1 / 9

What Milk?

What Milk?. Jo Caines Paediatric Specialist Dietitian. Breastfeeding. 1 st choice - continuation of breastfeeding ? Mother may require exclusion diet if child has severe eczema or gastrointestinal symptoms Most evidence with maternal exclusion diets is for cow’s milk and egg

kura
Télécharger la présentation

What Milk?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. What Milk? Jo Caines Paediatric Specialist Dietitian

  2. Breastfeeding • 1st choice - continuation of breastfeeding • ? Mother may require exclusion diet if child has severe eczema or gastrointestinal symptoms • Most evidence with maternal exclusion diets is for cow’s milk and egg • ? Calcium supplementation for mother if excluding cow’s milk

  3. Degree of Hydrolysis

  4. Extensively Hydrolysed Casein Formula (EHC-F) Nutramigen 1 (£8.20/400g) Well tolerated in younger infants Unpalatable Nutramigen 2 > 6 months Tastes better and has increased calcium Pregestimil (£8.91/400g) Similar formula containing increased level of medium chain triglycerides useful in fat malabsorption

  5. Extensively Hydrolysed Whey Formula • Pepti (£17.10/900g) More palatable than extensively hydrolysed casein formulas Contains lactose Larger peptides - ? Less well tolerated Useful in children who refuse EHC-F • Pepti Junior (£9.42/400g) Contains MCT’s Does not contain lactose More expensive than Pepti

  6. Amino Acid Formulas • Neocate LCP and Nutramigen AA Suitable for children with: - multiple food allergies - children with food allergy and GI symptoms/faltering growth - failure of extensively hydrolysed formula Expensive (Neocate £22.02/400g, NutramigenAA £21.22/400g) Unpalatable but very effective

  7. Amino Acid Formulas • Neocate Advance (£35.50/15x50g) • >1 year • 1kcal ml • Need large volumes to be nutritionally complete but can be used as a sole source of nutrition • Neocate Active (£49.12/14x63g) • > 1year • 1kcal/ml • Increased iron and calcium to meet requirements in 600mls • Designed as a supplement to diet

  8. Soya Formulas • Safety concerns regarding effect of phytoestrogens (COT 2003) • Cross reactivity with cow’s milk protein - Non IgE Up to 60% - IgE 17-47% • More palatable • SMA Wysoy(£7.58/860g) / Cow & Gate Infasoy (£7.44/900g) / Heinz Soya Nurture Formula • BDA Paediatric Group (2004) - Avoid < 6/12 as a precautionary measure - Vegans, Galactosaemia, CMPA refusing eHF

  9. Partially Hydrolysed Formulas • Not suitable for cow’s milk protein allergy treatment • More peptides with high molecular weight • Antigen content reduced to avoid primary sensitisation • Example: NAN HA (£4.29/400g)

More Related