In addition to the four types of classic follow-on milk (for premature infants; starter or type 1 -up to six months-, follow-on 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. These follow-on milks should always be recommended 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, to adapt to the baby’s age.
Types of follow-on milk
- Lactose-free milk (SL): for people who are intolerant to lactose , the sugar in milk.
- Anti-regurgitation (AR) milks : for infants who vomit a lot. They are formulated with carob flour and other thickeners to prevent regurgitation.
- Anti-colic milk (AC) : they can be partially hydrolyzed (part of the proteins are broken so that they can be better digested) and thus minimize intestinal discomfort.
- Anti-constipation milks (AE): they favor intestinal transit in cases of difficulty in bowel movements.
- Hydrolyzed milks (HA): all milk proteins are broken down so that babies allergic to cow’s milk protein can have an option to feed.
- Vegetable milks (soy and rice): they are not top-of-the-line and used to be used more than now. They are especially indicated in allergy to cow’s milk protein.
All artificial milk must be packaged in a “protective atmosphere”. This means that the air surrounding the product in the packaging has been replaced by a gas or mixture of gases. This system maintains the quality of the product for longer and increases its useful life with the advantage of not requiring additives or preservatives.
Labeling of follow-on 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 preserving and preparing the milk, as well as warning about the health risks in case of improper use. In addition, as we have said before, they cannot compete with breast milk, so they cannot imply that they are better than breast milk or use words such as “maternity” or “humanized”.
How are follow-on milks prepared?
The manufacturer may sell the powdered or fluid milk (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 in powder form, the water must be reconstituted. The water does not have to be boiled, but it is recommended that it be hot. It does not need to be bottled if we have drinking tap water. In the event that the water is bottled, it must be low in sodium and little mineralized.
the gold standard
Breast milk is the “gold standard”, the reference 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 provable because its composition is variable:
- It changes its composition throughout the day.
- It changes its composition during the same feeding: it presents more fat at the end of the feeding than at the beginning.
- It changes throughout lactation: higher content of protein, water and mineral salts in the first days of lactation, which is 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 maternal malnutrition. This ensures the survival of the baby.
This ever-changing pattern, so tailored to suit the growing child, is virtually impossible to imitate. Until now, as we have mentioned in the types of artificial milk, it has been agreed to make three different compositions: milk for premature babies, initial milk and continuation milk.
Adequate, optimal and functional nutrition and artificial milk
Adequate nutrition is the one that provides the basic nutrients for the development of the individual. In milk we would be talking about: lactose, protein, fat, vitamins and minerals in the same proportions as breast milk. Optimum nutrition would be that which provides, in addition to the basic nutrients of breast milk, other components of great importance for the child’s development in the first months of life, 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 follow-on milk in the best way?
The latest recommendations of the pediatric associations recommend that follow-on milk be offered in a similar way to breast milk:
- On demand (on schedule and quantity)
- Looking at, talking to, and stroking the baby
- Change the child’s arm in each feeding, to stimulate both cerebral hemispheres.
- Switching brands can help her get used to different flavors (like when she breastfeeds, as breastmilk changes flavor depending on what mom eats).
Are adapted yogurts with follow-on milk necessary?
All pediatric associations ratify 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, you can do it 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 suit the growing child that it is virtually impossible to imitate.
- Follow-on 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 artificial milk be offered in a similar way to breast milk (on demand, caressing it, talking to it and changing sides), and it is also advisable to change brands.