FEEDING OPTIONS
Most babies feed well and thrive, with no, or very few problems. However, some
simply do not have the ability to take in enough nutrients to thrive and grow
optimally. This may be because of problems with sucking, immaturity of the
digestive system or the way in which the digestive tract absorbs nutrients.
Fortunately, research has advanced to the point where most of these babies can be
helped to overcome feeding and nutritional difficulties – either through changed
feeding practices, specialised infants formula, medical treatment or surgery – and go
on to thrive and develop normally.
Breastfeeding
Breastfeeding is certainly natural, but some mothers are surprised when their babies
don’t seem to know what to do automatically. It will take time, patience and support
for both mother and baby to learn how to breastfeed.
Breastfeeding provides your baby with all the nutrients he needs for optimal growth in
his early stages. Breast milk is the most nutritionally complete and most easily
digested foodstuff for your baby. It contains at least 400 essential nutrients, hormones
and antibodies that your baby needs for optimal growth and development, and to help
him fight off a range of the illness – both in infancy and later in life. Breastfeeding
exclusively for the first six months of baby’s life has been shown to improve his
overall health in infancy and can reduce his risk of developing certain conditions in
adulthood.
Bottle (formula) feeding
Bottle-feeding, just like breastfeeding, is an opportunity to give your full attention as
you hold your baby close. If you choose to formula feed, be confident you‘re meeting
your baby’s nutritional needs with complete, balanced nutrition. Remember that each
baby feeds according to his/her own needs and schedule. If your baby appears
satisfied after a feed, is alert, developing normally, and is growing steadily, you need
not to worry.
Minor problems
Cramps, colic, constipation and abdominal distension are usually minor feeding
problems, although they can cause discomfort for the baby.
Thankfully, in most cases, these problems are short term and indicative of the fact that
the baby’s systems still adapting to the new experience of feeding. There are
formulas on the market that combine easily digestive proteins and a specially
developed fat blend, which are suitable for the temporary immaturity of the baby’s
digestive system.
Allergies and Intolerance
In case where a normal, healthy, bottle-fed baby fails to thrive or develops digestive
upsets, it is possible that allergy or food intolerance is the cause. Food intolerance
and allergies are complex and distressing problems for parents of young babies. True
food allergies are fairly rare, with between 3% and 8% of children allergic to various
foodstuffs. However, a relatively significant proportion of childhood feeding
problems are caused by food intolerance. Fortunately, many children outgrow food
intolerance and allergies by their fifth or sixth year.
Food Intolerance or Food Allergy
Food allergy and food intolerance are easily confused.
A food allergy occurs when the body’s immune system mounts an allergic
response (reaction) against a specific foodstuff. This may trigger a range of
symptoms that can affect the skin (itchy rash), respiratory tract (cough and
wheeze), heart and circulation (low blood pressure/shock) and digestive
system (cramps and diarrhoea). The characteristic feature of food allergy is
the involvement of many body systems, not just the digestive system.
Food Intolerance, on the other hand, is an abnormal response to foods or food
additives, which is not caused by an immune reaction, but is due to an inability
to digest the food. Typically, it is limited to the digestive symptoms including
cramps, bloating, diarrhoea and foul-smelling stools.
If your child is allergic to cows’ milk, it may be appropriate to switch to a soy-based
infant feed, which has a lower incidence of allergic reaction.
Alternatively, switch to formula based on extensively hydrolysed proteins, which are
suitable for both milk, and soy protein allergy.
Milk and formula allergy and intolerance can be confusing because some of the
symptoms – such as abdominal cramps and diarrhoea – are similar.
Before you change your baby’s diet, it is important that you confirm that any
symptoms are indeed signs of allergy or intolerance. Simply withdrawing foods from
your baby’s diet without medical advice could deprive him of essential nutrients
unnecessarily. It is also important test for any other allergies in a child with allergies
tendencies.
Lactose Intolerance
Lactose is found in cow’s milk products. Lactose Intolerance develops where there is
a deficiency of a small intensive enzyme called lactase, which breaks down lactose
into simple sugars, which can be absorbed.
However, if too little lactase is present, the body cannot properly absorb the lactose,
which then goes on to ferment in the bowel. This causes gas, abdominal cramps and
diarrhoea.
