GUIDE TO INFANT AND TODDLER MILKS

Breastmilk provides a baby with perfectly balanced nutrition, which is why both the Department of Health (DoH) and the World Health Organisation (WHO) recommend exclusive breastfeeding for the first six months of a baby’s life and continued breastfeeding alongside the introduction of appropriate solid foods beyond six months1,2.

Some mums choose not to or can not breastfeed. In this instance, infant formula milks provide the only alternative to breastmilk. The Department of Health recommends that cows’ milk should not be introduced as a main drink before 12 months of age. To optimally support the changing nutritional needs of infants and toddlers throughout the different stages of their development, there are different formula milks available.

• FIRST INFANT MILK (STAGE 1) is a nutritionally tailored formula suitable from birth onwards if mum is combination feeding or exclusively bottle feeding.

• FOLLOW ON MILKS (STAGE 2) are nutritionally tailored to complement a weaning diet for formula fed babies from 6-12 months of age.

• GROWING UP MILKS (STAGES 3 & 4) have been specifically fortified with nutrients to support toddlers’ increased nutritional needs, such as iron to support normal cognitive development.

• SPECIALIST MILKS are specifically tailored to the differing needs some babies may have including common feeding issues such as reflux, colic and constipation, Cows’ Milk Allergy (CMA) and lactose intolerance and provide all the nutritional requirements the babies need to develop.

1. http://www.who.int/nutrition/topics/infantfeeding_recommendation/en/ [Accessed October 2017] 2. UK Department of Health. Infant Feeding Recommendation 2003.

For Healthcare Professional Use Only

Conception Toddlerhood

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Childhood &Adolesence

Adulthood–

THE FIRST 1000 DAYS

SOME KEY INGREDIENTS TO LOOK OUT FORLong chain polyunsaturated fatty acids (LCPs) can be made in the body from essential fatty acids. In infants this process is not very efficient and so preformed LCPs should be provided by the diet as well. Breastmilk and most formula milks contain LCPs, the most important of which are EPA, DHA (both Omega 3) and AA (Omega 6). LCPs support the normal visual and cognitive development of infants9.

Protein is needed for growth and development of infants. There are two types: Whey and Casein. Whey forms a soft curd in the stomach, easily digested and promotes rapid gastric emptying. Casein forms a firmer curd in the stomach, is more slowly digested and promotes slower gastric emptying10.

Prebiotic oligosaccharides e.g. galacto- and fructo- oligosaccharides (GOS/FOS) are non-digestible carbohydrates that occur naturally in breastmilk. They encourage growth in the numbers of friendly bacteria in the gut, at the expense of potentially harmful bacteria11.

LOOKING INTO THEIR FUTURE

The early stages of life, from conception to toddlerhood, are a period of rapid growth and development. Research into this period is known as ‘Early Life Science’ and current evidence indicates that environmental factors, including nutrition, can have a major influence on a child’s lifelong health3-5.

The first 1,000 days of an infant’s life, from conception until their second birthday, are key to determining their lifelong health6,7. This is when environmental factors – such as nutrition – can influence rapidly developing organs and body systems4,5.

GUIDE TO MAKING UP A BOTTLEFEEDFeeds need to be prepared when required, storing or freezing formula milk is not recommended. It’s always best to follow the instructions on-pack. Please note these instructions are for powdered milks only. Preparation instructions for Specialist Milks will vary. For Follow-on milks and Growing Up milks: If you are bottle-feeding, the Department of Health advises to introduce a cup or beaker from about six months8.

3. Gluckman P. Impact of early-life nutrition on NCD development in adulthood. Medical Tribune: February 2013 [online]. Available at: https://enews.mims.com/landingpages/mt/pdf/Medical_Tribune_February_2013_HK.pdf [Accessed June 2017]. 4. Scientific Advisory Committee on Nutrition. The influence of maternal, fetal and child nutrition on the development of chronic disease in later life. London: TSO, 2011. 5. British Nutrition Foundation Task Force. Nutrition and Development: short and long term consequences for health. Chichester: Wiley-Blackwell, 2013. 6. National Childbirth Trust. First 1000 days [Online]. Available at: http://www.nct.org.uk/about-nct/first-1000-days [Accessed June 2017]. 7. 1,000 Days. Why 1,000 days? [online]. Available at: www.thousanddays.org doi:10.1016/S0140-6736(13)60355-4 [Accessed June 2017]. HCP596.

© 2017 Danone Early Life Nutrition; 17-055

8. https://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/drinks-and-cups-children.aspx. 9. Koletzko B et al. J. Perinat. Med. 36 (2008) 5–14. 10. Billeaud C et al. Eur J Clin Nutr 1990;44:577-83. 11. Arslanoglu S et al. J Biol Reg & Homeost Agents 2012;26(3):49-59.

