In this episode, we will be reviewing what you need to know before your first discussion about infant formula.  We will cover the characteristics and types of formulas, why infants might require different types, the correct way to prepare formula and how much infants need, common concerns from parents, indications for changing formulas, and when to transition away from it.
 

Reasons for formula feeding 
Human milk is first choice for most infants
Concern about lactating parent’s milk supply
Workplace conditions make it difficult to sustain human milk feeding
Parent preference 
There are few true contraindications to breastfeeding. 
Galactosemia
Maternal HIV infection that has not achieved an undetectable viral load
Maternal phencyclidine (also known as PCP) or cocaine use
Active Herpes Simplex virus lesion
Active tuberculosis




Types of formula: 3 characteristics
Caloric density: calories per ounce. Standard term formula is 20 calories/oz. Infants born preterm or have growth failure may need 22-27 calories/oz.
Carbohydrate source: Lactose (galactose + glucose) or non-lactose
Protein type: 
Cow-milk based formula proteins are whey and casein.
Hydrolyzed formulas: proteins are broken down into smaller protein “chunks” or into individual amino acids, which are hypoallergenic and easily digestible. 
Other formulas utilize different sources of protein, including soy protein and goat’s milk.
Special formulas for infants with specific metabolic conditions: eg. phenylketonuria, maple syrup urine disease, homocystinuria.




Forms of formula
Powder: most common and least expensive. Usually, 1 scoop of formula powder is mixed with 2 oz water. 
Liquid concentrate: mixed 1:1 with water. 
Ready to feed: no mixing required, but most expensive.
Be sure that the formula is being mixed correctly! Incorrect formula mixing can result in growth failure or electrolyte abnormalities.


How much formula should b...

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