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(11) Save Kids International

 NATA23

 Natalia Yefimova

 UNICEF: Developmental Milestones in Children

SK11

0-6 months

 Is it OK to store bottles of made-up formula milk in the fridge?

It is recommended that bottles should be made immediately before a feed, rather than prepared in advance and stored in the fridge-for hygiene reasons. It may seem a little overcautious, but the powder itself is not sterile and there is a small risk that the made-up formula could become contaminated with micro-organisms.

Discard any of your baby’s half finished bottles when she has finished feeding. Don’t be tempted to reheat them later on, since this can allow harmful bacteria to multiply.

If you are out for the day, use an insulated container to store freshly boiled water and mix up with the formula powder or liquid when you need it.

My baby has had an upset tummy since I changed her formula; should I go back?

It’s probably a good idea to go back to your original formula, which may have a different ratio of casein to whey or simply a different combination of nutrients. Some babies are very sensitive to change, which is why it can be sensible to bring reserves of his usual formula when traveling. If he doesn’t improve when you return him to his original formula, it would be a good idea to see your doctor to establish whether or not there is another cause.

My baby will only accept a certain formula, which makes it difficult when we travel or run short. What should I do?

Many babies become very attached to a specific formula, and will be resistant to trying anything new. You can help to prevent this problem by swapping between two similar brands from time to time, to accustom her to different tastes and nutrient balances. You can also purchase a supply of her regular formula in “ready-made” format, to take with you on vacation. If you go prepared with plenty of formula, you will hopefully not be caught short. If you do find yourself running out of your baby’s favorite formula, try making up a bottle of another brand and mixing it with your baby’s usual milk. She may be less resistant if the taste is very similar, and you can eventually eliminate her original formula altogether.

Since there’s so little difference between formulas milks, if you switch between them, your baby will get used to different flavors. After all, breast milk changes flavor all the time.

The right temperature

Heating formula milk to the correct temperature is important. It should be at body temperature. Check this by shaking a few drops on the inside of your wrist-you shouldn’t feel the milk. You can heat your baby’s milk in the microwave, but look out for “hot spots” in the milk, which can burn your baby’s mouth. Shake it carefully after heating, and do not offer until it has reached body temperature.

Does my baby need extra water if he is drinking his formula?

Neither breast- nor bottle-fed babies should need any extra water; milk provides all the fluid they require until six months of age. However, you may occasionally want to offer some cool boiled water if the weather is very hot, he is unsettled between feeds, or he is constipated. However, be careful not to give too much, and to offer it after feeds, as there are no calories in water and it will fill him up, possibly causing his weight gain to suffer.

Do I really have to sterilize everything I use to prepare formula?

It is important to sterilize everything involved in the preparation of your baby’s milk. The reason is that even small traces of bacteria on a spoon or jug can multiply and cause sometimes serious health problems for your baby. Your baby’s milk contains sugars that will literally feed bacteria, which can breed very quickly, particularly in warm milk.

Do I have to use a sterilizer for all the bottles, or will the dishwasher do?

The dishwasher is fine, as long as the machine is clean, and the other dishes washed alongside are not covered with food debris, which can cling to the bottles and the teats, and attract harmful bacteria once removed from the machine. It’s also important to ensure that your machine reaches a temperature of at least 175ºF or more, which is necessary to kill bacteria and viruses. Rinse the bottles in cooled, previously boiled water when you take them out, to remove all traces of detergent, and fill the bottles with formula as soon as possible.

How can I sterilize my baby’s bottles when we are traveling?

If you have access to a kitchen, microwave sterilizer bags are good for traveling. Also, you can now buy microwavable bottles that can be sterilized in the microwave on their own. You can sterilize bottles and teats in a dishwasher too. Otherwise, the most effective method is to boil them for about 10 minutes in a clean pan (the pan needs to be used exclusively for this purpose), which will remove any potentially harmful germs and bacteria.