IMPORTANT NOTICE: Breastfeeding is best for babies. Infant formula is suitable from birth when babies are not breastfed. Follow-on milk is only for babies over 6 months, as part of a mixed diet and should not be used as a breastmilk substitute before 6 months. We advise that all formula milks including the decision to start weaning should be made on the advice of a doctor, midwife, health visitor, public health nurse, dietitian, pharmacist or other professional responsible for maternal and child care. Foods for special medical purposes should only be used under medical supervision. May be suitable for use as the sole source of nutrition for infants from birth, and/or as part of a balanced diet from 6-12 months. Refer to label for details.

Many environmental factors have an impact on later health, but diet and early life nutritional exposure are particularly significant4. By making the right nutritional choices from conception to toddlerhood, mothers can make a significant difference to their children’s long term health.

To find out more about the first 1000 days and their importance you can visit thousanddays.org.

1 Wash and sterilise bottles and teats according to manufacturer’s instructions. Wash your hands and wipe clean all surfaces to prevent the spread of germs.

2 Boil 1 litre of freshly run tap water and leave to cool for 30 mins, unless otherwise indicated on pack. Measure required amount of water (refer to on-pack instructions) into a sterilised bottle. Do not use artificially softened or repeatedly boiled water.

3 For accurate dosage, always use scoop provided and level off powder with built-in leveller (if provided). Alternatively, level with a clean, dry knife. Do not press extra powder into scoop.

4 Add correct measure of powder to water. Adding too many or too few scoops can be harmful. The feeding instructions on the pack will give you an indication of the number of feeds the baby may need per day.

5 Screw cap on bottle and shake well for 10 seconds to dissolve powder in water. If necessary, cool feed under cold running water. Remove seal and replace with sterilised teat. Test temperature of milk by allowing some drops to fall on your wrist. If it feels comfortable, it should be just right for the baby. Do not heat feeds in a microwave as hot spots can occur and cause scalding.

6 Use made-up feeds within two hours. Once used, discard any leftover milk, wash bottles and teats, and re-sterilise, ready for next feed.

EARLY NUTRITIONAL INTERVENTION CAN HAVE A POSITIVE EFFECT ON LONG-TERM HEALTH OUTCOMES.4

PRETERM

FIRST INFANT MILK, FOLLOW

ON MILK & GROWING UP

MILK

HUNGRIER BABIES, TO HELP DELAY

THE EARLY ONSET OF WEANING

COWS’ MILK ALLERGY

LACTOSE INTOLERANCE

FUNCTIONAL GASTRO

INTESTINAL DISORDERS

(FGIDS) including colic,

constipation and reflux

MALABSORPTION

ON PRESCRIPTION

RETAIL

OVER THE COUNTER IN PHARMACY

IN HOSPITAL

Availability:

For Further information on our products visit eln.nutricia.co.uk

Teat and preparation instructions may differ compared to standard milk. Please refer to instructions on pack.

PRODUCTS FOR A RANGE OF NEEDS

Hungry Milk Hungry milk is a casein-dominant, Infant formula for hungrier, bottlefed babies. Suitable for use from birth onwards.

Nutriprem Human Milk Fortifier Used to fortify expressed breastmilk for preterm babies.

Pepti 1 Extensively hydrolysed formula for the dietary management of cows’ milk allergy from birth.

Pepti 2 Extensively hydrolysed formula for the dietary management of cows’ milk allergy from 6 months as part of a weaning diet.

Comfort Nutritionally tailored for the dietary management of colic and constipation.

Pepti-Junior Extensively hydrolysed formula with medium chain triglycerides (MCTs) for the dietary management of malabsorption related conditions in infants.

Anti-Reflux Thickened formula for the dietary management of frequent reflux and regurgitation.

Lactose Free For the dietary management of lactose intolerance.

Instant Carobel Thickener for the dietary management of infantile vomiting and possetting when no organic cause is known; habitual and recurrent vomiting, e.g. gastro-oesophageal reflux; dysphagia; rumination.

Nutriprem Protein Supplement For extremely low birthweight infants who require extra protein.

Nutriprem 1 Meets the increased needs of preterm and low birthweight babies.

Nutriprem 2 Helps support the catch-up growth of preterm and low birthweight babies once they have been discharged from hospital.

First Infant Milk Stage 1 Formula suitable from birth onwards, if mum is not breastfeeding or is combination feeding. Suitable for use from birth onwards.

Follow On Milk Stage 2 Nutritionally tailored to complement a weaning diet for babies 6 months onwards, including iron and vitamins A, C & D.

Growing Up Milk Stage 3 These fortified milk drinks, are nutritionally tailored for toddlers between the ages of 1 and 2 years, as part of a varied, balanced diet.

Growing Up Milk Stage 4 These fortified milk drinks, are nutritionally tailored for toddlers between the ages of 2 and 3 years, as part of a varied, balanced diet.

For Healthcare Professional Use Only

Hydrolysed Nutriprem For preterm and low birthweight babies not tolerating standard preterm formulas.

birth-6 months 6-12 months 1-2 years 2-3 years