Follow-up milks, types and preparation

In addition to the four types of continuation milks classic (for premature babies; initial or type 1 -up to six months-, continuation or type 2 -up to 12 or 18 months-, growth or type 3 - from one to three years), the different brands offer special milks adapted to some situations. Are continuation milks they should always be advised by the pediatrician, since they are not the first choice for any child if it is not justified. Many have two versions: the starter and the continuation version, to adapt to the baby's age.

Types of follow-on milks

• Lactose-free milk (SL): for, the milk sugar.
• Anti-regurgitation (AR) milks: for infants who vomit a lot. They are formulated with carob flour and other thickeners to avoid regurgitation.
• Anti-colic milks (AC): they can be partially hydrolyzed (part of the proteins are broken so that they can be digested better) and, thus, minimize intestinal discomfort.
• Anti-constipation milks (AE): promote intestinal transit in cases of difficulty in bowel movements.
• Hydrolyzed Milks (AH) - All milk proteins are broken down so babies allergic to cow's milk protein can have a choice for feeding.
• Vegetable milks (soy and rice): they are not first line and were used more than now. They are especially indicated in

All artificial milk They must be packaged in a "protective atmosphere". This means that the air surrounding the product in packaging has been replaced by a gas or gas mixture. This system maintains the quality of the product for a longer time and increases its useful life with the advantage of not requiring additives or preservatives.

Labeling of continuation milks

Labeling is of the utmost importance and must comply with a series of requirements and laws. Of course, they must include the formulation and its nutritional components, the way of conservation and preparation of the milk, as well as warn about the health risks in case of improper use. Furthermore, as we have said before, they cannot compete with breast milk, so they cannot imply or that they are better than breast milk or use words such as "formulated" or "humanized".

How are follow-on milks prepared?

The manufacturer can sell the milk powder or liquid (already reconstituted). Liquid ones require less handling and are more practical, although they are also more expensive and there is less variety than powdered milk. In cases where it is powder, the water must be reconstituted. The water does not have to be boiled, but it is recommended that it be hot. It does not have to be bottled if we have potable tap water. In the event that the water is bottled, it must be low in sodium and not very mineralized.

The gold standard

La is the "gold standard", the benchmark that all artificial milks want to imitate. But what makes it so special? The main thing is that it is a living and functional food. This is demonstrable because its composition is variable:

• Change its composition throughout the day.
• Change its composition during the same feed: it has more fat at the end of the feed than at the beginning.
• It changes throughout breastfeeding: higher content of protein, water and mineral salts in the first days of breastfeeding, known as colostrum, so that it "adapts" to the needs of the child as it grows.
• Mother's milk does not usually alter its composition even in circumstances of malnutrition of the mother. This ensures the survival of the baby.

This changing pattern and so tailored to fit the growing child is virtually impossible to replicate. So far, as we have commented on the types of artificial milks, it has been agreed to make three different compositions: milks for premature babies, starter milks and continuation milks.

Proper, optimal and functional nutrition and artificial milk

Proper nutrition is what provides the basic nutrients for the development of the individual. In the milk we would be talking about: lactose, proteins, fat, vitamins and minerals in the same proportions as breast milk. The optimal nutrition would be the one that provides, in addition to the basic nutrients of breast milk, other components of great importance for it, such as growth factors, nucleotides, immunoglobulins, oligosaccharides, certain amino acids such as taurine and α-lactalbumin. The union of adequate nutrition with optimal nutrition would provide the so-called functional nutrition or functional formula. This formula is the one currently endorsed by health authorities and pediatric associations as the best option for infants who cannot breastfeed.

How can I give the follow-on milk in the best way?

The latest recommendations from pediatric associations recommend offering the continuation milk similarly to the maternal:

• On demand (in time and quantity)
• Looking, talking to the baby and stroking it
• Change the child's arm at each feeding, to stimulate both cerebral hemispheres.
• Changing brands can help her get used to different flavors (such as when breastfeeding, as breast milk changes flavor depending on what the mother eats).

Are yoghurts adapted with follow-on milk necessary?

All pediatric associations confirm this: they are absolutely unnecessary, since babies under one year old do not need to consume yogurts, which are also full of sugars, flavorings and preservatives. If you want to offer yogurt to the baby, it can be made with natural yogurt (without sugar) at eight or nine months in small quantities (a few tablespoons).

• The pattern of breast milk is so changeable and so tailored to fit the growing child that it is virtually impossible to imitate.
• The continuation milks adapted to the baby's age (from six months to three years), we find milks for special needs (lactose-free, anti-constipation, anti-colic ...)
• The latest recommendations from pediatric associations recommend that it be offered in a similar way to the maternal one (on demand, caressing it, talking to it and changing sides), and it is also advisable to change the brand.

Pediatric Specialist