The feeding regimen of a newborn on artificial feeding

Every mom knows that the best way to give a newborn baby all the necessary and vital nutrients, vitamins and minerals is to breastfeed him for the first six months of his life. But sometimes natural feeding of the baby for various reasons is impossible. And then the baby needs to be transferred to artificial feeding with special mixtures.

We will analyze what mixtures are, and how they differ from each other, we will determine the correct feeding regimen for a newborn on artificial feeding and the rules of feeding.

Why is breastfeeding not available?

To begin with, we will analyze the reasons why a newborn child must be fully or partially transferred to artificial feeding.

There are several of them:

• Difficult childbirth, accompanied by complications, after which the mother needs a long period to restore her strength.
• Mom needs to take medications to restore her health or keep it normal.
• Some infectious diseases of the mother.
• Lack of breast milk production or its complete absence. In this case, you should first try to restore lactation, resorting to the doctor's recommendations. If this does not work, then transfer the baby to formula feeding.
• A long absence of the mother, when there is no possibility of feeding with expressed breast milk.

Please note that artificial feeding of a newborn is a necessary measure. Moms should not resort to it only for their own convenience or for fear of losing their external attractiveness. These false motives for refusing breastfeeding can have a very negative effect on the baby.

To choose the right mixture, you need to focus on the age of the baby, the characteristics of his body, the presence of allergic reactions.

Formulas for artificial feeding are divided according to their composition and consistency.

In composition, they can be:

• highly adapted - as similar as possible in composition to mother's breast milk. This is achieved through the use of a special whey.
• mixtures with less adaptation. They are made from the milk protein casein. This is the most common type of baby food.
• follow-on formulas that are used for feeding babies aged 6 months and older.
• hypoallergenic. Such nutrition is necessary for babies who have severe allergic reactions, and simply replacing one mixture with another does not lead to a result.
• specialized. They are used only as prescribed by a doctor and contain supplements from various useful vitamins or trace elements necessary for the full development of the child and solving a specific problem.
• sour milk. Such mixtures are used for problems in a child with a gastrointestinal tract, but cannot serve as a constant source of nutrition, only as an auxiliary measure.

According to their consistency, infant formulas are divided into dry, liquid and liquid concentrated.

How much?

The norm of feeding a newborn on artificial feeding is somewhat different from the norm of breastfeeding. This is due to the difference in composition and different nutritional levels.

In general, the standard norms for formula feeding for healthy children are as follows:

• from 1 to 10 birthdays - the daily rate of the mixture used is calculated by the formula: 70-80 ml is multiplied by the number of days lived by the child;
• from 10 days to 2 months - the daily rate is 1/5 of the child's weight;
• 2-4 months - the daily rate is 1/6 of the child's weight;
• 4-6 months - 1/7 of the child's weight;
• from 6 months to a year - the daily rate is 1/9 of the weight.

Once again, we will make a reservation, these are standard norms for healthy children. If there are any deviations in the health or development of the baby, then you should contact your pediatrician for special nutritional recommendations.

…and how often?

Also, mothers whose babies are bottle-fed are interested in the schedule of feeding the newborn.

In fact, it does not differ much from the breastfeeding schedule.

Many mothers prefer to breastfeed their baby on demand. If in the case of breastfeeding this can make some sense, then with artificial feeding it is better not to get involved in such a practice. Infant formula is more nutritious than human breast milk due to its higher protein content and therefore takes longer to digest. And if the baby is fed too often, then he may develop excess weight and develop obesity.

The optimal interval between feeding a newborn should be 3 - 3.5 hours. This time is usually enough for the stomach to fully digest the mixture, and the child is ready for the next meal.

Now let's look at how to properly prepare a mixture for feeding newborns.

If you prefer a dry mix, then it can be diluted directly in the bottle in the ratio with water and the amount indicated on the package. Be sure to stick to the prescribed dosage. If you put a smaller amount of formula, then the baby may not eat enough. If, on the contrary, shift, then an increased amount of nutrients and trace elements can adversely affect the process of digestion of food, which will lead to stomach cramps.

Before diluting the mixture, bottles, nipples and caps must be sterilized. To dilute the mixture, boiled water is used, if it is from the tap, or special children's water. Its temperature during breeding should be 60-70 degrees, then the finished mixture is cooled to 36-37 degrees. Before giving it to your baby, put some of the mixture on your wrist to make sure it's at an acceptable temperature.

As for liquid nutritional mixtures, they are simply poured into a bottle, heated to the desired temperature and given to the baby. Concentrated liquid mixtures are diluted with water to the desired consistency. The main thing is to hold the bottle correctly when feeding a newborn so that he does not catch air.

In order for your baby to be full and satisfied, you need to follow a few more recommendations that must be followed when artificially feeding:

• If the baby has not finished the mixture, you can not leave the leftovers, and then add a new portion to them. Always discard leftovers, and the mixture should always be freshly prepared. This will help to avoid poisoning and disorders of the gastrointestinal tract of the child.
• Change bottle nipples regularly. They tend to become thinner over time, the hole increases, and the mixture flows in a thin stream. This makes it easier for the baby to suckle, he can become lazy, and is not very useful for digestion.
• Make sure the bottle nipple is always filled with formula. This will prevent the baby from swallowing air during feeding and relieve him of colic and gas formation.

Health to you and your children!

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Artificial feeding of newborns

Feeding a baby from the first days of life with breast milk is an ideal option for both mother and child. Well, if it so happened that your baby is on artificial feeding. then you need to take seriously the issue of compliance with the rules of artificial feeding of a newborn.

Indications for artificial feeding of newborns

There are circumstances in which it is impossible to breastfeed newborns partially or completely. Then the baby is supplemented or even transferred to artificial feeding. This happens in cases where, for example, the mother had a difficult pregnancy and childbirth, requiring restoration of strength and taking medications; hypogalactia (insufficient formation of milk, which is confirmed by the control weighing of the child). Or the mother is forced to work, and there is not enough expressed and frozen milk.

Before you completely transfer the baby to artificial feeding, you need to carefully weigh the pros and cons. Be sure to consult a pediatrician, neonatologist, breastfeeding specialist. Even just a little breast milk will benefit the baby.

How to choose formula for artificial feeding of newborns

Before buying any formula for artificial feeding, first of all, pay attention to its date of manufacture. What specifically is better to choose a mixture for artificial feeding - the pediatrician will tell you, taking into account all the features of the development of the child, including indicators of his body weight. If the mixture is suitable for the baby, he will eat it with pleasure, but if not, turn away, spit it out and spit up a lot, cry - this means that the mixture needs to be changed. Again, after consultation with a pediatrician.

However, even if the baby eats the artificial feeding formula well, the formula for artificial feeding should be changed in such situations:

• allergic reaction to formula for artificial feeding
• the baby has grown up (each formula for artificial feeding is designed for a certain age)
• in case of illness, when special therapeutic mixtures for artificial feeding are introduced into the baby's diet (only as prescribed by a doctor)
• after recovery and a course of therapeutic mixtures, the baby is again transferred to his usual mixture for artificial feeding.

How much formula is needed for artificial feeding of newborns?

The diet when feeding newborns with a mixture for artificial feeding remains free, as with breastfeeding. And the amount of formula for artificial feeding largely depends on the body weight of the child, on how fast he grows, on his metabolism and, of course, appetite. It must be remembered that the amount of food that is used for one feeding is not always the same throughout the day: sometimes more, sometimes less than the norm recommended by the doctor (the child may not be hungry or tired, did not get enough sleep, and therefore does not want to eat ).

Estimated daily intake of formula for formula feeding for a child under 12 months of age (if the baby's body weight is within the average age norm)

The daily volume of the mixture for artificial feeding, ml.

Rules for mixed feeding of a newborn

Mixed feeding of a newborn is such feeding in which the baby is given both breast milk and artificial mixtures. It is very important to observe the necessary proportions. The volume of breast milk should be at least 1/5 of the daily amount of food consumed by the baby.

Artificial mixtures should be given only those prescribed by a doctor. At the same time, he must examine the newborn and study the features of his body. To assign a mixed diet to a baby, one cannot do without consulting a specialist.

Reasons for mixed breastfeeding

1. Hypogalactia is a severe lack of milk in a nursing mother. Such a decrease in the functions of the mammary glands is observed in 5-10% of women. The reason for this may be severe late toxicosis, bleeding in late pregnancy, postpartum trauma or obstetric negligence, during which dangerous infections could be introduced into the mother's body.
2. Social conditions - when a young mother is simply not able to be near her baby for 24 hours. This is due to many factors: study, work, or just she is a single mother and is forced to work to the detriment of the child.
3. Severe illness of the mother - requiring immediate hospitalization and treatment for a long time. These can be cardiovascular diseases, diseases of internal organs and respiratory systems.
4. The presence of inadequate breast milk in a nursing mother. The chemical composition of milk does not meet the required standards. It is too liquid and non-greasy. In this case, the pediatrician transfers the newborn to mixed feeding in order to provide the growing body of the baby with all the trace elements and vitamins it needs. If this is not done on time and the baby is left breastfed, he will experience the following diseases: malnutrition and anemia.

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Feeding a newborn mixed: basic rules

It is necessary to start feeding with breast milk.

This is due to the fact that it is more nutritious and will most satisfy the baby's need for food. In addition, at the beginning of the diet, the newborn has an active appetite and he suckles his mother's breasts with pleasure. If you immediately offer him an artificial mixture from a bottle, then, having had enough of it, he will not want to suck breast milk, because this is much more difficult to do. As a result, milk can simply burn out if it is not expressed in time. It is necessary to breastfeed a newborn until it is completely empty, and then proceed to supplementing the baby with an artificial mixture.

