Supplementary feeding
Supplementary feeding is allowed only after preliminary application of the baby to the breast, even in the case of very small amounts of milk from the mother.
If the volume of supplementary feeding is small, then it makes sense to give it from the spoon, with a large amount of complementary food - from the cup, as the easier flow of the milk mixture through the nipple promotes the child's failure from the breast. With a large amount of complementary feeding, you can still use a bottle, but with a sufficiently elastic nipple and small holes at the end, so that the mixture flows out with droplets. Fodder in the form of independent feeding can be recommended only in exceptional cases - in the absence of the mother during the child's feeding hours. Large intervals between applying to the chest dramatically inhibit lactation. As a supplement, adapted milk mixtures are used. Fruit juices and purees for the correction of vitamins and mineral salts are advisable to appoint from 3-3,5 months, respectively.
Transfer of a child from mixed to artificial feeding usually does not encounter difficulties. The transfer of a child from natural feeding to artificial requires extreme caution, since adaptation of the digestive system, metabolic processes and mechanisms regulating homeostasis occurs more strenuously at the same time. In such situations, the district pediatrician should periodically calculate the chemical composition of the food actually received by the child, make a correction. This is necessary to match the nutrition of the child to its physiological needs in proteins, fats, carbohydrates, calories. Children who do not gain weight, who are often ill, and also from the risk group, need to make calculations on the body weight.
Special attention should be paid to premature babies, children from multiple pregnancy, those born with large body weight, who are on artificial feeding, suffering from hypotrophy. The diet of such children should be determined strictly on an individual basis. For premature babies and children from twins, it is advisable to organize weighing at home, especially in the first two months of life. At the same time, the district nurse should teach her how to determine the amount of milk sucked by the baby.
It is advisable to maintain a diary of nutrition under the supervision of a nurse. Based on these data, the district doctor can calculate the amount of food, its ingredients, adjust the diet.
Children who were born with a large mass( more than 4 kg), even if they are gaining weight, also need correction of nutrition. But, getting sufficient amount of breast milk, often they are deficient in individual food ingredients, especially in protein. Such children need to count the food, especially during the first three months of life.
Hypotrophy in children in the first months of life is most often the result of improperly balanced or inadequate nutrition, as well as a long-term current disease. All children with hypotrophy of even 1 degree need to individually designate and adjust food, which is based on the calculation of food ingredients, taking into account the actually eaten food. Such a nutritional assessment, the calculation of food ingredients should be done at least twice a month until a stable( over two months) weight gain corresponding to the child's age is obtained.