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8f63Hot Milk April 2012

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					                                      Hot Milk – April 2012


In this edition of Hot Milk
Leaflets for parents’                                                        page1
Documents for those that work with parents                               pages 1&2
Infant Formula Explained DVD                                                page 2
List of UK Infant Formula                                                pages 2-7

Information on formula feeding special
We last produced a “formula feeding special” Hot Milk in November 2009 and decided it was time
to do a 2nd version. For those of you who wish to go back through old issues of Hot Milk (which
can be found on the NHS Intranets), there is this useful A-Z produced earlier this year;



IFIT A-Z listing , up
 to January 2012


Since 2009 a number of very useful leaflets and documents, about using infant formula have been
produced, which we have highlighted as they have become available;

Leaflets for Parents

 UNICEF Guide to
    Formula



 DH Step by Step
 formula feeding



 DH_Bottlefeeding
     leaflet


None of these are currently available to order, but we have plans, locally, to distribute the UNICEF
leaflet “ A guide to infant formula for parents who are bottle feeding” and the Department of Health
“Step by Step Guide to preparing a powdered formula feed”.

Documents for those that work with parents
UNICEF UK has produced a useful health professional guide to the parents leaflet “A guide to
infant formula for parents who are bottle feeding”. Additionally there is the longer document from
the Caroline Walker Trust on “Infant Milks in the UK”, and then a shorter article by NCT (National
Childbirth Trust);

Report from the Infant Feeding Information Team, Blackpool and North Lancashire: April 2012
For further information contact infant.feeding@northlancs.nhs.uk
                                                Page 1 of 7
Documents for those that work with parents (contd)


  UNICEF Guide on
  Formula for HPs




Infant Milks in the UK
     2011 CWT.



   NCTChoosing a
      formula



Plus these locally produced guidelines for formula fed babies with suspected intolerances, which
are available on the Intranets of NHS Blackpool and NHS North Lancashire.


  NHS-BNLClin002
Guide for formula fed babies with suspected intolerances.pdf

They are now going through the ratification process for Blackpool Teaching Hospitals NHS
Foundation Trust


Infant Formula Explained DVD
Thus DVD been produced to help those of you who work with parents, who are formula feeding
their babies; to answer commonly asked questions such as “Which is the best infant formula on
the market?” Which is closest to breastmilk?” “How do you reconstitute it properly?” This link
shows you some clips from the film;
http://www.babyfeedinglawgroup.org.uk/babyfeeding/infantformulaexplained
If you wish to see the whole film, contact us at contact infant.feeding@northlancs.nhs.uk and we
can organise for you to see it. We are working to put this on the NHS Intranets to make it more
accessible.




Report from the Infant Feeding Information Team, Blackpool and North Lancashire: April 2012
For further information contact infant.feeding@northlancs.nhs.uk
                                                Page 2 of 7
List of UK Infant Formula
Taken from the Hot Milks in January and March this year. They are listed in alphabetical order by
brand.

Aptamil infant milks (owned by Danone)

     Aptamil 1 First infant milk from birth (blue shape and “1” on tub) Whey: Casein ratio 60:40

     Aptamil 2 Hungry infant milk (pink shape and “2” on tub) . Whey: casein ratio 20:80. There is
      no evidence that babies settle better or sleep longer if given these milks. At least one study
      showed no difference between casein and whey dominant formulas in terms of settled
      behaviour and sleep. They are not CURRENTLY recommended in the UK for young babies
      although the can states that they are suitable from birth

     Aptamil 3 Follow On milk (green shape and “3” on tub) it is not necessary and may be
      disadvantageous to move babies on to these milks after 6 months of age. Whey: Casein
      ratio 50:50.

     Aptamil Growing Up milk 1+yr (yellow shape and “1+yr” on tub) . There is no evidence to
      suggest this cow’s milk product is superior to regular full cream cow's milk for babies over
      one year of age, as part of a healthy diet. Too much formula at this age can mean children
      do not progress to a balanced diet of a wide variety of foods.

     Aptamil Growing Up milk 2+yr (amber shape and 2+yr” on tub). There is no evidence to
      suggest this cow’s milk product is superior to regular full cream cow's milk for babies over
      one year of age, as part of a healthy diet. Too much formula at this age can mean children
      do not progress to a balanced diet of a wide variety of foods.

     Aptamil Comfort baby milk,(blue lid, white on container) , this a partially hydrolysed protein
      formula. IFIT have asked to see any independent evidence to support the inference that this
      milk is less problematic for babies with colic and constipation than regular formula

     Aptamil Pepti 1 baby milk from birth(mid-purple shape and ‘1’ on tub) an extensively
      hydrolysed whey based formula. See local guidelines for diagnosis and management of
      cows’ milk protein allergy before using.