In the case when there are social problems or the mother is forced to be treated, the baby can be offered artificial nutrition twice a day, but no more, and then supplemented with expressed breast milk or milk from the children's kitchen.

It is better to supplement the child with a spoon (if the volume of the mixture is not too large), because the intake of the mixture from the bottle facilitates, on the one hand, the process of feeding the newborn, but on the other hand, it can completely atrophy in him the instinct to suck on the mother's breast. If the volume of supplementary feeding is too large, then you can’t do without a bottle. Try to get an elastic nipple with a small hole so that the child could not distinguish it from the mother's breast and also ate the mixture offered to him with appetite.

As for the feeding regime, then everything is also very individual. Depending on how well your newborn baby is gaining weight, the amount of food may be increased or decreased. It is better to find out after consulting with a specialist who will competently prescribe the amount of food for your baby, as well as write out a detailed schedule in which you will feed. Strictly follow the recommendations of the doctor, if he says which of the two types of food should be reduced and which should be increased. Ultimately, the health of the newborn depends on it.

Remember to sterilize all baby feeding supplies. Teats and bottles must be perfectly clean so that no infection or bacteria can enter the baby's body through them.

The temperature of the finished mixture should not exceed 37-38 degrees. To do this, before offering the baby his food, try it on your wrist.

Complementary foods with mixed feeding are introduced into the baby's diet 2-3 weeks earlier than with natural feeding.

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How to calculate the daily requirement of the baby in the main ingredients

To calculate the needs of the baby in food ingredients, it is necessary to take into account his age and weight. It is also important to know exactly what kind of feeding the food is close to, natural or artificial.

The type of mix also matters. Depending on the recommendation of the doctor, both adapted and non-adapted mixtures may be prescribed.

Mixed feeding of newborns and the correct calculation of nutritional ingredients is the key to the health of your child.

A more detailed calculation should be clarified with a doctor.

Artificial feeding of a newborn baby

There is nothing better for a newborn baby than breast milk. After all, with him the child receives not only useful substances, but also maternal immunity. But, unfortunately, it often happens that for some reason, the mother cannot give him this. Complications after childbirth requiring treatment with drugs dangerous for the child, a decrease in lactation as a result of postpartum depression. hypogalactia (insufficient milk production) and other factors can make it impossible to breastfeed. Many mothers who are faced with such a problem are having a hard time psychologically. But don't despair so much. Nowadays, there is such a variety of baby food that every mother can choose the most suitable for her baby in all its parameters. So, artificial feeding is the topic of this article.

How to switch to artificial feeding?

First, let's figure out how to switch to mixtures. If the baby began to feed on artificial formula immediately after birth, he quickly gets used to it. Even in the hospital, a neonatologist or a consultant on breastfeeding newborns will select the mixture that is most suitable for the crumbs. The situation is more complicated if, from the first days after childbirth, the mother fed the baby with breast milk, but it so happened that she was forced to transfer him to artificial feeding. It is more difficult because many children who switched to mixtures begin to have some problems - refusal of food, allergic manifestations. constipation. By the way, constipation with artificial feeding is a frequent "side effect" of the transition to artificial nutrition. Therefore, it is important for the mother not only to choose the mixture for the baby, but also to know how to feed the baby with it.

Rules for artificial feeding

It is good if the transition to artificial feeding of the child is gradual, i.e. over a period of two weeks or more. At first it will be possible to give one serving of the mixture a day, then, after a few days, two, etc. This will make it easier for your baby to get used to the new food. It happens that the child refuses the bottle. In such cases, a gradual transition would also be more appropriate. But if you need to wean from the breast immediately, then nothing can be done - you will have to make a sharp transition to artificial feeding. And this is already more difficult, because the child may not immediately adapt to the innovation. What should mom do in this case?

• Choose the most suitable mixture (with a doctor).
  Breed it according to the instructions. You can not put the powder more or less than indicated on the package.
  Warm the formula water to the same temperature as breast milk.
  Feed the baby on demand.
  For short-term constipation, give the baby dill water. For prolonged periods, contact your pediatrician.
  If you are allergic to the mixture, immediately change it.
  If you notice any side effects, contact your doctor immediately.

I would like to note that it is better to learn how to transfer a baby to artificial feeding at a consultation with a pediatrician or a breastfeeding specialist. When choosing food for a child, one should be guided not only by knowledge of the proper composition of the product or its manufacturer, but also by the individual characteristics of the baby. Therefore, a doctor who knows these features better than a mother will find it easier to choose the most suitable mixture for the baby.

How to choose a mixture?

Most formulas on the baby food market today are made from cow's milk. It is processed in a special way so as to reduce the risk of allergic reactions in the child. The composition of mixtures for newborns is adapted, making it similar to breast milk. Now mixed or artificial feeding of children up to a year with mixtures is possible due to their diversity in composition. There are two main types of mixtures:

• - maximally adapted with the content of easily digestible whey protein, which are suitable for children from birth,
  - partially adapted, containing casein (complex milk protein), intended for children over 6 months old.

You can also distinguish between mixtures by the numbers on the package. The number "1" means that the mixture is as adapted as possible, and it can be given to a child from birth. The number "2" indicates that this mixture is for children from six months.

In order to find the ideal mixture for the baby, you may have to change it more than once. But it won't be endless, as it might seem at first. Indeed, from the age of three months, the digestion of children becomes better, they absorb food well. However, sometimes problems such as constipation in newborns remain for a long time. Here, the mother will have to help the child cope with it.

How much mixture to give newborns?

Most importantly, you need to remember that artificial feeding of a newborn from breastfeeding does not differ in feeding time. That is, artificial animals must also be fed on demand. Now about the amount of the prepared mixture for one feeding. Each package of baby food has feeding instructions. However, for any indication, the doctor may prescribe his dosage.

In any case, every mother needs to know that a newborn child from the moment of birth to 10 days usually eats an amount of milk per day equal to 70 ml × the number of days of life. From 10 days to 2 months - 1/5 of body weight, from 2 to 4 months - 1/6, from 4 to 6 months - 1/6, from 6 months to a year - 1/8. If, for example, a baby is 3 months old and his weight is 6000 g, then his daily diet will be 1/6 of his body weight, i.e. 1000 ml. And since mommy visits the pediatrician every month and knows the weight of the child, it will be easy for her to calculate the doses of nutrition.

If you strictly follow the instructions and prescriptions of the doctor, then formula feeding will actually not seem such a problem. And the mother should not despair that she cannot give her milk to the child. After all, the baby does not really understand what he eats now, the main thing for him is that his mother is nearby.

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• Quantity
• Schedule
• Cooking process
• Feeding process
• Rules

If it so happened that the baby became an artificial and was for some reason deprived of breast milk, parents should take this with all responsibility. First, you need to familiarize yourself with the approximate daily amount of food needed by children. different ages. Secondly, you will have to focus on a specific meal schedule by the hour. Thirdly, there are rules on how to feed a newborn with a mixture: they must be followed and try not to deviate from them.

All this will help the baby quickly adapt to the new surrounding world, develop normally and grow energetic and healthy.

Quantity

If it turned out that the newborn needs to be fed with a mixture, first you need to choose it correctly. Modern market baby food offers a wide variety of options: highly or partially adapted, dairy and dairy-free, anti-reflux and gluten-free, liquid and dry. After studying the ratings and reviews (reviews, types and ratings the best mixes for newborns you will find in our article), after consulting with a pediatrician, parents select one of the most optimal options.

After the desired powder (or emulsion) is purchased, one of the main tasks is not to overfeed the child, or vice versa - not to leave him hungry. And here the table "Daily norms of the mixture" is of great help.

Since the table contains several parameters, we will consider each of them in more detail.

• Age

Despite the fact that our task is to feed the formula to the newborn (who, by definition, should be from 0 to 1 month old), the table shows data for a later age. So parents will be able to compare indicators and focus on them in the future, as the crumbs grow older.

• The amount of the mixture for 1 feeding

These indicators have a fairly wide range of range, as can be seen from the numbers in the first line. So how much to give the mixture? 20 ml or 60? This indicator will depend on what schedule the mother will feed the newborn. If 7 times, according to the recommendations of pediatricians, then the figure will be one. If on demand (the so-called free artificial feeding) - the number of meals will be more, and the doses will be less.

• The amount of mixture per day

There is no longer such a wide range. And if the numbers from the second column are easily adjusted depending on how often you feed the newborn with formula, then in the end you should still get the indicators from the third column - focus on them.

Although they also depend on the weight and health of the newborn. If he is premature, has some kind of pathology, he will not eat much anyway. But if a hero was born with remarkable health and heavy weight, he, accordingly, will need more mixture. But this difference is taken into account in another, more convenient, from the point of view of many parents, table.

There is various ways calculate how much formula you should feed your newborn, based on his individual indicators (in particular, weight). You can use these formulas. They will give more accurate numbers. As soon as you decide on the amount of food, you will need to draw up a feeding schedule.

Useful advice. Most often, all these tables and formulas turn out to be unnecessary for parents for one simple reason. Most artificial formulas for newborns contain detailed instructions on how much powder to dilute in what amount of water at a time. For some manufacturers, this information is contained on the box, for others - directly on the measuring bottle, which is part of the mixtures.

Schedule

Immediately decide how you will feed the newborn with a mixture - on time or on demand.

In the first case, a specific schedule will be developed that will organically fit into the daily routine. This is convenient, will allow mom to do household chores at intervals, teach the baby and his stomach to order.

On the other hand, many pediatricians say that it is much more useful to feed the baby on demand, in accordance with the natural urges of his body. However, there is a risk of overfeeding and further obesity.

