Modified milk – what it is, types, indications and contraindications to use

Proven content

Modified milk is designed to supplement the infant’s diet or is an alternative to mother’s milk when the child cannot consume it for various reasons. Various types of formula are available, as well as special milk replacers. The use of individual products requires that you first familiarize yourself with the indications and contraindications for formulated milk and breastfeeding. Breast milk remains the optimal food when it can be administered safely.

What is formula milk?

Formula milk is cow’s milk that has been modified in such a way as to resemble human milk as much as possible in terms of its composition and nutritional value. This type of modified milk is used primarily when, for various reasons, it is not possible to breastfeed a child. Mother’s milk is considered to be the most beneficial feeding of the child, therefore breastfeeding or expressed milk is recommended if possible. However, in the event of contraindications to breastfeeding or separation of the child and mother, modified milk preparations remain an alternative.

Proper nutrition of newborns and infants is crucial for the proper development of their immune system. Nutrition in the case of the youngest may also affect their health in the future, because the proper supply of food reduces the risk of developing allergies, osteoporosis, obesity, atherosclerosis or type 2 diabetes in the future. .

See also: Mother’s milk from a pediatrician’s perspective – truths and myths

Modified milk – indications for use

The indications for infant formula feeding usually relate to specific health problems affecting the mother or child, including the inability to breastfeed or express breastfeeding. The main indications for feeding an infant with modified milk include:

1. baby food intolerances (lactose intolerance, galactosemia);
2. your baby has a suckling problem;
3. chronic diseases of the mother, which require taking certain medications that affect the composition of milk;
4. some diseases of the mother, affecting the condition of milk.

Modified milk can also be a component of mixed feeding, i.e. the use of mother’s milk and modified milk in the child’s diet.

When is breastfeeding inadvisable?

According to the recommendations for infant nutrition (ESPGHAN guidelines – European Association of Gastroenterology, Hepatology and Nutrition in Pediatrics), it is considered optimal to feed infants with breast milk during the first 4-6 months of life. Such nutrition is sufficient to provide the baby with the ingredients necessary for proper development if the mother is healthy. During the first six months of a child’s life, apart from mother’s milk, it is only possible to administer vitamins.

Check it out: What is the lactation crisis?

It is not always possible to breastfeed your baby. Relative contraindications to this method of nutrition may be the child’s severe general condition, the occurrence of a cleft palate (it makes it difficult to suck) or conditions that make sucking too much effort for the child (e.g. in the case of some heart defects or cachexia). In these situations, the solution may be to give the baby previously expressed breast milk.

Do absolute contraindications to breastfeeding they include:

1. congenital lactase deficiency in a child;
2. classic galactosemia in a child;
3. maternal HIV, HTLV-1 or HTLV-2 infection;
4. active and untreated tuberculosis – in this case, starting breastfeeding is possible after a minimum of two weeks of treatment;
5. taking certain medications by the mother.

Modified milk – types

When natural breastfeeding is not possible, modified milk is introduced into the baby’s diet. The appropriate type of preparation is selected based on the child’s age and any additional dietary recommendations. Basic types of modified milk have:

1. starting milk – served to a child from birth to 6 months of age;
2. next milk – intended for children from 7 months of age.

These types of modified milk are appropriately differentiated in terms of quantity and quality to meet the needs of a child at a given stage of development. If specific clinical indications arise, nutrition is introduced with the following products:

1. modified milk for premature babies and newborns with low birth weight – these are the so-called post-discharge preparations (PDF)which have a richer composition (more iron, protein, vitamins, minerals, trace elements) and higher caloric content than the starting milk, thus reducing the risk of deficiencies;
2. hypoallergenic milk preparations (HA) – these types of preparations are used in the prevention of allergies, when a child has a higher probability of its occurrence due to family tendencies; HA preparations contain a partially hydrolyzed fraction of cow’s milk proteins (pHF), so they cannot be used when a child has symptoms of lactose intolerance or allergy to cow’s milk proteins;
3. antireflux formulas of modified milk – contain thickeners (AF), pHF and oligosaccharides, preparations that are given in the case of suspected gastro-oesophageal reflux disease in a child, but not in the event of spilling or food allergy;
4. low-lactose or lactose-free formulas of modified milk – administered especially in the case of osmotic diarrhea with abdominal pain and flatulence, colic or constipation; this group includes, for example, Comfort low-lactose formula milk; in the case of congenital lactose intolerance, lactose-free products are used.

In addition to formulated milk, it is also used in specific medical indications milk replacerswhich belong to food for special medical purposes. Milk replacers include:

1. amino acid preparations, or elemental (AAF) – used in the case of eosin esophagitis, severe enteropathy or severe anaphylactic reaction caused by cow’s milk proteins;
2. preparation eHF (with hydrolyzed fractions of cow’s milk proteins) – products of this type are given to the child in the absence of disaccharidases, and also to diagnose and treat allergies caused by soy and cow’s milk proteins;
3. preparaty MCT – they are enriched with medium-chain fatty acids, they are also distinguished by a reduced lactose content; the use of MCT preparations begins with specific diseases, including cystic fibrosis, hyperlipidemia, hypoproteinemia, after bowel resection, liver failure, pancreatic problems, digestive disorders, deficiency of disaccharidases or resistant diarrhea;
4. milk replacers administered for phenylketonuria and hyperphenylalaninemia – can be given only to sick children, they do not contain phenylalanine.

Modified milk – contraindications

Modified milk can be used as baby food only if it is completely safe and none of the ingredients of the product will harm the baby. It is also recommended identifying specific reasons to include modified milk in the child’s diet or to replace it completely with mother’s milk.

The type of modified milk should be adapted to the age of the child, as well as any possible health problems. Certain types of preparations may have different contraindications to their use. Among contraindications to the use of certain types of modified milk are located:

1. allergy to cow’s milk proteins or lactose intolerance – in this case it is necessary to choose a preparation that does not contain these ingredients;
2. the type of hydrolyzed protein (or the degree of hydrolysis) that is inappropriate for the infant or the inappropriate qualitative and quantitative composition of a given product;
3. good health of the child – in healthy children, specially enriched varieties of modified milk or milk replacers are not used; if the mother cannot feed her child for health or other reasons, the formula should be selected with the appropriate composition.

How to give infant formula milk?

Feeding a child with modified milk is associated with the need to properly prepare the food in a way that is safe for the child. Powder products should be prepare for administration immediately before feeding – food portion should be fresh. Remaining formula milk should not be used in the next feeding. Any milk residues should be thrown away.

Another recommendation for formula milk is its storage – the mixture should not be placed in thermos jugs or bottle warmers. It is possible to put heated water in a thermos flask, but the powdered preparation should be dissolved in it immediately before the planned feeding.

Read also:

1. Which lactose-free formula is best?
2. What how much to feed a newborn baby?
3. The 7 most common health problems associated with breastfeeding