You may not always have access to a kitchen or electricity, though, in which case cold-water sterilization (using a non-toxic solution) is your best bet. You can purchase fluid or tablets that can be added to water in special sterilizing units or a clean plastic container with a lid. The bottles will need to be soaked or submerged for about half an hour and you may wish to rinse them with cool, previously boiled water to remove all traces of the solution, although this isn’t necessary. You can leave the bottles in the solution for up to 24 hours, and use them as required. Remember that they can quickly lose their sterility, so try to fill them immediately after they have been treated.

Weight worries

It’s natural for new parents to be concerned that their baby is growing and developing at the right speed, and that he is getting the right amount of milk for his needs. Rest assured that within the first few weeks, your new baby will let you know exactly what he needs, and you’ll soon become alert to any potential problems.

 How can I tell that my baby is growing normally?

When your baby is born, you’ll be given a growth chart, usually in the back of your baby’s record book, on which the healthcare professional will plot her height and weight. The current growth charts are based mainly on bottle-fed infants, but you can ask for a chart designed for breastfed babies if your baby is exclusively breastfed. For the sake of accuracy, it is important to have your baby weighed at her clinic from time to time, to ensure that you have the correct data.

From birth, your baby’s height and weight can be plotted on the chart, which is broken up into percentiles. The percentile charts work on averages so being on the “50th percentile” for weight or height means your baby is absolutely average for her age. Similarly, being on the “91st percentile” for height indicates that your baby is tall for her age. The idea of plotting these figures is to ensure that your little one remains on much the same line as she grows. So if she was born heavy, she is likely to remain heavy throughout infancy and into childhood, and if she was born smaller than most other babies, she is likely to remain on that line as well. There will always be upward and downward blips, and it’s important not to worry too much about these, as they represent normal growth patterns. What you are looking for is a fairly regular picture over time. In the short-term, if your baby is alert, putting on weight, sleeping well, and looks well and content, she will be growing properly and there is no need for concern.

My baby was small at birth and is still slight for his height; should I be worried?

If your baby is on roughly the same percentile line that he was when he was born, there is absolutely no need for concern. Some children (and adults) are smaller and slighter than others, and are perfectly healthy. He may have a significant growth spurt later in childhood, which may bring him to a more average height and weight, or he may remain small. If he is healthy and well, and he’s growing normally, there is nothing to worry about.

My baby seems hungry even though I’m giving her the recommended number of feeds. Is it OK to offer more?

A All babies have different needs, and formula manufacturers base their instructions upon the average baby. The best advice is to offer about 4-5fl oz (120-150ml) of milk per 2lb 3oz of body weight during each 24-hour period while your baby is below 11lb (5kg). If your baby still seems hungry, try offering an extra 1-2fl oz (30-60ml) during each feed, to see if that makes a difference. If your baby’s weight is above 11lb (5kg), she will need 31⁄3-4 fl oz (100-120ml) per 2lb 3oz of body weight.

It is important to follow your baby’s hunger and satiety patterns. If babies demand more, they often need more. Your baby may be experiencing a growth spurt (see page 24) or she may be trying to tell you that she is ready for solids.

Sometimes very hungry babies will need a formula with more casein than whey. These take longer to digest, helping babies to feel fuller for longer.

Is it possible to overfeed my baby?

It is possible to overfeed a bottle fed baby, and this can lead to vomiting, diarrhea, and excess weight gain. It is therefore important to interpret your baby’s cues and not just feed whenever he feels unsettled. It is difficult to feed a breastfed baby too much, as you will make just the right amount of milk that he needs.

Newborns often have six to eight feeds per day, dropping to four or five by around seven months. The amount you offer should be based on your baby’s weight, and he should

be satisfied by the time he finishes his bottle. There should always be a little milk left in the bottle at the end of each feed, so you can be sure he has stopped feeding because he has had enough milk, rather than because there was no more available. If you find your

baby is always hungry, and putting on weight too quickly, talk to your doctor about it. It may be that he’s ready to begin weaning.

Did you know...?

That it’s very important to weigh your baby on the same scale, with the same clothing (or no clothing), each time, in order to be sure that you get an accurate result? Scales can vary enormously, and you don’t want to be sent into a panic that your baby has suddenly “gained” or “lost” a large amount of weight. You can expect your baby to put on between 100g (31⁄2oz) and 225g (8oz) a week in his first few months.

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