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Putting infants on the right road to good health

By Irish Pharmacist - 31st May 2023

Eamonn Brady MPSI provides an overview of infant nutrition, including potential challenges in breastfeeding

As a pharmacist and a parent, I have observed a lot of misinformation and confusion around infant nutrition. Many parents struggle to make informed decisions about what to feed their babies, which can have serious consequences for their child’s health and development.
The purpose of this article is to provide a general overview of infant nutrition, including the different types of infant formula, the benefits of breastfeeding, and some general guidelines for introducing solid foods.

BREASTFEEDING

Breastfeeding is the recommended method of infant feeding and has numerous benefits for both the mother and baby. Breast milk contains a perfect balance of nutrients that are easily digestible and provide optimal nutrition for infants. Breast milk also contains antibodies that help protect infants from infections and illnesses.

Breastfed infants have a lower risk of developing respiratory infections, diarrhoea, ear infections, and other illnesses compared to formula-fed infants. Breastfeeding may also be protective against obesity, type 1 diabetes, and other chronic conditions later in life. Additionally, breastfeeding promotes bonding between mother and baby and is associated with better cognitive development and emotional wellbeing.

The World Health Organisation (WHO) recommends exclusive breastfeeding for the first six months of life, followed
by the introduction of complementary foods while continuing to breastfeed until at least two years of age. However, it is important to note that every mother’s breastfeeding journey is unique, and some may encounter challenges that make it difficult to breastfeed exclusively.

CHALLENGES NEW MOTHERS CAN HAVE BREASTFEEDING

Breastfeeding is a natural and wonderful process, but it may not always come easily for new mothers. Many difficulties can arise, particularly during the first few weeks postpartum, that can make breastfeeding a challenge.

Some of the main difficulties new mothers have with breastfeeding include: 1. Latching problems: The most common problem that new mothers encounter while breastfeeding is difficulty latching the newborn comfortably and effectively. Sometimes, the baby doesn’t open its mouth wide enough, causing a shallow latch or a poor seal. It can lead to sore and cracked nipples, which can be painful for mothers and make feeding sessions uncomfortable.

2. Low milk supply: Another issue that many new mothers face is a perceived low milk supply. This perception can be at- tributed to a baby’s frequent demand for milk, as well as the difficulty of determining how much milk a baby is receiving at any given time. This worry can lead to anxiety and stress, which ironically can reduce milk production further.

3. Pain and discomfort: Many new mothers experience pain and discomfort during breastfeeding. Sore nipples can be a sign of a poor latch, and breast engorgement, a condition in which the breasts become swollen and tender, can be painful. The discomfort caused during feeding can become an issue that discourages mothers from continuing to breastfeed.

4. Mastitis: Mastitis is a breast infection that is characterised by inflammation of the breast, often caused by a blocked milk duct. It is not uncommon for breastfeeding mothers, particularly during the first few weeks postpartum. Mastitis symptoms include pain, swelling, and tenderness. The condition can be treated with antibiotics, but if left untreated can lead to abscesses or chronic inflammation.

5. Breastfeeding with inverted or flat nipples: For mothers with inverted or flat nipples, breastfeeding can be an additional challenge. Inverted or flat nipples make it difficult for the baby to latch properly, causing pain and discom- fort during feeding.

6. Milk allergies and sensitivities: Newborns can be particularly sensitive to certain foods and drugs that a nursing mother may consume, leading to allergies or sensitivities. This may affect both milk production and the baby’s ability to digest milk and may require the mother to avoid certain foods while breastfeeding. This is an area of expertise a pharmacist can advise on.

With proper support and knowledge from healthcare professionals, such as lactation consultants, new mothers can overcome difficulties and enjoy the many benefits of breastfeeding, including stronger bonds with their babies, stronger immune systems, and better health for both mother and baby.

INFANT FORMULA

Infant formula is a type of milk that is specifically formulated for infants aged 0-12 months. There are various types of infant formula available, including cow’s milk-based, soy-based, and hypoallergenic formulas. While breastfeeding is best, as discussed earlier, formulas are often needed as a substitute for breast milk. Each of these formulas has its own set of advantages and disadvantages, and parents should work with their healthcare provider to determine which type of formula is best for their baby.

Cow’s milk-based formulas are the most commonly used formulas and are made from cow’s milk that has been modified to resemble breast milk as closely as possible. These formulas contain a blend of carbohydrates, fats, proteins, vitamins, and minerals that are essential for infant growth and development. Most cow’s milk-based formulas are fortified with iron, which is important for preventing anaemia in infants.