This dilemma needs to be solved by parents on their own or by listening to the opinion of the local pediatrician. If the hourly schedule option is selected, the following table can be used.

This is an approximate schedule for artificial feeding of a newborn by the hour, which can be adjusted at your discretion, taking into account the daily routine and the individual characteristics of each family individually.

The age from 1 to 5 months is given for comparison and for convenience: after all, then it will be quite easy to stretch the intervals between meals if you immediately teach the child to eat on time, and not on demand. So choose a scheme and - it's time to learn how to properly prepare the mixture.

It needs to be known. To date, the World Health Organization (one of the most competent bodies in medicine and pediatrics) recommends that new parents abandon a strict hourly schedule in favor of feeding on demand of a newborn.

Cooking process

The well-being of a newborn who is bottle-fed will most directly depend on how correctly the mother prepares the mixture.

All such products are accompanied by detailed instructions, which must be carefully studied, and all of its points must be strictly followed. Among them, several common points can be distinguished.

1. To dilute the dry mixture, use bottled water, which can not be boiled to preserve all its beneficial properties.
2. Be sure to boil tap water.
3. Accurately follow the dosage indicated in the instructions for the mixture. A lot of powder and a lack of water will cause colic and dyspeptic disorders. Too little dry base and too much water is a guarantee that the newborn will be naughty and ask to eat out of time.
4. Dilute the mixture immediately in the bottle.
5. First, water is poured, preheated to 50 ° C. If its temperature is higher than this indicator, it will destroy the beneficial bacteria of the mixture.
6. After pouring the powder into the bottle, shake it well so that there are no lumps.
7. Before feeding a newborn, check the temperature of the mixture again: it should not exceed 37 ° C.
8. The width of the hole in the nipple should force the newborn to make some effort to squeeze the mixture out of the bottle.

The process of preparing the mixture is one of the main stages of feeding. The correctness of its implementation will determine how satisfied the baby will be with food, whether he will be fully saturated, as well as his health and further physical development.

As soon as you master the basics of cooking for such babies, you will have to take small “courses” to learn how to feed them properly.

Life hack. To determine the temperature of a ready-made formula for a newborn, drip a little milk liquid from the bottle onto your wrist. If the skin does not feel anything, you can feed your hero. If she feels a hot or cold touch, the food will have to be cooled or heated.

Feeding process

Very important point for all young mothers - to learn how to properly feed a newborn with a mixture, because the technique of this process is significantly different from that used for infants.

The sooner you master it, the less problems with nutrition and further development will arise. Several useful tips help to do it.

Newborn position

1. It should not lie on its back, as the mixture will flow out of the bottle on its own. Because of this, the child may choke or choke. The sucking reflex will also be formed incorrectly.
2. The head should be slightly higher than the body, on the bend of the mother's arm bent at the elbow.
3. The head and spine of the newborn should form a straight line.
4. The position of the baby during formula feeding should be the same as when breastfeeding.

Feeding technique

1. Do not allow the newborn to capture the entire nipple with his lips. Correct position: in his mouth he should have only its oblong part, but on the round one - lie lips.
2. Make sure that the oblong part of the nipple is constantly filled with the mixture. So the newborn will not swallow air, and then suffer from colic.
3. Don't rush your baby while breastfeeding. He himself knows the pace at which it is convenient for him to suck. Don't shake the bottle, don't yell at him, and try not to show your impatience yourself.
4. If the newborn refuses to eat, do not force him to eat everything to the last drop. If the dose is less than usual, take a closer look: he may not feel well. In this case, consult your pediatrician.
5. After feeding, gently pat the baby on the back - this will make him burp the air swallowed during sucking.

breaks

1. Want to learn how to properly formula feed your baby? Then you should take small breaks directly during meals.
2. The fact is that when sucking, the baby still swallows air, which creates a false feeling of fullness in him. To get rid of it, you need small stops. They allow the newborn to burp, i.e., get rid of the air, and again feel that he has not yet eaten.
3. As soon as the baby moves away from the bottle, hold it in a semi-vertical or vertical position with a column and wait for spitting up.
4. For the same purpose, you can put it with your tummy - to your shoulder, and the handles - on your back.
5. Another way to get rid of swallowed air is a light back massage, gentle pats on the pope.
6. If you put him on his knees with his tummy down - the result will be the same.
7. Practice different methods and choose the technique that will allow you to quickly achieve the desired effect.
8. At the same time, do not forget to protect your and his clothes from spitting up.
9. If you do not take a break and do not wait for spitting up, the swallowed air will provoke colic and gas.

Mom and baby bond

1. Very often, women who do not breastfeed their babies feel guilty, as it is believed that babies have a much closer emotional connection with their mothers. However, it can be adjusted with artificial people just during the feeding process.
2. While eating, gently hold the baby to you.
3. Talk to him: call him affectionate names, try to convey all your love and tenderness through your voice.
4. Stroke the newborn during feeding - this will create a close bodily contact, which is so lacking in artificial babies.
5. One of the advantages of formula feeding is the interaction of a newborn with other relatives, in particular, with dad, who can also give him formula from a bottle. However, in order to establish an emotional connection with the mother, it is she who must feed the baby during the first month of life.

This is the technique of formula feeding newborns. If you learn how to do it correctly, it will avoid many unpleasant moments, which are considered disadvantages of artificial nutrition.

Adapted food is as close as possible in composition to breast milk. Emotional connection and close bodily contact can also be achieved. So there shouldn't be any problems. A few more useful tips to top it off will dispel the last doubts.

Little nuance. During a break in the middle of formula feeding, when you help the child burp swallowed air, you should not put him on his knees with his tummy down, although this method exists and is used in practice. Yes, air will come out, but the pressure exerted in this position on the crumbs' digestive tract can cause disturbances in its work.

Rules

By following all the above tips, you can quickly learn how to properly bottle feed your newborn. If in any doubt, you can always consult your doctor or look at the list of general recommendations.

1. Do not leave a newborn alone with a bottle.
2. Periodically change the nipple - as it deforms and wears out.
3. Check the expiration date of the mixture.
4. Do not feed a child who is depressed or irritable. First you need to relax and calm down. Newborns are very sensitive to the mood of their mother. You will be tense - the baby will also be worried.
5. Do not feed the baby if he is screaming or crying so that he does not choke. Try to calm him down first.
6. Keep in mind that formula is harder and takes longer to digest in the baby's stomach than breast milk. Therefore, the intervals between feedings should be at least 3 hours.
7. The bottle and nipple are disinfected for every meal.
8. Do not leave the uneaten mixture until the next time.

All these nuances of how to feed a newborn with a formula are very important for his further development and health. If everything is done according to the recommendations of specialists, based on individual consultations of a pediatrician, no problems will arise.

You should not even worry that your baby is deprived of breast milk. Contemporary children food adapted to the developing gastrointestinal tract of a small organism and contains a large number of useful and nutrients necessary for normal development. Feed your child correctly with high-quality, carefully selected mixtures - and he will delight you with his good health and indefatigable energy.

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All young mothers are well aware that in the first months of life there is no healthier food than breast milk for a newborn baby. But sometimes a situation arises in which there is a need to transfer the child to another diet (there is no breast milk or the mother cannot breastfeed). Artificial feeding of a newborn baby requires the right approach both to the choice of formula and to following a new diet. Consultation with a pediatrician is a prerequisite before starting IV.

Indications for switching to IV

Feeding even the highest quality mixtures will not be able to make up for those microelements that the baby receives with mother's milk. Therefore, the introduction of adapted nutrition should always be justified. Pediatricians identify several circumstances when artificial feeding is considered necessary:

• Difficult childbirth, after which the mother must restore her strength;
• Reception of certain groups of vital medicines by a woman;
• Infectious diseases of the mother;
• Lack of milk in the glands of the breast or its insufficiency. The lack of milk is determined by the control weighing of the baby after feeding;
• Inability to feed the child due to temporary absence. This indication is justified when there are no conditions for storing expressed milk or the period of absence of the mother is calculated in weeks.

Insufficiency of milk production should first be restored with the help of drugs that enhance lactation. Artificial feeding of a child is started only if these drugs do not bring the expected result. It is not necessary to introduce mixtures completely at once, even a few grams of breast milk are useful for the baby's body and it is impossible to deprive him of this benefit.

Pros and cons of using artificial mixtures

Not all young mothers seriously think about what awaits them and their baby when switching to the use of infant formula. Often, just because of her convenience, a woman deprives a child of the microelements necessary for his immunity and general health. Before deciding to switch to IV with a pediatrician-recommended formula, you need to weigh all the advantages and disadvantages of a new diet. The obvious advantages of artificial feeding of a child include:

• The possibility of feeding the baby to other relatives. That is, the mother can calmly go about her business and not worry that the baby will cry from hunger;
• When feeding a baby from a bottle, the mother always knows how much he eats at a time and, if there are health problems, he immediately notices this by the amount of food left;
• The appearance of an allergy is always associated with the type of mixture. In order to determine the allergen in a breastfed child, a nursing mother has to completely revise her diet;
• Formula takes longer to digest than milk, so the number of meals your baby has to eat is reduced.

This is one of the benefits of formula feeding. but there are more cons:

• Artists are more likely to get colds and allergies in subsequent years. This fact is explained by the absence of special enzymes in their body, which the baby can only get from mother's milk;
• The use of bottles requires their constant sterility. If cleanliness is not observed, then the development of dyspeptic disorders is possible;
• Formula-fed babies often suffer from colic and periodic regurgitation - a poor-quality nipple contributes to the swallowing of air;
• When traveling with a child, you have to take a separate bag with a mixture, bottles, sterilizers, that is, extra luggage;
• Often you have to change several types of mixtures in order to find the most suitable one;
• Artificial feeding of a child also implies certain financial costs. A good mixture cannot be cheap, and as the child grows older, more and more of it is required from time to time.

