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INFANT FORMULA

INFANT FORMULA. ESPGAN ( European Society for Paediatric Gastroenterology and Nutrition) : Cow`s milk is forbiden in infant`s nutrition during the first year of life

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INFANT FORMULA

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  1. INFANT FORMULA

  2. ESPGAN(European Society for PaediatricGastroenterology and Nutrition): Cow`smilkisforbiden in infant`s nutrition during the first year of life For this reason they have been created milk powder preparations with a composition similar to human milk = milk formulas.

  3. INFANT FORMULA 1. Start Formulas (0-6 months)2. Follow - up Formulas:  - 6 to 12 months;  - 1-3 years (junior formula);  - hypoallergenic formula (HA);3. Special formulas:  - for premature infants; - low lactose / lactose free (source of protein is cow milk / soybean); - height energy, low sodium formula.

  4. INFANT FORMULA Start Formula: • source of protein is cow milk, • used until the age of 6 month, • NAN 1, Lactogen 1, Humana 1, Milumil 1, Aptamil 1, Similac, Vitalact etc. Follow –up Formula: • source of protein is cow milk, • used from 6 month to 1 year, • NAN 2, Lactogen 2, Humana 2, Milumil 2 şi 3, Vitalact.

  5. Start Formulas

  6. Start Formulas

  7. Follow –up Formulas

  8. Follow –up Formulas

  9. INFANT FORMULA Junior Formula (Lait de croissance): • usedbetween1-3 years • NAN 1+, NAN 2+, Milumil Junior, Humana Junior. Hypoallergenic Formula (HA): • source of protein: extensive hydrolyzed cow milk proteins • used in infants withpersonal or familyhistory for allergies • NAN HA, Milumil HA.

  10. Junior Formula

  11. Hypoallergenic Formula

  12. Infant formula Preterm infant Formula: • adequated to their special needs- higher protein content- smaller amounts of lactose- easily assimilated fat (MCTs - Medium Chain  Triglycerides)- amount of calcium and phosphorus almost double- higher vitamin content than standard formulas PreNAN, AptamilPrematil, Humana 0, BIOPre etc.

  13. Preterm infant formula

  14. Infant formula Human milk fortifiers: - recommended for VLBW and ELBW preterm infants, - increase human milk caloric value, - used only under medical supervision - extensively hydrolyzed protein mixtures, - easily assimilated carbohydrates, - contain no fat, - Nestle FM85, Aptamil FMS.

  15. Human milk fortifiers

  16. Infant formula Low lactose /lactose free formula: - for the new - born babies and infants with lactose intolerance,- carbohydrate source: glucose polymer / starch- source of protein:  enzymatically hydrolyzed cow milk protein  (Alfare,Althera) or unchanged cow milk protein  (Milupa HN 25) - rich in MCTs.

  17. Low lactose /lactose free formula

  18. Infant formula Lactose free soy formula: • used in: • secondary lactose intolerance , • cow milk protein allergy, • Milupa SOM, Milupa Pregomin.

  19. Lactose free soy formula

  20. Infant formula Probiotics:- live bacteria, viable, resistant to gastric acid,  nonpathogenic, usually producing lactic acid- favor the multiplication of bacteria in the colon - bifidobacterias and lactobacilli.

  21. Infant formulaProbiotics Roles:  - stabilizing effect of intestinal barrier function  - protection against food / environmental antigens       - stimulates the production of Ig As and mucus,   - attenuates inflammatory responses inducedby pathogens.

  22. Infant formulaProbiotics Effects on the “distance“: - osteoporosis prevention; - colon cancer prevention; - prevention of inflammatory bowel disease; - effects on lipid metabolism.

  23. Infant formula Prebiotics (oligosaccharides and disaccharides): carbohydrate food`s components which are not digested  and absorbed in the proximal colic digestive tract → fermentation substrate → stimulates bifidobacterias proliferation.

  24. Infant formulaPrebiotics Roles:  - modulate immune function;  - compete for receptors with pathogens;  - selectively stimulate and enhance a limited number  of endogenous beneficial bacterial species, resident in the colon, producing antimicrobial substances.

  25. Infant formulaPrebiotics Effects: - multiplication of lactobacillus flora and faecal fermentizing type; - improve bowel function; - increase the resistance against digestive pathogens; - systemic immune response modulation; - reduce the risk of allergies; - reduce the risk of colon cancer; - reduce serum cholesterol and lipids; - increase the bioavailability of the colon; - increase the bone mineralization.

  26. Infant formula Long Chain Polyunsaturated Fatty Acids - L.C.P.U.F.A. Major sources:  microalgae  fungal and marine oils  egg yolk.

  27. Infant formulaL.C.P.U.F.A. Roles:- major structural components of cell membranes  (phospholipids);- promote  brain and retina development;- confer  protective antiallergic;- immune system development.

