
FORMULA FEEDING
Cow's Milk-Based Formulas The alternative to human milk is iron-
fortified formula, which permits adequate growth of most infants and
is formulated to mimic human milk. No vitamin or mineral
supplements (other than possibly fluoride after 6 months) are needed
with such formulas. Cow's milk formulas are composed of
reconstituted, skimmed cow's milk or a mixture of skimmed cow's milk
and electrolyte-depleted cow's milk whey or casein proteins. The fat
used in infant formulas is of vegetable oils,. The carbohydrate is
generally lactose, although lactose-free cow's milk-based formulas are
available. The caloric density of formulas is 20 kcal/oz , similar to that
of human milk.
Formula-fed infants often gain weight more rapidly than breastfed
infants, especially after the first 3 to 4 months of life. Formula-fed
infants are at higher risk for obesity later in childhood; this may be
related to differences in feeding practices for formula-fed infants
compared with breastfed infants. Cow's milk-based infant formulas are
used as substitutes for breast milk for infants whose mothers choose
not to or cannot breastfeed or as supplements for breast feeding
Soy Formulas
Soy protein-based formulas provide an alternative to cow's milk-based
formula when intolerance occurs from immune reactions to cow's milk
proteins. A significant proportion of infants allergic to cow's milk
protein also are allergic to soy protein, however. The soy formulas are
nutritionally safe alternatives to cow's milk-based formulas.
The soy protein is supplemented with methionine to improve its
nutritional qualities. The carbohydrates in soy formulas are glucose
oligomers (smaller molecular weight corn starches) and sometimes
sucrose. The fat mixture is similar to that used in cow's milk formulas.
Caloric density is the same as for cow's milk formulas
Soy protein formulas do not prevent the development of allergic
disorders in later life, and clinical intolerance to soy protein or cow's

milk protein occurs with similar frequency. Soy protein formulas can be
recommended for use by vegetarian families choosing not to serve
animal protein formulas and in the management of galactosemia and
primary and secondary lactose intolerance. Soy protein-based formulas
are not recommended for premature infants with birth weights less
than 1800 g
Therapeutic Formulas The composition of specialized infant and
pediatric formulas is modified to meet specific therapeutic
requirements. Therapeutic formulas are designed to treat digestive and
absorptive insufficiency or protein hypersensitivity. Semi elemental
include protein hydrolysate formulas
formulas
These formulas contain an abundance of essential fatty acids from
vegetable oil. Certain brands also provide substantial amounts (25% to
50% of total fat) of medium chain triglycerides, which are water soluble
and are more easily absorbed than long chain fatty acids; this is a useful
feature for patients with malabsorption resulting from such conditions as
short gut syndrome, intestinal mucosal atrophy or
injury,
chronic diarrhea, or cholestasis
Elemental formulas also are available that contain synthetic free amino
acids and varying quantities and types of fat components. These are
especially designed for patients with protein allergy or sensitivity. The
carbohydrate content of these specialized formulas varies, but all are
lactose free; some contain glucose oligomers and soluble
starches.
How to calculate the daily requirement
The baby needs 100 – 120 calories / kg / day . each number in the bottle
called OZ which is equal to 20 calories . e.g. baby weight is 10 kg how can
we calculate the daily requirement ?
Answer / 100 × 10 kg = 1000 calories per day .
1000 ÷ 20 = 50 OZ ( number) , this amount should be given( 8 ) times
over 24 hrs , so 50 ÷ 8 = 6 OZ each feeding