The disadvantages of formula feeding are much greater than the advantages, and therefore it is worth first trying to restore hypolactation, and only then resorting to such an extreme measure.

How to choose a mixture

The selection of the mixture must be agreed with the pediatrician. The doctor knows the peculiarities of your child's health and will advise the most gentle nutrition. It is also necessary to independently show increased attention to the choice of mixtures and be sure to comply with the following criteria:

• Best before date- the most important condition for the absence of unwanted reactions. Choose those boxes where there is a margin of several months of use;
• The packaging must not be opened or deformed. The presence of dents, scratches indicates non-compliance with the conditions of transportation, and such a mixture may be damaged;
• Meals are provided according to age categories. It is impossible to give a newborn child a mixture intended for older children; an unformed stomach and intestines can react with serious diseases;
• It is necessary to accustom the baby with the introduction of hypoallergenic mixtures;
• If the child has certain health problems, then the diet may contain additives that are useful for improving the functioning of the organs. Mixtures may contain herbs to boost immunity, iron to treat anemia.

Read the detailed article: How and what mixture is better to choose

When giving a mixture to a child for the first time, be sure to look at his skin, behavior, frequency of bowel movements and the nature of the stool.

How to cook food

With artificial feeding of a child, his well-being will directly depend on how you prepare the mixture. The instruction must be read and follow its points.

• For dilution, it is best to use special bottled water, when boiling part useful substances is lost. If water is taken from the tap, then boiling it is mandatory;
• The dosage must be fully respected. Exceeding the amount of dry mixture or lack of water can lead to oversaturation of the intestines with nutrients, and this is reflected by colic, dyspeptic disorders. The lack of a dry base leads to the fact that the baby is naughty, asks for a bottle at the wrong time;
• The mixture is diluted directly in the bottle, where water is first poured with a temperature not higher than 50 degrees. Higher temperatures lead to the destruction of beneficial bacteria;
• After dilution, shake the mixture and make sure that there are no lumps. Before feeding, check the temperature - it should not be higher than 37 degrees;
• The hole in the nipple should be such that the baby makes some effort to suck. The outflow of a thin stream leads to the complete rejection of the breast and to the fact that the stomach begins to quickly stretch.

The mixture can be prepared in advance, but it should be stored in the refrigerator for no more than a day and heated in hot water.

Video instruction:

How to properly feed a baby

Formula-fed babies often weigh much more than their mother's milk-fed peers. It's not as good as it seems, with increased obesity comes a variety of health problems. To avoid this, you do not need to overfeed the baby, it is necessary to take into account how much he drinks and how long he can do without a bottle.

• The bottle is chosen when the baby is fully fed with mixtures or their amount reaches 2/3 of the total nutrition. The nipple must be necessarily with a narrow hole, this will not allow the baby to wean from the breast (how to choose a bottle for feeding);
• A teaspoon is used when the child is mainly breastfeeding, and the missing amount of food is received in the form of mixtures;
• Sometimes a child refuses both a bottle and a spoon, but he needs to be fed. In this case, the diluted mixture is poured through a syringe without a needle in small doses.

Feeding technique

1. The baby should be in an almost vertical position, it is convenient for sucking and will not allow you to choke.
2. Make sure that the milk completely covers the nipple, and that air accumulates at the bottom of the bottle. This will prevent air from entering the stomach.
3. After feeding the child, you need to hold it in an upright position so that the trapped air comes out.

Reading: How to bottle train your baby

Just because you're formula feeding your baby doesn't mean you should leave him alone. The baby may choke on milk or lose the bottle. The emotional contact of the mother with the baby is also important, so holding him in your arms you can calmly observe the concentrated face of the crumbs and take a break from household chores.

The nipple on the bottle needs to be changed periodically, it quickly becomes thinner, and the mixture flows through the hole in a continuous stream. Always use the mixture after preparation or store it in the refrigerator. The rest of the food is poured out immediately.

The baby "artificial" needs to use additional complementary foods earlier, this will make up for the deficiency of missing trace elements.

How much formula should a baby eat?

A newborn child in the first month of life eats from 700 to 800 ml of the adapted mixture for 8-10 times. For 2-3 months of life, the amount of the mixture grows to 900 ml. With the introduction of complementary foods, the volume of mixtures decreases.

It is believed that the child has enough food, which is 1/5 of his body weight per day. That is, if the baby weighs 4 kg, then he should drink 800 ml of milk per day. In the first days of life, the baby can drink 30-40 ml at a time, later up to 100 ml. In this regard, the frequency of feeding after the first month of life decreases. See material: how much milk (mixture) does a baby eat in the first month

Feeding bottle and teat sterilization frequency:

In the first month of life, all bottles and nipples should be sterilized after each feeding. First, the remnants of the mixture are removed with warm water and a brush, then all appliances are boiled for 10 minutes. It is best to purchase a special sterilizer, using it, you will always be sure that the dishes are clean.

After the first month of life, it is enough to rinse the nipple and bottle and rinse them with boiling water. But still, make sure that the bottles are thoroughly washed, special attention should be paid to threads, hard-to-reach places where bacteria can multiply in a few hours.

Is it possible to store the prepared mixture:

The prepared mixture is stored at room temperature for no more than 2 hours, in the refrigerator for no more than 12 hours. The remaining remnants of the mixture after feeding are poured out; drinking such milk after an hour can lead to poisoning.

Video: Proper bottle feeding

Free IV

The need for food in a baby at different times of the day is not the same. But still, it is necessary to adhere to a certain schedule with a deviation of half an hour in one direction or another. So you will always know what time the baby usually eats and you can guess the time of the visit to the clinic or for a walk. Subject to the regimen, the baby falls asleep easier and is less prone to excessive weight gain,

Situations in which a mixture change is necessary:

• The mixture is not suitable frequent regurgitation, diarrhea or constipation, allergic reactions;
• Reaching a certain age. For a 6-month-old baby, there is no point in giving a mixture for newborns;
• The need for special medicinal nutrition.

Problems of artificial feeding:

Artificial feeding of a child is considered in medicine as "metabolic stress" and therefore causes a wide variety of reactions. Allergies, stool problems, colic occur in the first days in most babies. Some of them get used to it, others have to change the mixture.

Komarovsky

razvitie-krohi.ru

GBOU VPO TVER STATE MEDICAL

ACADEMY OF THE MINISTRY OF HEALTH AND DEVELOPMENT OF RUSSIA

DEPARTMENT OF PEDIATRICS

MEDICAL AND DENTAL FACULTY

Mixed and artificial feeding

Guidelines for independent work of students

4 Courses of the Faculty of Medicine

Compiled by:

Doctor of Medical Sciences, Professor A.F. Vinogradov

Candidate of Medical Sciences, Associate Professor A.V. Koptseva

Tver, 2012

Name of the topic: Feeding mixed and artificial. Nutrient mixtures used for mixed and artificial feeding. Canned, adapted products. Peculiarities of feeding premature babies. Principles of nutrition for children older than a year. The role of the local pediatrician in the organization of rational nutrition of children.

Examination of children who are on various types of feeding. Development of the survey methodology. Drawing up a diet and menu layout for children of the first year of life on mixed and artificial feeding on the instructions of the teacher.

The purpose of studying the educational topic: To study modern aspects of mixed and artificial feeding of children of the first year of life at the level of knowledge and skills to draw up a nutrition map for children of the first year of life who are on mixed and artificial feeding, as well as to solve situational problems on this topic. To master the concepts of supplementary feeding, canned and adapted products. To acquaint students with the basic principles of feeding premature babies and children older than a year. To determine the role of the district pediatrician in organizing the rational nutrition of children.

1. Basic terms:

1) Mixed feeding

2) The concept of "supplementary feeding"

3) Artificial feeding

4) Adapted milk formula

1. Topic study plan:

Definition and principles of mixed feeding

Definition and principles of artificial feeding

Classification of adapted milk formulas

AMS selection criteria

Sour-milk mixtures

Consequences of artificial feeding

Features of nutrition of premature babies

Principles of nutrition for children older than a year

1. Presentation of educational material:

Under mixed feeding understand breastfeeding with forced (non-physiological) supplementation in the form of cow's milk (milk of animals and plants) or its dilutions (mixtures) in the amount of 1/5 to 4/5 of the daily requirement.

Mixed feeding is a type of feeding when, along with women's milk, milk mixtures are given to children, because due to the age of the child, he cannot yet be given complementary foods. Supplementation with artificial milk formulas is called supplementary feeding.

Indications for mixed feeding is a lack of milk in the mother (hypogalactia) or some diseases of the mother. The clinical symptoms of a fasting child are flattening or falling of the weight curve, restlessness, infrequent urination, and stool changes. The stool is usually at first reduced or, conversely, speeded up.

In order to find out if the mother has enough milk, it is necessary to weigh the baby in the early hours before and after feeding, i.e. spend control weighing child. By the difference in weight, you can judge how much milk the baby sucked. Having calculated the required amount of milk according to the formulas, and knowing the amount of milk received by the child from the mother, it is possible to calculate the required amount of supplementary feeding.

When mixed. feeding before feeding is prescribed depending on the amount of milk in the mother, that is, after each feeding, or some of them, or by alternating full feedings with breast milk and formula. As supplementary food in modern dietetics, adapted milk mixtures are used, which are used in artificial feeding, and are described in the corresponding section.

Principles of mixed feeding:

The introduction of supplementary feeding not earlier than 4-7 days of the fight against hypogalactia.