Lactose intolerance may be present at birth or develop late in infancy, when cows’
milk is introduced into the diet. In some cases, children who have suffered from vital
or bacterial gastroenteritis (“gastro”) may develop temporary lactose intolerance
because of damage to the cells of the intestines.
Special Cases
Certain special circumstances may require a modified approach to feeding.
Amongst these reflux and low birth weight are particularly important.
Reflux
Gastro-oesophageal reflux is a condition where the valve between the food pipe
(oesophagus) and the stomach, which normally prevents the stomach contents from
travelling back up to the throat, is immature. This causes the baby to vomit small
amounts of milk from time to time.
Many babies bring up a small amount of milk after a feed. As long as the baby is
growing normally and is otherwise healthy, this is not a cause for concern. If reflux is
problematic, try giving smaller feeds more frequently, hold the baby upright during
and after feeds, or put him on his stomach or side after feeding, with the head-end of
the cot elevated (place blocks under the legs of the crib, instead of using a pillow). If
your baby vomits very large amounts of milk after a feed more than five times a day,
your doctor might recommend a thickened formula. In the case of breast fed babies,
provided weight gain is good, no treatment is usually necessary.
Most babies improve as they are weaned onto solid foods.
Low Birth Weight Babies
Babies born prematurely (too early), and those whose weight-for-age is low, have
special nutritional needs.
Underweight for age: An underweight-for-age baby usually has a mature
sucking reflex and a digestive system capable of absorbing nutrients, so the
main feeding challenge is to help the baby gain weight rapidly. Breast milk is
still best for these babies, but they should be encouraged to drink as much as
they want. A high-energy formula with a higher fat ratio than usual may be
needed to help the baby build up fat stores to assist it with body temperature
regulation
Prematurity: in contrast, premature babies have an immature sucking-
swallowing reflex, and the digestive system is often not mature enough to
process and digest proteins efficiently. A premature baby may, therefore need
specialised formula and feeding techniques.
For example, expressed breast milk, supplemented with additional calcium,
phosphorous, other minerals and fats nay be appropriate.
Breastfeeding premature babies takes considerable patience, as these babies tend to
suck weakly, choke, and fall asleep during feeds.
It is important to ensure that the baby takes as much milk as possible from one breast
before being switched to the other breast, because the hind-milk (that comes at the end
of a feed) is richer in essential fat and calories than the milk that flows first.
Successful Feeding Tips
If your baby is a fussy feeder, and your doctor has found no physical causes for
feeding problems, try the following tips:
Feed before the baby starts screaming for food. His crying could cause him to
swallow air, causing discomfort and reducing the amount of milk he is able to
drink.
If your baby is too fretful to start feeding immediately, soothe him first.
Avoid using strong perfume on your neck or chest, which may put baby off
feeding.
Check that your breasts are not too engorged to allow baby to latch on
successfully. If he has trouble ‘getting a grip’ on your nipple, try expressing a
little milk before a feed.
Stop feeding every few minutes to wind (burp) your baby.
Hold baby in semi-upright position during feeding, and keep him upright for
some time, up to 30 minutes if necessary, after a feed.
Keeping baby upright should help him to eliminate wind and keep his feed
down.
If you are bottle-feeding your baby, try offering a variety of teats until you
find one he is happy with.
Make feeding time soothing and relaxed. Avoid distractions and to maintain
skin-skin and eye contact during every feed.
When to Call a Doctor
Consult a doctor about the following symptoms:
Forceful or repeated vomiting.
Green or black vomit.]
Your baby loses interest in feeding, and misses two or three feeds in a row.
Your baby fails to gain weight or actually loses weight.
Your baby appears to be dehydrated (dry skin, dry mouth, sunken eyes).
Your baby’s stool smell foul, or contain mucous or blood.
Your baby cries inconsolably.
Your baby appears to have abdominal pain.
Your baby seems constantly hungry.
Your baby develops skin rashes or other allergic symptoms
Your baby develops severe diarrhoea
Your baby does not gain weight or actually loses weight
Your baby has a lot of wind.
Get your baby to an emergency ward at once if he has difficulty breathing, or
develops swelling in or around the mouth.
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