     Aptamil Pepti 2 baby milk from 6 months, (grey shape and “2” on tub) an extensively
      hydrolysed whey based formula. See local guidelines for diagnosis and management of
      cows’ milk protein allergy before using.

     Aptamil Preterm milk (used only in hospital – ready to use bottles with green shape on
      them)


Report from the Infant Feeding Information Team, Blackpool and North Lancashire: April 2012
For further information contact infant.feeding@northlancs.nhs.uk
                                                Page 3 of 7
Cow & Gate infant milks (owned by Danone)

     Cow & Gate 1 First infant milk from birth(red & green tub) Whey: Casein ratio 60:40

     Cow & Gate 2 Hungry infant milk (red & blue tub). Whey: casein ratio 20:80. There is no
      evidence that babies settle better or sleep longer if given these milks. At least one study
      showed no difference between casein and whey dominant formulas in terms of settled
      behaviour and sleep. They are not CURRENTLY recommended in the UK for young babies
      although the can states that they are suitable from birth

     Cow & Gate 3 Follow On milk (red & purple tub) It is not necessary and may be
      disadvantageous to move babies on to these milks after 6 months of age. Whey: Casein
      ratio 20:80.

     Cow & Gate Growing Up milk 1-2 years(red & white tub). There is no evidence to suggest
      this cow’s milk product is superior to regular full cream cow's milk for babies over one year of
      age, as part of a healthy diet. Too much formula at this age can mean children do not
      progress to a balanced diet of a wide variety of foods.

     Cow & Gate Growing Up milk 2-3 years(red & white tub). There is no evidence to suggest
      this cow’s milk product is superior to regular full cream cow's milk for babies over one year of
      age, as part of a healthy diet. Too much formula at this age can mean children do not
      progress to a balanced diet of a wide variety of foods.

     Cow & Gate Comfort baby milk, (red & yellow tub) this a partially hydrolysed protein formula.
      IFIT has asked to see any independent evidence to support the inference that this milk is
      less problematic for babies with colic and constipation than regular formula.

     Cow & Gate Pepti-Junior (white lid, pink, white & blue tub) see local guidelines for diagnosis
      and management of lactose intolerance or cows’ milk protein allergy before using.

     Cow & Gate Infasoy, is a soya based milk (red & orange tub)* note CMO concerns on this
      milk- should only be used in exceptional circumstances and only under the recommendation
      of a doctor

     Cow & Gate Nutriprem 1 (used only in hospital – ready to use bottles with purple writing)
      preterm and low birth weight formula

     Cow & Gate Nutriprem 2 Catch-up formula for Preterm and low birth weight infants Note
      IFIT are currently investigating the evidence for this milk as there is a Cochrane review that
      comments on this.




Report from the Infant Feeding Information Team, Blackpool and North Lancashire: April 2012
For further information contact infant.feeding@northlancs.nhs.uk
                                                Page 4 of 7
HiPP infant milks

     HiPP Organic First milk from birth Whey: Casein ratio 60:40

     HiPP Organic Hungry infant milk. Whey: casein ratio 20:80. There is no evidence that babies
      settle better or sleep longer if given these milks. At least one study showed no difference
      between casein and whey dominant formulas in terms of settled behaviour and sleep. They
      are not CURRENTLY recommended in the UK for young babies although the can states that
      they are suitable from birth

     HiPP Organic Follow On milk Whey: Casein ratio 60:40. It is not necessary and may be
      disadvantageous to move babies on to these milks after 6 months of age.

     HiPP Organic Good night milk Whey: casein ratio 20:80.. This has a similar nutritional
      composition to HiPP Organic Follow-on Milk. The addition of organic corn starch, rice flakes
      and buckwheat flakes results in increased viscosity and the carbohydrate content is 35%
      starch. This product is also gluten-free.

      The Scientific Advisory Committee on Nutrition (SACN) published a statement on the risks
      associated with the use of goodnight milk products. Since the publication of the report, the
      formulation of Hipp Organic Good Night Milk has changed. HiPP Organic used to promote
      the product as being a suitable replacement for a light evening meal. SACN did not agree
      with HiPP Organic that the product was suitable for this purpose.

       SACN also stated that there is no published scientific evidence that they offer any
      advantage over infant or follow-on formula in settling babies at night.

      “Good Night milks” might encourage poor dental hygiene, as parents might be tempted to
      put their babies to bed immediately after bottle feeding. This could result in the development
      of nursing bottle caries. Parents are advised to clean the baby’s teeth after the last feed,
      which rather undermines the idea of using this milk to “settle” babies at night.

       HiPP Organic Good Night Milk is considerably more expensive than their standard follow-on
      formula.

      HiPP Organic Growing Up milk . Whey: casein ratio 20:80. There is no evidence to suggest
      this cow’s milk product is superior to regular full cream cow's milk for babies over one year of
      age, as part of a healthy diet. Too much formula at this age can mean children do not
      progress to a balanced diet of a wide variety of foods.