The choice of supplementary feeding, taking into account age, appetite.

Supplementary feeding is prescribed after breastfeeding.

The number of feedings remains the same as with natural feeding, but if the milk deficit is more than 50%, then the number of feedings is reduced by 1.

Supplementary feeding can not be introduced into all feedings if the milk deficit is 50% or less.

Do not change supplement.

Carry out weekly control feedings (2-3 times a day 2-3 days a week at different hours of the day).

Change in the need for food ingredients when using non-adapted mixtures up to 3.5-4.0 g/kg per day of protein.

Supplementation is introduced in a spoon or through a small hole in the nipple.

Taking into account modern views (National program for optimizing the feeding of children in the first year of life, 2010), the timing of the introduction of complementary foods with mixed and artificial feeding does not change.

Artificial feeding - this is the feeding of a child in the first months of life with animal or plant milk (soybean, almond) with a deficiency of breast milk, which is 4/5 or more of the daily diet.

Principles of artificial feeding:

The frequency of feeding when prescribing adapted formulas can be the same as when prescribing non-adapted formulas - the number of feedings is reduced by 1 and you can switch to 5 meals a day from 3-4 months.

The volumes of nutrition during artificial feeding are calculated in the same way as with natural feeding (the volumes do not depend on the type of feeding, but on the capabilities of the gastrointestinal tract).

Complementary foods are introduced at the same time as with natural feeding.

The need for protein increases when feeding with non-adapted mixtures up to 4-4.5 g / kg, when receiving adapted mixtures, the amount of protein is the same as in natural.

Calorie increases by 10% when using non-adapted mixtures.

Any attempt to switch to mixed and natural feeding is encouraged.

The transfer of a child to artificial feeding is a "metabolic stress" and in this regard, doctors should pay great attention to the correct choice of "substitutes" for women's milk, taking into account individual characteristics of health, physical development and even appetite.

The basis of most "replacement" or mixtures is cow's milk, which differs significantly from human milk in its composition and properties. In cow's milk, the content of protein, calcium, potassium, sodium and other mineral salts is significantly higher than in women's milk. At the same time, the level of carbohydrates, a number of fatty acids and vitamins, on the contrary, is lower than in human milk. In order to bring the composition of cow's milk closer to the composition of women's milk (or otherwise "adapt" its composition to the characteristics of the immature body of the child, hence the name "adapted milk formulas"), it is necessary to reduce the content in cow's milk. protein and salts, but to increase the level of carbohydrates (lactose), some vitamins and fatty acids. Currently, various substitutes for women's milk, both domestic and imported, are widely represented on the Russian market. "Substitutes" for women's milk can be dry or liquid (ready-to-drink), unleavened or sour.

Milk mixtures are divided into 2 large groups - adapted and non-adapted, in turn, mixtures in each of these groups - into sweet and sour-milk.

Adapted milk formula(AMS) - a food product in liquid or powder form, made on the basis of cow's milk, milk of other farm animals, intended for use as a substitute for women's milk and as close as possible to it in chemical composition in order to meet the physiological needs of children of the first year of life in nutrients and energy. The content of protein, fats, carbohydrates, minerals and vitamins in mixtures must comply with domestic and international standards for adapted milk formulas. There is a modern classification of children's adapted milk formulas (Fig. 1). This mainly concerns the division of mixtures, depending on the age of the children, into “initial” (from 0 to 6 months), “subsequent” (from 6 to 12 months) and for children from 0 to 12 months.

Particular attention is paid to the "initial" mixtures, the composition of which is maximally adapted to the physiological needs and characteristics of the metabolism of children in the first six months of life. Recently, there has been a tendency to reduce the level of protein in modern dairy products in order to bring it closer to human milk quantitatively. So, in most "initial" mixtures, the amount of protein is 1.4-1.6 g / 100 ml, and the minimum level is 1.2 g / 100 ml, the ratio of whey proteins and casein is 60:40, 50:50, in separate mixtures 70:30. almost all modern mixtures contain taurine, α-lactalbumin, and some contain nucleotides.

To adapt the fat component of the "initial" mixtures, vegetable oils (sunflower, corn, soybean, rapeseed, coconut, palm), rich in polyunsaturated fatty acids (PUFAs), are introduced into their composition. To improve the emulsification of fats, a small amount of natural emulsifiers lecithin, mono- and diglycerides are introduced into the mixtures. Almost all mixtures contain L-carnitine, which promotes the assimilation of fatty acids at the cellular level. The current trend is the enrichment of mixtures of DSHIFA (arachidonic and docosahexaenoic), which are precursors of prostaglandins, thromboxanes and leukotrienes,

As a carbohydrate component, mainly lactose and maltodextrin are used. A number of mixtures contain galacto- and fructooligosaccharides, which have a prebiotic effect and promote the selective growth of bifidobacteria. Some formulas contain lactulose, which is also a prebiotic.

All mixtures include the necessary set of vitamins and minerals in accordance with the physiological needs of children in the first months of life. This is primarily iron, copper, zinc, iodine. selenium, which has antioxidant properties, was introduced into a number of mixtures. The ratio of calcium and phosphorus is in the range of 1.5:1 - 2.0:1.

The level of vitamins in AMS exceeds that in women's milk by 15-20% on average. their digestibility is lower than from human milk. At the same time, much attention is paid to vitamin D. Its content in 100 ml of the finished mixture should be 40-50 MB according to the standards. Vitamins of group B, vitamin A, β-carotene are added to all mixtures.

"Subsequent" mixtures, unlike the initial one, contain a higher amount of protein (up to 2.1 g/100 ml). The predominance of whey proteins over casein is no longer mandatory. Products for children of this age group are distinguished by a higher content of iron, calcium, zinc.

Formulas "from 0 to 12 months" can be used in the nutrition of children throughout the first year of life. However, this group of products is not numerous and in modern conditions is used to a limited extent, due to a wide range initial and subsequent formulas.

In a number of dry fresh mixtures, probiotics were introduced: bifidobacteria and lactobacilli. Modern technologies make it possible to ensure the safety of microorganisms in the product throughout the entire shelf life.

Criteria for the selection of adapted milk formulas (AMC):

the age of the child;

socio-economic conditions of the family;

allergic history;

individual intolerance to the product.

The criterion for the correct choice of the mixture is the good tolerance of the child to this product.

As a result of all these changes, a fairly good substitute for breast milk is obtained, but it is necessary to strive to minimize the risk of sensitization to a foreign protein by using protein hydrolysates and providing the child with non-specific protection against intestinal infections by adding substances such as lactoferrin, lactoperoxidase, lysozyme, etc.

Among the adapted women's milk substitutes are domestic liquid ones - "Agu-1" (Lianozovsky baby food plant, Russia), "Baby Milk" (Lianozovsky dairy plant, Russia) and dry mixes - "Mikamilk" (Kofranleit / Rosdetspecprodukt, France / Russia ), as well as imported ones - Nan (Nestlé, Switzerland), Nutrilon (Nutricia, Holland), Efamil-G (Bristol Mayer Squibb's Mead Johnson Branch), Pre-HiPP and HiPP (KhiPP, Austria ), Humana-1 - taurine-containing mixture for children from the first days of life up to 3-6 months, whey protein / casein ratio 60:40, does not contain glucose, sucrose and gluten, Humana-2 - from 3-4 months to 1 year, Humana-Baby-fit - from 6 to 12 months, gluten-free, enriched with iron, protein component 80:20, good content of vegetable oils, banana pectins in combination with starch increase the viscosity of the mixture and have an anti-dyspeptic effect, Frisolak - from 0 to 12 months , has a good ratio of linoleic and linolenic acids, protein component 60 :40, fermented milk mixtures - "Gallia" and "Lactofidus" (Danone, France).

Somewhat less adapted mixtures are the so-called "casein formulas". Their name is due to the fact that they are made on the basis of powdered cow's milk, the main protein in which is casein, without the addition of demineralized whey. As a result, such mixtures are less close to the protein composition of human milk. At the same time, for all other components (carbohydrate, fat, vitamin, mineral, etc.), these mixtures, as well as the adapted ones described above, are as close as possible to the composition of human milk. Casein formulas include such well-known blends as Similac (Abbot Laboratories, USA), Nestogen (Nestlé, Switzerland) and others.

Finally, partially adapted blends. Their composition is only partially close to the composition of human milk - they lack demineralized whey, the fatty acid composition is not fully balanced, not only lactose, but also sucrose and starch are used as a carbohydrate component. These mixtures include "Aptamil", "Milumil" (Milupa, Germany). These substitutes can be used in the nutrition of children of the first year of life, starting from 2-3 months.

All modern women's milk substitutes and "follow-up" mixtures are among the instant (instant) products. For their use in children's nutrition, it is only necessary to mix a strictly defined amount of dry powder with pre-boiled warm (50-60 ° C) water and mix thoroughly, avoiding the presence of lumps.

Benefits of fermented milk formulas:

improve digestion processes;

have a partially cleaved protein that loses its allergic properties;

vitamins produced by bacteria;

they partially destroy lactose, which some children do not tolerate well;

displace pathogenic flora;

there is no more ethyl alcohol in them than in bread, juice, breast milk; it is necessary for the metabolic processes taking place in the body.

Disadvantages of fermented milk mixtures:

have a high calcium content;

the ratio of whey protein to casein 20:80;

when they are used, a shift in acid-base balance occurs in the acidic direction.

Thus, milk formulas are considered good if:

Protein 1.2 - 1.5 g/dl;

The ratio of whey protein to casein is 60:40;

The composition contains taurine;

Vegetable fat - 1%;

Carbohydrates - dextrinmaltose;

Vitamins A, D, E;

Osmolarity = 280 mOsm/l.