Soy-based formulas are made froms oy protein and are often used as an alternative to cow’s milk-based formulas in infants with lactose intolerance or cow’s milk allergy. However, soy- based formulas are not recommended for premature infants or infants with certain medical conditions, as they contain phytoestrogens that can affect hormone levels.

Hypoallergenic formulas, also known as elemental formulas, are usually recommended for infants with cow’s milk allergy, lactose intolerance or other medical conditions. These formulas contain broken-down proteins that are less likely to trigger an allergic reaction.

MORE ABOUT THE MOST POPULAR INFANT FORMULAS AVAILABLE IN IRELAND
Infant formula is manufactured to mimic breast milk in its composition and can be used as a complete or partial substitute for breast milk. There are a variety of infant formula options available in Ireland, including cow’s milk, goat’s milk, and soy-based formulas.

COW’S MILK-BASED FORMULA

Cow’s milk-based formula is the most common type of infant formula. It has been modified to mimic the composition of breast milk and is fortified with vitamins, minerals, and other nutrients to support baby’s growth and development. Aptamil First Infant is an example of a milk formula brand available in Ireland. Milk formulas contain nutrients like vitamins A, C, D, iron, and other essential fatty acids that are beneficial for babies.

SOY-BASED FORMULA

Soy-based formula is made from soy protein and is a good option for babies who are allergic or intolerant to cow’s milk. Soy-based formula is also an option for vegan families who want to avoid animal products. Similac Soy Isomil Formula is an example of a soy-based formula in Ireland.

LACTOSE-FREE FORMULA

Lactose-free formula is an option for babies who are lactose intolerant. Lactose is a sugar that is naturally found in milk, so this formula is made without lactose. Nutramigen LGG Hypoallergenic Formula is an example of a lactose-free formula. Lactose-free formulas are  safe to use as an alternative for breast milk and can be used for preventing or managing certain types of food allergies.

GOAT’S MILK FORMULA

Goat’s milk formula is becoming a popular alternative to cow’s milk-based formula. This formula is very similar to cow’s milk-based formula, but the main difference is the protein content. Goat milk formula has a slightly different protein composition, which may make it easier for some babies to digest. Hipp Organic goat milk formula is an example of a goat milk formula made from organically-raised goats.

SPECIALISED FORMULA

Specialised formula is designed for babies who require specific nutrients for medical reasons.
Examples include:
a. Premature infant formula, for babies who are born prematurely and require extra nutrients.

b. Anti-reflux formula, for babies with gastro-oesophageal reflux disease (GORD).

c. Hypoallergenic formula, designed for infants who are allergic to cow’s milk protein.

d. Formula for metabolic disorders, which is specially made for babies with metabolic disorders that make it difficult for them to break down certain nutrients, like fats or proteins.

SOLID FOODS

Introducing solid foods to an infant’s diet is an important milestone that typically occurs between four-to-
six months of age, depending on the individual needs and readiness of the infant. Solid foods provide additional nutrients that are necessary for infant growth and development and help facilitate the transition from a liquid- only diet to a more varied diet that includes different textures and flavours.

When introducing solid foods, it is recommended to start with infant cereal mixed with breast milk or formula, followed by pureed or mashed fruits and vegetables, and eventually introducing soft finger foods. It is important to introduce new foods one at a time and wait two-to-three days before introducing another food in case an allergic reaction occurs.

Additionally, it is important to avoid choking hazards such as hard candy, nuts, and raw fruits and vegetables until the infant can sufficiently chew and swallow these foods. Parents should also avoid adding salt, sugar, or other seasonings to the baby’s food and should opt for fresh, whole foods whenever possible.

CONCLUSION

Infant nutrition is critical for supporting infant growth and development and
can have long-term effects on health outcomes. While there are many different types of infant formula available, breastfeeding is the recommended method of infant feeding and has numerous benefits for both the mother and baby. Introducing solid foods is an important milestone that should be approached with care and attention to detail. Parents should work with their healthcare provider to determine the best feeding plan for their infant and provide a variety of nutrient-rich foods to promote optimal growth and development. Pharmacists can provide reliable and informative resources to support the health and wellbeing of infants and their families.

Brands mentioned in this article are examples only and are not to be considered as superior to other brands; Parents should speak to their health professional for the best formula to suit their baby’s individual needs if breast feeding is not possible.

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