Re: [pronut-hiv] The best replacement to mothers' milk is formula

["cener" <cener@wananchi.com>]

 Zippy,
Can you suggest how a poor mother somewhere in the middle of a remote
village is going to add vitamins and minerals to cow milk?.

Alice Ojwang-Ndong.  "M Nutr (Stellenbosch)"
Nutrition  & Dietetic Consultant,
Center For Nutrition Education and Research
P.O.BOX 8105,00200, Nairobi.

"Healthy Choices, Longer Life"
cener@wananchi.com


----- zipporah bukania wrote:


The best replacement to mothes milk is formula
milk because its been prepared to be closest mothers
milk, however in its absence in the first 6 months of
life its wise to give those babies home modified
formulas such as cows milk, but with vitamin and
mineral supplementtion to meet the deficits.

plant sources will cause more harm than good to the
babies, so lets be careful on this.

zipporah bukania>
>
> -----Rachel Stern wrote:
>
>
> Yes. And introduction of food may need to be earlier
>  than what is commonly recommended for exclusively
> breastfed infants.
>
> ----- "Kristof & Stacia Nordin" wrote:
>
>
> For iron, you could use cooked greens, beans, fish,
> insects -
> they could be pounded, strained and/or made into a
> strong soup (little water and lots of food).  It
> would take some testing of different options to try
> and get an high vitamin/mineral water, or high
> powder.  Just ideas at this point!
>
> They are things we are going to work on for an older
> population.
>
> Stacia
>
> ----- "Rachel Stern"wrote:
>
>
> Stacia describes pretty much the recipe for homemade
> formula that was used
> in the US for about 40 years or so, during the
> period when bottlefeeding
> became widespread but there was little or no
> commercial formula. Yes, it may
> be low in some nutrients, but in the absence of an
> alternative, it should
> work.
>
> By the way, has anyone looked at those
> vitamin/mineral guidelines recently?
> vitamin D would not generally be a problem in warm,
> sunny areas, but vitamin
> C could be provided by supplementary juice if
> vitamins weren't available.
> Iron is a problem.
>
> Rachel Stern
>
>
> ----- "Peggy Papathakis" wrote:
>
>
> I investigated the nutritional adequacy of the "home
> prepared" infant
> feeding options in South Africa, and found these to
> be low in multiple
> vitamins and minerals, and in essential fatty acids.
>  If any of these
> alternate infant feeeding milks are to be the sole
> source of nutition, then
> perhaps the addition of soy oil and a mulitiple
> vitamin and mineral
> preparation are needed as well.  Below is the
> reference and abstract.
>
>   Papathakis and Rollins. Bulletin of the World
> Health Organization | March
> 2004, 82 (3)
>   Objective Little is known about the nutritional
> adequacy and feasibility
> of breastmilk replacement options recommended by
> WHO/UNAIDS/UNICEF. The
> study aim was to explore suitability of the 2001
> feeding recommendations for
> infants of HIV-infected mothers
>   for a rural region in KwaZulu Natal, South Africa
> specifically with
> respect to adequacy of micronutrients and essential
> fatty acids, cost, and
> preparation times of replacement milks.
>   Methods Nutritional adequacy, cost, and
> preparation time of home-prepared
> replacement milks containing powdered full cream
> milk (PM) and fresh full
> cream milk (FM) and different micronutrient
> supplements (2 g UNICEF
> micronutrient sachet, government supplement
>   routinely available in district public health
> clinics, and best available
> liquid paediatric supplement found in local
> pharmacies) were compared. Costs
> of locally available ingredients for replacement
> milk were used to calculate
> monthly costs for infants aged one, three, and six
> months. Total monthly
> costs of ingredients of commercial and home-prepared
> replacement milks were
> compared with each other and the average monthly
> income of domestic or shop
> workers. Time needed to prepare one feed of
> replacement milk was simulated.
>   Findings When mixed with water, sugar, and each
> micronutrient supplement,
> PM and FM provided <50% of estimated required
> amounts for vitamins E and C,
> folic acid, iodine, and selenium and <75% for zinc
> and pantothenic acid. PM
> and FM made with UNICEF
>   micronutrient sachets provided 30% adequate intake
> for niacin. FM prepared
> with any micronutrient supplement provided no more
> than 32% vitamin D. All
> PMs provided more than adequate amounts of vitamin
> D. Compared with the
> commercial formula, PM and FM
>   provided 8-60% of vitamins A, E, and C, folic
> acid, manganese, zinc, and
> iodine. Preparations of PM and FM provided 11%
> minimum recommended linoleic
> acid and 67% minimum recommended á-linolenic acid
> per 450 ml mixture. It
> took 21-25 minutes to optimally
>   prepare 120 ml of replacement feed from PM or
> commercial infant formula
> and 30-35 minutes for the fresh milk preparation. PM
> or FM cost
> approximately 20% of monthly income averaged over
> the first six months of
> life; commercial formula cost approximately 32%.
>   Conclusion No home-prepared replacement milks in
> South Africa meet all
> estimated micronutrient and essential fatty acid
> requirements of infants
> aged <6 months. Commercial infant formula is the
> only replacement milk that
> meets all nutritional needs.
>   Revisions of WHO/UNAIDS/UNICEF HIV and infant
> feeding course replacement
> milk options are needed. If replacement milks are to
> provide total
> nutrition, preparations should include vegetable
> oils, such as soybean oil,
> as a source of linoleic and a-linolenic acids, and
> additional vitamins and
> minerals.
>
>
>   Peggy Papathakis
>
> Kristof & Stacia Nordin <nordin@eomw.net> wrote:
>
> Malawi has Guidlines through the Ministry of Health,
> although not sure if
> they've been officially released? What I have in my
> files for choices are:
>
> N.B. PLEASE HAVE THESE CONFIRMED BEFORE YOU USE
> THEM, I do NOT have
> experience using this myself:
>
> Breastfeeding:
> · exclusive breastfeeding (EBF)
> · heat treated expressed breastmilk
> · wet nursing
>
> Replacement Feeding:
> · modified cow's or goat's milk
> · full-cream milk powder
> · commercial infant formula
>
> Breastfeeding Options
>
> ** Exclusive Breastfeeding:
> If EBF is practiced the baby should be exclusively
> breastfed for six months.
> The EBF means that the baby is only offered breast
> milk (no other liquids
> even water), however EBF allows for the
> administration of medicines and
> vitamin drops. During The EBF reduces the
> transmission rate from the mother
> to the baby, and ensures the health and nutrition of
> the baby in addition to
> offering health benefits to the mother.
>
> Babies who are being EBF should receive unlimited
> feedings (on demand), with
> the no limits placed on suckling time and length of
> breastfeeding session.
> Newborn babies should be fed eight to twelve times
> in a 24 hours period.