Currently, in the diet of patients with food allergies, dairy-free mixtures prepared on the basis of soy protein isolates of foreign production are widely used: Humana SL (Germany), Nutrisoy and Frisosoy (Holland), Prosobi (USA), Alsoy (Sweden), as well as domestic product - Nutrilak-soy. The protein component of these products is represented by soy protein isolate; fatty - formed due to vegetable oils; carbohydrate - represented by dextrinmaltose, which has a positive effect on intestinal microbiocenosis. The products are enriched with a complex of vitamins and minerals in accordance with the requirements of young children. The mixtures do not contain milk protein, lactose and gluten.

Formula-fed children, like their peers, need complementary foods. Given that modern adapted milk formulas contain the necessary set of vitamins and minerals, there is no need to correct for these substances with complementary foods in more early dates than when breastfeeding.

Consequences of artificial feeding

Shortening of average life expectancy by 10 years (min);

Sensitization of 75% of children;

Dysbacteriosis 100% of children;

Chronic diseases of the gastrointestinal tract - 45-55%;

The development of early sclerosis (there is no activator of cholesterol utilization enzymes);

Early hypertension;

Early coronary artery disease, strokes, etc.;

Children are at risk for oncology and hemoencology (leukemia);

The ratio of diseases of children on natural: mixed: artificial feeding as 1:3:6. 2-3 times more group of FBI;

Children "artists" are prone to mechanical, uncreative labor, nihilism and aggression.

Features of nutrition of premature babies

A premature baby should be admitted to the pediatric site with a well-formed sucking reflex and diet. Usually this is 7 feedings with a 6 hour night break. For 6 meals a day, it is transferred upon reaching a body weight of 3,000 gr.

The most optimal type of feeding a premature baby is breastfeeding. The amount of milk absorbed by the child should be strictly monitored. Therefore, a premature baby should be provided with scales, which the clinic should provide him. In cases of insufficient absorption of breast milk, additional feeding with a spoon is required. This should be told to the mother and taught to her. In this case, special dry adapted mixtures for premature babies are used. A feature of these mixtures is a higher content of protein and carbohydrates, and, accordingly, calorie content, compared to conventional adapted mixtures. Special adapted formulas for preterm infants should be used until they reach 4 kg, and then switch to regular adapted formulas.

Types of feeding premature babies

Women's milk after premature birth has a special composition that is more in line with the needs of premature babies in nutrients and is consistent with their ability to digest and assimilate. Compared to the milk of women who have given birth at term, it contains more protein (1.2-1.6 g per 100 ml), especially in the first month of lactation, slightly more fat and sodium and less lactose, with the same total level of carbohydrates. The milk of women after premature birth is also characterized by a higher content of a number of protective factors, in particular, lysozyme. Human milk is easily digestible and well tolerated by premature babies.

Despite the special composition, the milk of women who gave birth prematurely can satisfy the nutritional needs of only premature babies with a relatively large body weight - more than 1800-2000 g, while premature babies with a lower body weight after the end of the early neonatal period gradually begin to experience a deficiency in protein, a number of minerals (calcium, phosphorus, magnesium, sodium, copper, zinc, etc.) and vitamins (B 2, B 6, C, D, E, K, folic acid, etc.).

It becomes possible to preserve the main advantages of natural feeding and, at the same time, to meet the high nutritional needs of a premature baby when fortifying human milk with "amplifiers" or fortifiers (for example, "Pre-Semp", Semper, Sweden, "Breast milk fortifier, Friesland Foods, Holland, etc.). They are specialized protein-mineral or protein-vitamin-mineral supplements, the addition of which to freshly expressed or pasteurized human milk eliminates nutritional deficiencies.

Indications for the appointment of artificial feeding for premature babies are only the complete absence of mother's or donor milk, as well as intolerance to women's milk. In the nutrition of premature babies, only specialized formulas intended for feeding premature babies, the nutritional value of which is increased compared to standard adapted products (Pre-NAN, Pre-Nutrilak, Pre-Nutrilon with prebiotics, Humana-O-G A, Friso-pre, Enfamil premature).

Complementary foods are prescribed to premature babies starting from 4-5 months of age. The introduction of complementary foods up to 4 months is unacceptable due to the immaturity of both the digestive system and metabolic processes. Later (from 6 months) the appointment of complementary foods is also unacceptable, since the supply of nutrients (minerals and individual vitamins) in children born prematurely is sharply limited.

The introduction of complementary foods is carried out slowly and gradually. Until children reach 7-8 months of age, each feeding should end with the baby being attached to the breast or using milk formulas.

Organization of rational nutrition and the role of the district pediatrician

The organization of breastfeeding in primary health care is of paramount importance, because:

the preservation of natural feeding is the protection of the child's right to health; this is the official policy of the WHO and the government Russian Federation and, finally, it is the main positive factor determining health;

the leading organizer in this process is the KZR (healthy child's office);

in a children's polyclinic, one of the leading criteria for the qualification of a doctor and the effectiveness of his work is the proportion of breastfeeding.

Local pediatrician:

conducts constant preventive work to maintain a high proportion of natural feeding (at least 75% of all nursing mothers of children under 1 year of age) at all stages: before pregnancy, before childbirth, intranatal and postnatal.

identifies risk groups for hypogalactia;

uses all components of the diagnosis of hypogalactia: anamnestic, clinical, control feeding;

in case of a threat of hypogalactia, it immediately takes measures (algorithm for combating hypogalactia);

informs the head of the pediatric department in advance about the reasons for the possible transfer of each child to mixed and artificial feeding for a collegiate decision;

plans centralized or decentralized provision of breast milk to mothers with hypogalactia with donor breast milk (breast bank donor milk, circle of lactating mothers for mutual assistance);

organizes the improvement of medical literacy (medical "education") of parents through various forms education: “health universities”, “school for young parents” (there is also a “school for a young father”), where they teach, among other things, the basics of feeding.

The doctor should convey to the mother's mind the importance of following the regimen:

daily routine;

work and rest;

sleep and wakefulness;

loads (from general sports to strict bed);

nutrition (especially in terms of the frequency of feeding, the amount of food, the timing of the introduction of complementary foods and the duration of breastfeeding).

Nutrition for children older than a year:

Each period of childhood is characterized by its own characteristics of growth and development, the degree of morphological and functional maturity of individual organs and systems, and the specifics of physiological and metabolic processes.

Principles of nutrition for children older than a year:

Adequate energy value of daily food rations, corresponding to the energy consumption of children.

A balanced diet for all interchangeable and indispensable nutritional factors, including amino acid proteins, dietary fats and fatty acids, vitamins, mineral salts and trace elements, as well as minor food components (flavonoids, nucleotides, etc.).

The maximum variety of the diet, which is the main condition for ensuring its balance.

Rational diet.

Optimal technological and culinary processing of products and dishes, ensuring their high taste and preservation of the original nutritional value.

Accounting for the individual characteristics of children (including their intolerance to certain foods and dishes).

Ensuring sanitary and hygienic food safety, including compliance with sanitary requirements for the state of the catering unit, supplied food products, their transportation, storage, preparation and distribution of dishes.

Artificial feeding of newborns is recommended if a woman does not have breast milk or if natural feeding is impossible. How to organize it correctly in order to minimize the risks for the baby's body? What to feed and how much? How to establish psychological contact with the baby? Answers in the recommendations of pediatricians and lactation consultants.

In modern society, the question of what to feed a child is decided by a clear choice in favor of breastfeeding. Natural feeding up to two years is recommended by the World Health Organization as the only type of food that is one hundred percent appropriate child's body.

Numerous studies have confirmed that only breast milk does not burden the digestive system and does not cause malfunctions in its work. Its composition is ideally balanced for a particular child with his individual characteristics. It satisfies not only the need for nutrients, but additionally supplies the body with immune factors, hormones, enzymes that cannot be obtained artificially and “sharpened” into the most perfect mixture.

And finally, breast milk and the process of sucking it become for the baby both a way of feeding, and a way to get rid of fear and pain, the opportunity for the closest and necessary contact with his mother.

But there are situations when breastfeeding failed. This is facilitated by objective and subjective reasons.

Why is there no milk

The complete absence of breast milk, in which artificial feeding is necessarily introduced, is called agalactia. Contrary to popular belief that many women suffer from agalactia, breastfeeding consultants say that this is not the case. Experts from the international organization La Leche League state that true agalactia is observed in no more than 1-2% of young mothers. The reason for it are serious hormonal disorders in the body of a woman.

In other cases, the reason for the impossibility of organizing breastfeeding is completely different.

• Separate stay of mother and child. The lack of free access of the baby to the breast after birth excludes the correct formation of lactation. If a woman did not express her breasts, the arrival of milk in a natural time and in sufficient volume becomes impossible.
• Medical advice. In some cases, the mother is forbidden to breastfeed. Often, such recommendations are given to women with metabolic disorders, diseases of the heart, liver, and other pathologies of internal organs. According to WHO, these conditions are not absolute contraindications to breastfeeding. true reasons According to which a woman cannot feed naturally, there are only two: HIV infection and an open form of tuberculosis, in which the health of the mother is a danger to the health of the baby. In other cases, when a woman is ill or taking medication, she may arrange to breastfeed after recovery.
• Mom's unwillingness It may be associated with personal negative experience, "good" advice from older relatives. The decision is often influenced by the media promoting formula as a more convenient alternative to breastfeeding.

Women who do not want to breastfeed should be aware that no artificial formula will create such a powerful foundation for good health and the full development of the child, like breast milk. In addition, breastfeeding is much easier with practical point vision and much cheaper than feeding with high-quality mixtures.