  28. Infant formula Nucleotides (cytidine, uridine, adenosine, guanosine) Roles: - precursors of nucleic acids; - constituent of enzymes; - cellular energy source; - growth and differentiation of gastrointestinal tract; - antidiarrhea protection;  - immune system development.

  29. Infant formula Established intestinal microflora during the first 2 years of life determines the position and profile of intestinal adaptation for life, thus having a significant impact on the development of diseases: allergies, asthma, gastro-intestinal diseases.

  30. Disadvantages of bottle feeding Strict rules to reduce the risk of infection:  - fresh preparation at every meal;  - discard any unused quantity of the remaining milk;  - strict hygiene;  - in hospitals - guidelines (protocols) written for preparation and handling, with strict control of  compliance.

  31. Weaning foods

  32. Weaning foods Definition:foods introduced in infant`s diet after the age of 4 – 6 month - progressive process (it takes several months);- purpose: food supplementation (caloric and quality);- will be started at age 4 months to bottle fed infants;- may be delayed until the age of 6 months in breast fed infants.

  33. Weaning foods Principles:- diet should be balanced and rational;- introducing a new food will be made only when the infant is healthy;- first food introduced is individualized depending on the specifics of development in infants: - appropriate weight for age → vegetable soup or fruit puree; - weight deficit →  diet enriched in protein;

  34. Weaning foods • caloric value of newly introduced food (meal) must be greater than that which is removed from the diet; - introduction of new food will be progressive →20-30g/day at each  meal, reducing the same amount of milk, up to completely replace the milk at that meal with the new food; - newly introduced food will be administrated with a spoon;

  35. Weaning foods - should be introduced one new food per week - at the same meal  • can be combined more food but only after  testing each one tolerance; • - in case digestive disorders (vomiting and / or diarrhea) occur, the new food is interrupted and then resumed  after a few days to normalize intestinal transit; - we use second stage of age infant formula;

  36. Weaning foods - polysaccharides (starch)will be introduced into the diet with priority over sugar;- until the age of 6-7 months will not provide gluten  flour but only those of rice, corn;- will avoid rare and abundant lunch which:■ increased lipid synthesis from carbohydrates■ increased fat deposition■ increase the biosynthesis→ cholesterol and triglycerides■ causes gastric hypertrophy■ increase the intestinal absorption surface■ cause changes in liver enzymes.

  37. Weaning foods • number of meals per day will be determined by age, hunger - satiation sensation and infant`s weight; - the infant will not be forced to consume the entire meal offered (risk of "opposition "); - generalization of a food that is received with pleasure at all meals disrupt the nutritional balance of the infant; - hydration between meals is made with sweetened  liquids (tea, boiled and cooled water);

  38. Weaning foods - if the weaning chart is correct, we should not  supplement infant’s diet with vitamins; - from the age of 7-8 months self-supply should be encouraged; - weaning foods will be mashed until the first teeth appear and crushed after that age; - the best criterion of weaning success is tracking  infant`s growth curves and development.

  39. Weaning foods

  40. Weaning foods Foods used: 1. Vegetables: carrots, potatoes, parsley, spinach,  lettuce, zucchini, red peppers, green beans;  as soups and puree.Industrial products (simple vegetables / cereals with added vegetables, meat or fish) may be used after the age of 6-8 months, depending on composition.

  41. Vegetables, rice and turkey puree Patatoes, carrots, cicken puree

  42. Weaningfoods Infant cereal:- are introduced from the age of 4-6 months - important source of calories and fiber to regulate bowel movements - fortified with vitamins, calcium and iron • bacteriological secured    - gluten-free - for infants aged 4-6 months- with gluten - for infants aged > 6 months.

  43. Weaning foods

  44. Weaning foods Biscuits: after 6 months of age, in combination with fruit puree. White bread: after the age of 8 months Pasta (noodles) from the age of 8 months, boiled in soup.

  45. Weaning foods Fruits:   apples, peaches, bananas,  - juices, purees and compotes.Forbidden during the first year of life:   fruits with small seeds  (raspberries, strawberries,  blueberries, blackberries, kiwi) with strong allergy action.

  46. Three fruits juice with vitamin C Fruits puree

  47. Weaning food Cottage cheese:  from the sixth month of life, 20-30g each day,  mixed with rice, soup, mashed vegetables or fruits.Cow cheese (unsalted):  from 8-9 months of age,  mixed with porridge / Pasta (pudding).Fermented cheese: after 1 year of age.

  48. Weaning food EggYolk:  boiled for 5 minutes  after the age of 4-5 months, 2-3 times / week  mixed with soup or mashed vegetables.White: not given until the age of 1 year because it causes allergies.

  49. Weaning food Liver (chicken / beef)  after the age of 6 months  20 - 30g/day, in vegetable soup / puree, on days when  no egg or meat are used.Meat (chicken / beef)  after the 5 month of life  cooked, chopped very fine, place 20 -30g/day in  vegetable soup or vegetable puree.

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