Giving advice on bottle-feeding
In terms of infant feeding, although “breast is best”, for various reasons it is not always possible. Wendy Jones looks at the current recommendations for formula milks and advice pharmacists can give
Readers will be aware that exclusive breastfeeding is the best way to feed babies for the first six months of life because it provides the perfect balance of nutrients to support development as well as protecting against a wide range of illnesses, particularly diarrhoeal disease. This is the recommendation of the Department of Health and the World Health Organization. However, according to a survey into infant feeding, less than 1 per cent of mothers achieve this.
In addition, 22 per cent of babies are exclusively formula fed from birth. When asked why they chose to formula feed from birth, 25 per cent of mothers said that it gave more flexibility (other people were able to feed the baby), 32 per cent said that they simply did not like the idea of breastfeeding (this was higher in first time mothers; 45 per cent) and 13 per cent believed that bottle-feeding fitted better with their lifestyle.
Moreover, 31 per cent of women who had chosen to bottle-feed were aware that this was less advantageous to their child.
Many women do plan to breastfeed. Reasons for doing so include health benefits for the child and mother, convenience, low cost, the view that it is natural and promotes bonding, and the influence of healthcare professionals.
However, by the age of six weeks, 79 per cent of breastfed babies have been given some infant formula. Reasons for this could range from breastfeeding difficulties, such as sore nipples, to lactose intolerance. Whatever the reason, it is important that parents make informed decisions, using the best available evidence.
In 2006, guidelines on the preparation and storage of formula milk were changed to minimise gastrointestinal problems in babies due to microbiological growth in milk stored for too long at too high a temperature.
However, there is surprisingly little research on how to bottle-feed safely and, worryingly, the infant feeding survey also revealed that almost half of mothers who had prepared formula in the previous seven days had not followed the key recommendations for preparation and storage. It is clear that parents need advice on reducing the risk of infection and avoiding over- or under-concentrated feeds.
Information for health professionals on infant feeding, including weaning, is available in a PDF (110K) file
A useful leaflet about bottle feeding, produced by the Department of Health, is available in a PDF (330K) file
Further information on lactose intolerance in babies is available in an article by Anderson J
Reviews of mothers’ experiences of bottle-feeding (R Lakshman et al) and formula feed preparation (Renfrew M et al) have been published in Archives of Disease in Childhood (2009;94:596–601 and 2003;88:855–8, respectively ).
National Institute for Health and Clinical Excellence Guidance for midwives, health visitors, pharmacists and other primary care services to improve the nutrition of pregnant and breastfeeding mothers and children in low income households
To read the full article download the attached PDF (370K)
Wendy Jones PhD, MRPharmS, runs the Breastfeeding Network Drugs in Breastmilk helpline (0844 412 4665).
Citation: The Pharmaceutical Journal URI: 10993687
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