Blend selection

If all the pros and cons are weighed and artificial feeding of the child is inevitable, it is necessary to organize it according to the rules. There are three of them:

• mix selection;
• determination of the feeding regimen and volume;
• organization of feeding.

The main criterion for choosing a product for feeding should be the recommendations of a pediatrician. There are mixtures that are suitable for healthy babies and children with digestive disorders, allergic diathesis, premature babies.

Adapted Blends

Produced from cow's milk, in which the excess protein content for the child's body is reduced by the introduction of a whey component. For babies of the first days of life, mixtures of the primary or initial formula are intended. They are indicated by the number 1 in the name, for example, "Nutrilon 1" or "Baby 1".

They contain important components: amino acids, taurine, polyunsaturated acids. Manufacturers enrich them with a large "set" of vitamins and microelements, as well as carbohydrates in the form of easily digestible sugar: lactose or sucrose.

When the baby is six months old, his diet should include an adapted mixture labeled "2" or with a "subsequent formula". The amount of protein in it is higher than in the primary, and there are more carbohydrates to meet the energy needs of a grown-up baby.

Manufacturers also offer universal adapted formulas for children from zero to twelve months. Their "average" composition is dominated by casein protein or whey proteins.

Adapted fermented milk mixtures

What distinguishes them from adapted milk formulas is the quality of the protein. It is subjected to bacterial fermentation. Sour-milk formula is closer to breast milk than milk formula, since the protein is in a curdled state.

Thanks to this processing, it loads the immature stomach of the crumbs to a lesser extent and is more quickly absorbed in the intestines. The curd component helps the formation of the correct intestinal microflora, as it is saturated with lactic acid bacteria.

Pediatricians recommend the introduction of adapted fermented milk mixtures for babies with manifestations of dysbacteriosis, stool disorders, and allergic diathesis. You can use them as a constant food for the weakened, premature babies. And for periodic in order to prevent dysbacteriosis in children receiving an adapted milk formula.

Non-adapted milk formulas

For the preparation of these mixtures, fresh and powdered animal milk is used. The amount of protein in its composition is many times higher than in breast milk. It is represented by casein, which is alien to the child's body, which the baby's digestive system cannot digest due to the lack of appropriate enzymes. As a result, dangerous situations arise: from persistent dysbacteriosis with constant indigestion to insufficient weight gain in the baby and its developmental lag.

Pediatricians do not recommend the use of non-adapted milk formulas in the diet of a child of the first year of life. They do not meet the needs of the child's body and pose a threat to his health. It is unacceptable to use dry or fresh cow's, goat's milk for the preparation of mixtures, cereals.

When choosing a formula for a baby, consider the following nuances.

• A quality product cannot be cheap. Adapted milk and fermented milk mixtures are the result of serious scientific research. Their components are expensive, so the finished product is expensive. Unfortunately, this often makes them inaccessible to families with low and medium incomes. But it is categorically impossible to save on the purchase of a mixture. This excludes the possibility of healthy growth and development of your child.
• A reputable manufacturer values ​​its reputation. When choosing a mixture, pay attention to well-known brands. The risk of buying a low-quality product in this case is lower.
• The universal mixture is absorbed worse. More preferable for a child of the first months of life is a “starting” formula adapted to his needs.
• The mixture is not durable. Make sure the product has an adequate shelf life. An open jar can be stored in a dry and dark place for no more than three weeks. Do not put a dry product in the refrigerator, as it will become damp.

The principle "the more expensive the better" in the choice of mixtures for artificial feeding works to the fullest. The most expensive samples contain not only the "standard set" of components, but also additional ingredients, such as linoleic acid for the development of the baby's brain or carnitine, which promotes the absorption of fats.

Artificial feeding technique

The question of how to feed a newborn with a mixture is determined by the reviews, recommendations of pediatricians. It is not advisable to resort to the technique of free feeding, as in the example of breastfeeding "on demand".

The ingredients of the products are drastically different. And if breast milk does not create a burden on the digestive system, even with its frequent consumption, the mixture is not as "light" as well. After eating, the baby's body needs time to digest food.

Mode

Stick to a feeding schedule for bottle-fed babies.

• From birth. Every 3 hours during the day with a six-hour break at night. The number of feedings per day will reach seven.
• From three months. Every 3.5 hours during the day with a six-hour break at night. Thus, six feedings will be required during the day.
• From six months. Modern pediatrics does not recommend shifting the timing of the introduction of complementary foods in artificial babies. Just like with babies, it is necessary to start introducing the first products of the child at the age of six months. Gradually, one feeding will replace porridge or vegetable puree. And the number of feedings per day will be five every four hours with an eight-hour sleep break.

Mixture preparation

It is necessary to prepare the mixture for use in accordance with the manufacturer's recommendations. Dry foods require boiling or introducing warm water and stirring until dissolved. Ready-to-use liquid mixtures are also presented, which are enough to warm up in a water bath.

Rules for artificial feeding for babies in the first year of life.

• The temperature of the product should be 37-38 ° WITH. If the mixture was previously boiled, it must be cooled to a suitable temperature. Prepare food for the child in advance to feed him on time.
• Pour food into sterilized dishes. The presence of pathogenic microorganisms in the bottle can provoke a malfunction of the child's gastrointestinal tract.
• The hole in the nipple should not be large. The mixture should not freely pour out of it, but stand out in drops. It is ideal to use a pacifier with a hole adapted to the age of the baby. These can be purchased at pharmacies.
• Position the bottle at an angle when feeding. This will eliminate the possibility of the child swallowing air, which leads to spitting up and vomiting.
• The mixture can be stored for 2 hours at room temperature and 24 hours in the refrigerator. In artificial nutrition, there are no components that inhibit the growth of pathogenic microflora, which are rich in breast milk. Therefore, its storage period is limited.

If there is food left in the bottle, it cannot be used for the next feeding. Rinse the bottle, sterilize it and the nipple.

Contact with mother

It seems that artificial babies need much less maternal care than babies. Indeed, any member of the family can feed them, and when the baby is ill, the nipple will be a consolation to him.

Psychologists warn that this approach is dangerous. A bottle with a nipple can replace the mother's breast, but not the mother herself. Otherwise, when the child grows up, he will not reach out to you for support, help, but will seek solace "on the side." The close psychological connection experienced by a mother and a baby who is regularly applied to the breast is also possible when paired with a bottle-fed baby.

“Ensure close skin-to-skin contact,” advises breastfeeding consultant Maria Gudanova. - The baby should feel your warmth, hear sounds familiar to him from the period prenatal development. Carry it in your arms more often, sleep together, cuddle the naked baby to your chest, take a bath together.

A good solution would be baby massage, which mom can master herself. The child should not be left alone when he is awake. This is the time for your close communication and walks. This approach will help the baby understand that his joys, a sense of security, safety, and warmth are connected with his mother.

“The pacifier should not be perceived by the child as an independent object,” continues AKEV expert Maria Gudanova. “She should only be associated with her mother.” Therefore, adhere to the following rules when feeding and organizing a crumb regimen.

• Only mother feeds. Do not entrust feeding to other relatives. The more people who take part in this, the lower the level of trust the baby has in you.
• Mom offers a pacifier. Don't leave your baby alone with the pacifier. He should suck only on your hands, turning his face to you.
• The baby falls asleep in his arms. After feeding, offer the baby a pacifier and wait until he falls asleep. Remove the pacifier from his mouth and put it in the crib.

Even if there is no milk in your breast, the baby can suck on it. Experts from the international breastfeeding organization suggest combining artificial feeding of newborns with the SNS system. It is a soft bottle designed to be filled with a mixture. A tube is attached to the bottle, the tip of which is fixed on the mother's nipple.

The process of feeding with a mixture is completely close to natural feeding. The baby is in her arms, in close contact with her mother, sucking her breasts, while receiving the mixture. Using the SNS system provides another great opportunity - the chance to establish full breastfeeding.

When the breast is stimulated for several months after childbirth, the process of relactation starts, that is, the restoration of lactation. It will allow you to transfer the baby to mixed feeding. And then completely or largely replace the artificial mixture with your breast milk, which is invaluable for the health of your baby.

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A complete balanced diet required condition normal development of all organs and systems of the baby. It is important that children receive a certain amount of macronutrients (proteins, fats, carbohydrates), minerals and vitamins every day. Thanks to this, they will grow up healthy, cheerful and quick-witted. How to properly organize the feeding of children up to a year? Let's look into this issue, which interests all conscious parents.

Types of nutrition for children up to a year

There are three types of feeding children up to a year: natural, artificial and mixed. Each of them has its own diet. Consider the features of different types of menus for newborns. General schemes are given for healthy babies. In case of violations of the norm of food consumption, the doctor determines.

natural feeding

A breastfed baby from 0 to 6 months receives only mother's milk. According to WHO recommendations, solid food (complementary foods) is gradually introduced into his diet after this age. The proportion of breast milk in the daily amount of food is decreasing, but remains high. The famous children's doctor E.O. Komarovsky insists that the introduction of complementary foods at an earlier period is not advisable.

With natural feeding, most experts recommend feeding the baby freely, that is, at his request. This approach allows you to maintain lactation at the required level. After 2-3 months, even in the case of free feeding, a flexible feeding schedule for the newborn is established: meals occur at intervals of 2-2.5 hours.

Artificial feeding

With artificial feeding, the child receives an adapted milk formula. Breast milk may be present in its menu, but in a small amount - up to 20% of the total food volume.

