Mixed feeding is feeding in which due to hypogalactia or for maternal health reasons, part of the insufficient breast milk is supplemented with cow's or formula milk. It should be noted that the lack of breast milk in the first days after birth should not worry the mother and this should be the reason for the baby to be fed. During this period, you need to be patient, breastfeed more often at night and express breasts after the process. Two essential problems need to be solved in a mixed diet:
- The first is the detection of actual hypogalactia in the mother. Before that, it is necessary to do everything possible to increase lactation: the child should be breastfed, express milk after feeding and instill in the mother confidence in successful lactation, without rushing to supplement the child.
- The second problem is the choice of milk, which will supplement the insufficient milk.
Difference between breast milk, formula and cow's milk .
Sour (fermented) cow's milk. Until recently, the only option was to feed the children with cow's milk, especially sour milk. It is preferred to feed with fermented cow's milk due to the fact that it is easier to digest and better tolerated, and higher usability of protein, calcium and iron is found. When fermenting milk, part of the milk sugar is converted into lactic acid, which contributes to the fine precipitation of milk proteins in the stomach and has antibacterial action in the digestive system. Lactic acid bacteria in fermented milk suppress the development of pathogenic microorganisms, reduce the formation of toxins and toxic substances in the infant's colon and do not cause constipation. In addition, yogurt is more durable and harder to spoil or contaminate. Better absorption of iron is also ensured,
Cow's milk, whether fresh or fermented, has deficiencies as an nutrient for infants compared to human milk.
Breast milk is the most appropriate and complete food for children. The child is allowed to eat yogurt after 6 months of age, but it is better not to include it in the children's menu until the end of the first year of life. Children at this age can be fed yogurt only if it is impossible for parents to provide infant milk.
Cow's milk differs from mother's in its composition. Breast milk contains less salt and protein, but more carbohydrates. Cow's milk contains less enzymes than lipase and diastase, which are destroyed during digestion, as well as unsaturated fatty acids - linoleic and arachidonic acid. The biggest advantage of breast milk is its sterility, while cow's milk, even in the best storage, is always contaminated with microorganisms.
Research confirms that breast milk is the optimal species-specific food for the infant, especially in the first few months after birth, but that in case of proven hypogalactia or lack of breast milk as a supplement or substitute, formula should be used and only as a last resort. , to use fermented milk. Yeast can also be used in mixed and artificial feeding, mainly after the age of 4-5 months, in the absence of formula. Diluted fermented milk (1/2) (ratio of fermented milk and rice water 1: 1) is a defective food, used in exceptional cases and only in the first month after birth. From 2 - 4 months the child is given diluted fermented milk (2/3), sweetened with 5% sugar. The dilution is made with rice water in a ratio of 2 parts fermented milk: 1 part rice water and sweeten with a teaspoon of thick sugar syrup per 100 grams of milk. Diluted yogurt is better tolerated by children because the casein in diluted milk decreases, and reduces the amount of indigestible fats and minerals. From 5 months the fermented milk is not diluted. Milk can also be fermented at home. We need quality fresh milk and symbiotic yeast, which contains the two lactic acid microorganisms - Lactobacillus bulgaricus and Streptococcus thermophilus in certain proportions. Milk can also be fermented at home. We need quality fresh milk and symbiotic yeast, which contains the two lactic acid microorganisms - Lactobacillus bulgaricus and Streptococcus thermophilus in certain proportions. Milk can also be fermented at home. We need quality fresh milk and symbiotic yeast, which contains the two lactic acid microorganisms - Lactobacillus bulgaricus and Streptococcus thermophilus in certain proportions.
How to conduct a mixed diet?
Another problem that is very important from a practical point of view is how to calculate the amount of breast milk that the baby sucks to determine the required amount of formula to be added at each feeding. This is done by weighing the baby before and after breastfeeding and the difference in weight will show the amount of food consumed. Due to the fact that lactation is not the same at different times of the day and depends on many psychological factors, these measurements have to be performed several times over several days. Once the amount of milk that the baby is expressing is determined, the required amount of formula is added.
The technique of mixed feeding requires that the child be first placed on the breast to empty it completely and maintain, albeit insufficient lactation, and then with a spoon, a special breastfeeding bottle or a cup, he is given adapted or fermented milk. The amount of milk for supplementation is determined by the appetite of the child. It is possible that the child does not supplement in the morning, due to the fact that then the amount of breast milk is higher. Then the child should not be forced to drink the whole amount of formula. Force-feeding leads to anorexia and a negative attitude towards breastfeeding and eating. Mixed feeding, which alternates between breastfeeding and formula or fermented milk, is not recommended due to the fact that it leads to a rapid reduction in breast milk. On the other hand,
Objective indicators of malnutrition are:
- the child gains less weight than the corresponding age norm;
- systemic nutritional deficiency is established - reduced turgor and elasticity, reduced subcutaneous adipose tissue;
- at 3 weeks of age, physiological weight loss is not compensated;
- the weight of the child at 2 months is 10% lower than the birth weight.
There are two variants of mixed nutrition, the first variant is more physiological:
1. The baby is placed on the breast and then fed.
2. One or more feedings shall be replaced entirely by formula.
The number of feedings, the term of feeding, the intervals between them and the order of introduction of nutritious foods do not differ from those of natural breastfeeding.
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