Report from the Infant Feeding Information Team, Blackpool and North Lancashire: April 2012
For further information contact infant.feeding@northlancs.nhs.uk
                                                Page 5 of 7
Mead Johnson infant milks

     Pregestimil LIPIL (green header on tin) hypoallergenic formula for babies with poor fat
      absorption or diagnosed cow’s milk protein intolerance See local guidelines for diagnosis
      and management of cows’ milk protein allergy before using.

     Nutramigen LIPIL 1, from birth (red header and “1” on tin) Hypoallergenic lactose-free
      formula for babies with cow’s milk protein intolerance or allergy. Extensively hydrolysed.See
      local guidelines for diagnosis of cows’ milk protein allergy and lactose intolerance before
      using.

     Nutramigen LIPIL 2, from 6 months (red header and “2” on tin) Hypoallergenic lactose-free
      formula for babies with cow’s milk protein intolerance or allergy aged over 6 months.
      Extensively hydrolysed.See local guidelines for diagnosis and management of cows’ milk
      protein allergy and lactose intolerance before using. There is no evidence that it is
      necessary to move babies on to this product.
     Nutramigen AA, Hypoallergenic Amino Acid Based Formula (white tin)
      For the dietary management of severe cow’s milk allergy or multiple food allergies.

     Enfamil A.R.(blue banner on tin) Designed for reflux and posseting – contains rice starch as
      a thickener. When using this product the instructions state that cooled water should be used
      to mix the powder – this is therefore not able to kill any pathogens in the powdered product,
      as per the recommendation on reconstitution of powdered infant feeds.
      IFIT have yet to see any substantive evidence to support the claims made that this milk is
      helpful for babies with reflux or posseting.

     Enfamil O-Lac (orange banner on tin)Lactose-free cows’ milk-based milk designed for babies
      with temporary lactose intolerance.See local guidelines for diagnosis and management of
      lactose intolerance before using.




Report from the Infant Feeding Information Team, Blackpool and North Lancashire: April 2012
For further information contact infant.feeding@northlancs.nhs.uk
                                                Page 6 of 7
SMA infant milks (owned by Pfizer)

     SMA 1 First Infant Milk, from birth (yellow lid) Whey:Casein ratio 65:35

     SMA Extra Hungry Baby Milk from 6 months(blue lid) . Whey:casein ration 20:80 There is
      no evidence that babies settle better or sleep longer if given these milks. At least one study
      showed no difference between casein and whey dominant formulas in terms of settled
      behaviour and sleep. They are not CURRENTLY recommended in the UK for young babies
      although the can states that they are suitable from birth

     SMA 2 (“follow on milk”) from 6 months. (Red lid). It is not necessary and may be
      disadvantageous to move babies on to these milks after 6 months of age. Whey: Casein
      ratio 60:40.

     SMA 3 Toddler milk from 1 year(green lid). ). There is no evidence to suggest this cow’s milk
      product is superior to regular full cream cow's milk for babies over one year of age, as part of
      a healthy diet. Too much formula at this age can mean children do not progress to a
      balanced diet of a wide variety of foods.

     SMA Staydown, from birth for babies with significant reflux. (Purple lid).See “Hot Milk”s May
      2011, June 2011 and July/August 2011 for reports on this, IFIT did not see any evidence to
      support the clams made for this milk. Reflux is a symptom, and its cause needs to be
      identified before arbitrary changes of infant diet.

     SMA Wysoy is a soya based milk (lime green lid) * note CMO concerns on this milk- should
      only be used in exceptional circumstances and only under the recommendation of a doctor

     SMA LF (Lactose Free formula) from birth onwards (turquoise green lid, smaller tin). See
      local guidelines for diagnosis and management of lactose intolerance before using

     SMA High Energy (from birth to 18 months) (orange-topped UHT Tetrapacks) for infants and
      young children with medically identified increased energy and nutrient requirements, such as
      faltering growth.Note IFIT have not scrutinized information relating to this milk, yet. On first
      principles it would seem important to diagnose the cause of any failure to thrive before
      adding to the metabolic load of possibly compromised infants with perhaps genetically-
      limited capacity to tolerate or process animal proteins and non-human fats. Thus the use of
      any more-concentrated formula would ideally follow rather than precede diagnosis

     SMA Gold Prem 1preterm and low birth weight formula (use in hospital -ready to use bottles)

     SMA Gold Prem 2 Catch-up formula for Preterm and low birth weight infants(pink lid) Note
      IFIT are currently investigating the evidence for this milk as there is a Cochrane review that
      comments on this.

Report from the Infant Feeding Information Team, Blackpool and North Lancashire: April 2012
For further information contact infant.feeding@northlancs.nhs.uk
                                                Page 7 of 7

				
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