask when planning a bottle-fed regimen for their baby: is it true that babies accustomed to infant formula can be fed less frequently than breastfed babies. The short and to the point answer is yes.

If suspicions of an allergy to formula are confirmed, your doctor may recommend a soy-based formula. Or the solution to the problem may be to switch to an extra-hydrolyzed mixture, in which the casein protein is broken down into a more digestible form.

Another important “problem” is infant colic. They occur in children who are bottle-fed no less often, and perhaps even more often, than in those children who are fed breast milk. Of course, the constant crying of a child does not mean that he has colic - any experienced parent will confirm this to you. But if you see that the baby constantly feels discomfort after feeding, it is likely that the reason lies precisely in colic.

Unfortunately, or fortunately, by changing in any way the formula-fed baby’s regimen, you are unlikely to get rid of painful infant colic. You just need to survive this “attack” - in most cases, infant colic disappears on its own at the age of 3-4 months.

Some babies eat more, others eat less.

One day, while visiting your friend, you suddenly notice that her child, who is also on artificial feeding, barely drinks 100 milliliters of formula at a time. And your baby can easily cope with a double portion at the same time. Is there really a glutton in your family?

Not at all. Children's diet is a purely individual matter. Different babies on artificial feeding require different amounts of calories, and if one baby needs 100 milliliters of formula, the other will remain hungry.

There is one absolute advantage in artificial feeding mode -
can fully care for a newborn baby
not only mom, but also dad...

In addition, formula intake may vary from one meal to the next. Just like you: in the morning you can eat a vegetable salad, but at lunch you want something more serious. In general, don't be surprised if your baby eats 120 milliliters of formula, and three hours later he eats 200.

General rules for a bottle-fed baby

How much food should there be? In general, “artificial” children who have not yet received their first complementary foods should eat approximately 150-155 milliliters of ready-made formula per kilogram of weight during the day. So if your baby weighs, say, 3.7 kilograms, count on about 550 milliliters of artificial nutrition. If a child weighs 6 kg, he needs to be given up to 900 milliliters of formula per day.

Feeding frequency. The frequency of meals, as well as the quantity, changes as your baby grows. After the first few days, the newborn will eat 60 to 90 milliliters of formula per meal. The frequency of meals can also vary, but on average newborns eat every three to four hours for the first few weeks. It is believed that if during the first month your baby sleeps for more than four to five hours, starting to skip feedings, you should wake him up (but very kindly, gently and delicately!) and offer him a bottle of formula.

By the end of the first month, the child is ready to eat up to 120 milliliters per dose. By this time, the meal schedule usually has already stabilized, the baby eats on average every four hours.

All families are individual, and so are all the children in them. Often, the parent’s daily routine is no less subordinate to the newborn baby’s routine than the child’s routine is subordinate to your lifestyle. Moreover, regardless of what type of nutrition the baby is on.

And even if you feed your baby formula, the baby’s formula-fed regimen is by no means a strict medical regulation - it’s not so important how strictly you adhere to the hourly feeding schedule. It is much more important that both you and your baby feel harmonious together, so that feeding moments bring not only physiological saturation, but also the joy of joint emotional communication.