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Infant Feeding & Nutrition

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Infant Feeding & Nutrition

StructureIntroduction

Breastfeeding basics

Formula Feeding basics

Complementary Feeding

Growth monitoring

IntroductionFirst 1000 days between conception and a

child’s 2nd birthday : impact ability to grow, learn and reach full potential

South African Constitution / UN Committee on Rights of the Child / Convention of the Rights of the Child : HUMAN RIGHT OF A CHILD TO HAVE BASIC NUTRITION AND ACCESS TO FOOD

South Africa: Double burden Malnutrition and Obesity/Overweight and diet related chronic diseases

Breastfeeding BasicsMost Natural – body designed to breastfeed

Benefits are endless

Has ALL the essential nutrients: vitamins, minerals, protein, carbohydrates to sustain optimal growth

Bonding

FREE!!!

Right temperature

Easily digested

Maternal antibodies to boost babies immune system

Seldom Have problems with constipation/ diarrhea

Prevent allergies

Prevent obesity

MOM: Lose weight, Lowers the risk of Breast Cancer/ Ovarian Cancer

WHO : Exclusive breastfeeding for first 6 months and continuing with breastfeeding with the addition of complementary feeds until 2 years

BreastMILKColostrum:

- Rich in nutrients and antibodies – First immunization!!!

- Lines the digestive tract, enhances immunity

- Small amount – all baby needs

- Sick baby: express – feed with cup or spoon

Foremilk

Hindmilk

Basic tipsQuiet calm room

Prepare before the feed – tea/water/good chair/raise feet ENJOY!!!!

RELAXATION NB! Stress hormones inhibit Milk production hormones

Comfortable position/ style to feed

MAKE sure baby latches correctly – top and bottom lip must form a snug seal

Incorrect latching will hurt you

Help if you are hurt:

- Nipple creams/ shields/ laser/ physio

Breast feed on demand

Some take their time, Some are barracudas!! – Let your baby tell you when he is full and NOT the clock

First 2 weeks – feed every 3-4 hours - Should not go longer than 5 hours without a feed

Involve Dad/ Going to work

Express BREAST milk for cup or bottle feeds

Room air 6 hours

Refrigerate 48 hours

Frozen 3 months

- Date your milk – use the older milk first

- Freezer bags/ breast milk storage bottles (BPA free)

- Get a pump which you are comfortable with

Breastfeeding helpCheck that your hospital is “baby friendly” and

supports breastfeeding

Be weary of well meaning but inexperienced help

Midwife/ Neonatal Sister

Baby Clinics

Lactation Consultants (with a National Postgraduate Lactation Certificate)

Support groups (eg La Leche League

www.llli.org/SouthAfrica)

Breast milk BankingThe South African Breast Milk Reserve (SABR)

- Public benefit organization

- Supplies and redistributes donar milk to prems amongst 70 hospitals/ 8 provinces

- Meticulously screened and packaged

More info www.sabr.org.za or email [email protected]

Formula FeedingNot all moms able to breastfeed

NO : Cows milk, Goat’s milk, Skimmed milk, Coffee Creamers, Milk powders

Composition of Formula – strictly controlled by global standards board (European Society for Pediatric Gastroenterology, Hepatology and Nutrition)

Specific maximum and minimum requirements

Formula in the same classes are nutritional interchangeable

Types of formulaStandard Cow’s milk formula (protein similar to

cows milk)

STARTER (stage 1) birth to 6 months

FOLLOW ON (stage 2) 6 months to 1 year

Growing up milk (stage 3) – milk for toddlers 1yr – 3yr

Specialized formulaPartially hydrolyzed / hypoallergenic (protein broken

down)

Lactose free formula

Soya based

Anti reflux

Acidified

Preterm

SPECIAL INDICATIONS – MUST BE DISCUSSED WITH PAED/GP/Dietician

Additional components Pre and Probiotics

- Eases digestion

- Decrease frequency and duration gastro

- Reduce risk of antibiotic associated gastro

- Improves immunity

Omegas (Long chain fatty acids)

- neurological, cognitive and visual development

Nucleotides

- Increased weight gain and Head circumference

Preparation of Formula Hygiene !! Hygiene!! Hygiene!!

Wash hands

Boiled cooled water

Measure water

Measure power

- LEVEL of scoop

- Not more not less

- Use the scoop provided

- Read the instructions on the tin

- Make sure properly dissolved

Basic formula rulesAlways check the temp BEFORE feeding infant

Make enough for a single feed

Do leave lying around at room temp

Do not feed the infant unattended

Do not use the microwave to heat the milk

- Changes the protein

- Uneven Heating

No harm in changing formula – just don’t chop and change to quickly

SterilizationALWAYS sterilize ALL bottles and teats

Boiling – bottles for 15 min teats for 3-5 min

Steam sterilizers

Chemicals

- Hypochloride solutions – follow the instructions on the bottle sterilizing fluid carefully – some changed daily, others weekly

Baby poo!! Newborn poo –

Meconium

Breastfeeding poo

Bottle feeding poo

Starting solids poo

Constipation

Small dry hard pellets

- Incorrect mixing formula

- Fever

- Dehydration

- Changes in fluid intake

- Medication

Diarrhoea

Runny, more often, larger amounts

- Infection

- Too much fruit or juice

- Medication

- Food Allergy/ Sensitivity

Complimentary Feeding Discovering new things and mess!!

WHO Breastfeed until 6 months

EVERY BABY IS DIFFERENT

Gentle flavor and texture

Try one meal, 3 days in a row then change

Good started options: rice cereal/ butternut/ carrots/ pears/apples/ bananas squash – mixed with margarine/ sunflower oil / peanut butter

8-9 months chicken/lamb/ fish

By 1 year 3 meals a day with milk feeds being ”complimentary snacks” (at least 2 per day)

SPECIAL DIET – Discuss with Paed and Dietician – meeting all the nutritional requirements and ?supplements

Growth ChartsMonitor Babies growth

Weight for age

Length/ height for age

Weight for length

Head circumference

Body mass index

Thank you