Artificial feeding requires adherence to a clear feeding schedule with certain intervals between meals. E.O. Komarovsky reminds that they must be kept, as the mixture is digested more slowly than mother's milk.

mixed feeding

The need for mixed feeding occurs when the mother produces breast milk, but it is not enough for the child. The shortage is compensated with the help of artificial mixtures.

The proportion of mother's milk with mixed feeding is more than 20% of the daily diet. The feeding regimen with this type of diet depends on the level of lactation in the mother. If breast milk is the basis of the diet, then the schedule approaches free. In the case of the predominance of the mixture, feeding occurs by the hour.

How to calculate the required amount of food?

First 7-10 days

The calculation of the daily volume of formula or breast milk for children in the first 7-10 days of life is carried out in one of two ways:

1. Zaitseva formula. It is necessary to multiply the body weight of the child at birth by the number of days of his life and find 2% of this number. The result is the required amount of food per day.
2. Finkelstein formula. To determine the daily amount of milk or formula for a child weighing less than 3.2 kg, multiply his age in days by 70. If the weight of the crumbs is less than 3.2 kg, you need to find the product of the number of his days of life and 80.

Regardless of the formula used, the resulting daily volume must be divided by the number of feedings. So you can find out the amount of milk or mixture sufficient for one meal.

Older than 7-10 days

To calculate the amount of nutrition for a newborn older than 7-10 days up to 12 months, the method according to Geibener and Czerny or volumetric is used. The method of Geibener and Czerny allows you to find the required total amount of liquid per day, including formula, milk, water, juice, tea, and so on. This takes into account the weight of the child and his age. The main recommendations are presented in the table.

For example, a baby at 3 months weighs 5.2 kg. He needs 5200÷6=867 ml of milk or mixture per day. This figure should be divided by the number of meals. The total volume of liquid should not exceed 1 liter in 24 hours.

In modern conditions, the technique according to Geibener and Czerny is rarely used, since it is not designed for children with increased body weight, which in Lately more and more are being born. The volumetric method is considered more rational.

The norms of food consumption, depending on the age of the child, are shown in the table.

The introduction of complementary foods

There are special WHO instructions that contain information on the sequence of introducing solid food into the diet of children in the first year of life. Recommendations are broken down by month below.

Porridge must be boiled in water. Starting from 6 months in puree and porridge should be added vegetable oil. For the first time, it is recommended to limit yourself to 1 drop, gradually bringing the volume to 1 teaspoon. Butter is introduced into the diet at 7 months. The initial dose is 1 g, the average is 10 g. It is advisable to add it to ready-made cereals.

The above feeding scheme is relevant for breastfed children. If the baby is receiving formula, then solid food can be introduced from 5 months, as his body needs vitamins and minerals for normal development. The same table is used, but all rows are shifted by a month.

Detailed information on how to feed your baby with "adult" products can be found in the table. All recommendations are general in nature. Before introducing complementary foods, you should consult with your pediatrician.

Product	Term	Quantity	Dishes to start weaning
Vegetables	With normal or overweight from 6 (sometimes from 5-5.5) months.		Puree of 1 white or green vegetable.
Kashi	With normal or overweight from 6-7 months. If the weight is insufficient, then they are introduced from 4-5 months.	Initial - ½ teaspoon. Maximum - 100-200 g.	Gluten-free cereals boiled in water - buckwheat, rice, corn, oatmeal. After entering each porridge separately, you can cook cereal mixes.
Vegetable oil	6 months	Initial - 3-5 drops. Maximum - 1 teaspoon.	Sunflower, corn, olive oils. They should be added to mashed vegetables or meat.
Butter	7	Initial - 1/3 teaspoon. Maximum - 10-20 g.	High-quality butter without vegetable ingredients should be added to vegetable purees and cereals.
Fruit	8	Initial - ½ teaspoon. Maximum - 100-200 g.	Monopure of soft fruits. Gradually, you can make multi-component dishes.
Meat	8	Initial - ½ teaspoon. Maximum - 50-100 g.	Puree from one component - rabbit, turkey, veal, beef.
Yolk	8	Initial - 1/4 teaspoon. Maximum - ½ yolk of a chicken egg.	It is necessary to boil the egg and add the crushed yolk to the puree or porridge.
Dairy products*	9	Initial - ½ teaspoon. Maximum - 150-200 g.	Children's yogurt, kefir or biolact. After 10 months, products with fillers can be introduced (we recommend reading:).
Cottage cheese*	9	Initial - ½ teaspoon. Maximum - 50 g.	Children's cottage cheese in its purest form. From 10 months it should be supplemented with fruit puree.
Baby biscuits	9-10	Initial - 1/3 cookies. Maximum - 5 pieces.
A fish	The average period of introduction is 10 months (we recommend reading:). If the child has a tendency to allergies - 1 year.	Initial - ½ teaspoon. Maximum - 60 g. It is worth feeding the baby with fish 1-2 times a week.	Low-fat varieties of fish - river perch, hake, cod. It should be boiled or steamed and then mashed.
Juices	10-12	Initial - 2-3 drops. Maximum - 100 ml.	Clarified juices from green and white fruits.

*Note that the approach of Dr. E.O. Komarovsky regarding complementary foods differs from the WHO recommendations. He suggests starting acquaintance with adult food with the help of sour milk - kefir and cottage cheese.

A new product should be given to the baby in the morning. The amount is recommended to increase very slowly, gradually bringing to age norm and monitoring the reaction of the child's body. Every week, the child should be introduced to one new dish. If an allergy or malfunction of the gastrointestinal tract occurs, the product must be removed from the menu.

Nutrition after a year

The baby's menu after 12 months includes all major food groups. He no longer needs breast milk as food, so many mothers decide to stop lactating. However, it contains substances valuable for the baby, and the reasons to continue breastfeeding remain.

Lactation can be maintained even if the mother goes to work. The frequency of breastfeeding will decrease, but the baby will receive valuable elements. If there is a need to stop lactation, doctors advise not to do this during the period of illness of the child, when his body is weakened, as well as in summer, since at this time there is a high probability of contracting an intestinal infection.

The nutrition of a baby at 1 year old does not differ from its menu at 11 months old, but portions increase slightly (we recommend reading:). For breakfast and afternoon snack, it should be fed with porridge or mashed vegetables. Dinner and lunch should be hearty. For dessert, you can offer marmalade, marshmallows, marshmallows, and as a drink - water, tea, jelly, compote or fruit drink.

Preferably artificial, but not all women have the opportunity to breastfeed. In such situations, it is necessary to consult a pediatrician in order to choose the most suitable milk formula for the baby, corresponding to his age and health status.

Advantages and disadvantages of artificial nutrition

Many babies from the first days of life are on artificial feeding, and every year their number increases. The increase in the percentage of "artificial" is directly related to the deterioration of the environment, malnutrition of the adult population, affecting the state of health, as well as the inability of mothers to be constantly close to their children. There is, perhaps, one single advantage in feeding a newborn child with milk mixtures - such a baby will not have to be transferred from breastfeeding to artificial and his body will not need to adapt to a new nutritional composition. In the event that a mother has a choice between artificial and natural feeding, before starting to feed her baby with milk mixtures, she needs to familiarize herself with their positive and negative sides:

pros

• The ability to leave the child with relatives or a nanny due to employment;
• In the case, it is enough to simply replace the milk formula with a more suitable one, and not look for the cause in your own diet;
• The ability to see the amount of formula drunk by the child from the bottle. A breastfeeding woman can find out about the missing amount of milk only if the baby is underweight;
• The frequency of feeding is less than with natural feeding. The fact is that breast milk is digested by the baby's body much faster than formula milk.

Minuses

• The absence in the milk mixture of special enzymes contained only in mother's milk. Formula-fed babies are much more likely to have allergic reactions and colds than in infants;
• Frequent regurgitation and. When eating through a bottle, the baby swallows excess air, which causes bloating and discomfort;
• Bottle disinfection and formula preparation. It is customary to feed children who are bottle-fed according to a certain regimen, but each baby has an individual need for the number and frequency of meals, and this depends on many factors. A suddenly hungry baby can be fed much faster;
• Mixture selection. It takes time to choose the right mixture, and if it does not fit, the child suffers;
• Financial expenses. Good quality formula does not come cheap, and as the child grows older, more is needed.

Monthly formula feeding table

The data in the table is approximate. The pediatrician who monitors the child's weight gain will help you determine the individual daily need of the baby for milk formula.

Start of complementary foods

The first complementary foods of a formula-fed baby can be carried out when they reach 3 months. Best Product to start complementary foods - apple juice. You need to start with 0.5 teaspoon per day, diluting it with half boiled water. If the baby feels fine, you can try other natural juices as complementary foods, but not from exotic fruits.

With normal digestibility of natural juices, fruit and vegetable puree can be introduced into complementary foods at 4-5 months. You need to start with 0.5 teaspoon per day, gradually increasing the amount.

3-4 weeks after the baby has met the puree, you can introduce cereals (corn, buckwheat and rice) into the diet. If you are not allergic to lactose, you can cook them in milk. After 6-7 months, the baby's digestive system becomes quite strong, so oatmeal, semolina, wheat and barley groats can also be used to make porridge.

After 8 months, you can gradually introduce boiled meat into the baby's complementary foods, first chicken and turkey, then beef.

After 9 months, the child's menu can be varied with boiled fish.

Complementary feeding scheme

Video: Dr. Komarovsky about artificial feeding

Menstruation with artificial feeding

Postpartum discharge from the uterus is natural for every woman who has given birth, and they last about 6 weeks. In women whose children are bottle-fed from the first days of life, menstruation may begin from the third month of the child's life, but they will not become regular immediately. If after 5 months after giving birth, the menstrual cycle has not begun, or the periods are too plentiful, immediately consult a doctor for help.