Weaning, formula milk, Mixed feeding
World Health Organization (WHO) recommends the continuation of breastfeeding until the age of two years, with addition of nutritional supplements after the age of six months.
Weaning begins gradually at about 6 months, as the baby will be ready for other foods to meet baby’s growing nutritional needs. It is encouraged to continue to breastfeed during the weaning as long as it is comfortable for the mothers and babies.
The process performed on formula milk (Sterilization, Dilution, sweetening process)
1. Sterilization of milk:
Sterilization is carried out from bacteria (Brucellosis and tuberculosis) that infect animals and transmit to humans, and sterilization is also carried out from environmental bacteria (which is the largest polluter). There are several ways for the sterilization process as following:
A- Boiling: the boiling of milk should be at least 5 minutes after tearing off the creamy layer.
It is never permissible to consume milk that boiled for more than 24 hours, otherwise it must be boiled again.
The period between production of milk and boiling it should also be short.
B- Pasteurization: this process is used to eliminate pathogens from milk and it preserves most of milk’s yeasts and vitamins.
C- Sterilization in a water bath at 100°C.
2. Dilution of milk:
Cow’s milk is diluted by adding water or one of the starch soaked.
The dilution process leads to an amount of proteins in cow’s milk almost equal to the amount of protein in women’s milk, but it also leads to a reduction in sugar and fat content, so it was necessary to sweeten cow’s milk.
The lack of fatty substances is difficult to avoid, and according to the age of the baby, the ratio of dilution is according to the following:
baby’s age: The first three weeks
Dilution ratio: Half = 1/2 water + 1/2 milk
baby’s age: Until the third month
Dilution ratio: One-third (1/3) = 1/3 water + 2/3 milk
baby’s age: From the fourth month to the end of the sixth month until weaning
Dilution ratio: One-fourth (1/4) = ¼ water + ¾ milk
3. Sweetening process:
Cane sugar is used in this process. The sweetening ratio is related to the baby’s readiness to diarrhea or constipation. If the tendency towards diarrhea the sweetening ratio is decreased, and on the contrary in the constipation it is increased. The average of sweetener ratio is 15 mg/100 ml (5-8%)
Formula milk
The daily need for baby formula milk can be estimated according to one of the following methods:
-The numbers which are available in the international references and written on milk cartons.
-The amount of fluids that baby needs around 150-180 ml / kg / day.
-Applying the following rule, which determines the amount of milk required per day: one-tenth of the body weight in grams + 200 ml/.
-Gradually reduce the number of feeds given to the baby.
-The last thing to be omitted is the morning meal, preceded by the evening meal.
A formula-fed baby’s poop:
Pale color
Consistent texture
Bad smell
Alkaline reaction
Pass fewer 2-3 times a day, like constipation
Dry
A breastfeeding baby’s poop:
Yellow color
soft to runny in texture and contains mini white seeds
Sour and pungent smells
acid reaction
Pass several times after every feeding
Mixed feeding
Mixed feeding: supplementing breastfeeding with infant formula.
Temporary indications
1. In the first days after birth, when the breast milk secretion is low and does not meet the baby’s need, so a few additional feedings of formula milk are given to baby until it is secreted sufficiently.
2. Mother’s fatigue.
3. The mother has a disease or has a cracked nipple or a breast abscess.
Permanent indications
1. Exacerbation of insufficient breast milk.
2. When the mother is forced to work outside the home and absent from her baby.
Breastfeeding is applied in two ways:
1. Switch nursing technique.
2. Complementary feeding technique, which is the best.
Diversified feeding or mix feeding in infants
We begin to introduce varied supplemental feeding starting from the sixth month according to the recommendations of UNICEF, while previously the recommendations were to start feeding from the fourth, fifth or sixth month of life (after the sixth in case of an allergic history).
These new recommendations are based on the fact that breast milk is sufficient until the age of six months for most mothers, but after the sixth month, additional foods must be introduced to the infant because mother’s milk is no longer sufficient to meet all the metabolic needs and build the child’s body.
1. Vegetables: It is the first additional food offered to the young babies from the sixth month, previously it was given from the fourth month. Vegetables should be offered boiled only.
2. Carbohydrates: It is offered after the sixth month when the baby under breastfeeding or powdered modified milk.
Cereals which are containing gluten such as wheat, barley and oats, are offered after the sixth month.
3. Meat: It is offered starting from the end of the sixth month. Fish is offered after the first year in case of allergic history.
4. Eggs: Only the yolk of eggs is given during the second half of the first year of age, fully cooked or half-cooked, and in gradually increasing quantities. Previously, egg yolk and egg whites were given during the second half of the first year.
5. Fruits: orange juice, bananas, and finely grated apples are offered starting from the sixth month, in addition to the rest of the fruits.
The current recommendations emphasize on introducing the foods to babies from the sixth month of life, taking into consideration to be offered gradually and to be given in a low number of meals then increasing the number of meals.
Egg whites are given with caution during the first year because they cause severe and sometimes fatal allergic reactions. Despite this, egg whites are high in protein fast-digesting proteins.
Each type of vegetable is introduced separately to determine the causative reason in case of allergy, then vegetable soup can be introduced subsequently.
