Probiotics and Your Baby’s Health

The newest word in the area of immune health and digestive support is probiotics. These helpful bacteria are proving to have a number of benefits for good health in both adults and children. From thrush to colic to gastroenteritis, probiotics have been connected with helping to treat a number of conditions in babies.

How Probiotics Work

The human body is filled with microorganisms, some of which are beneficial to the body’s function, and some of which are not. Good bacteria exist naturally in the digestive system, but many factors can lead to reducing their levels so that they are no longer able to perform their tasks. This can cause reduced immunity to illness, poor digestion, and influence a number of other problems in the body.

Probiotics are supplements that can be taken as pills or added to foods to populate your body with good bacteria and help to bring the balance back to normal. These supplements add to your body’s natural supply of beneficial bacteria to help regulate your digestion and support your immune system.

What Can Probiotics Do for Your Baby?

Research is still being done on probiotics and their effects on the body. So far, there is encouraging evidence that these supplements may provide relief for a number of problems suffered by babies. Reducing colic, improving digestion to reduce gas, constipation and diarrhea, and lessening the impact of viral infections on your baby’s stomach are just a few of the benefits research is turning up for the use of probiotics.

Probiotics have also been connected with improvements in eczema, and with treating thrush, a yeast infection of the mouth that is common in young babies. If your baby has to take antibiotics, which are known for encouraging yeast infections and also causing diarrhea, a probiotic supplement will reduce these reactions.

Probiotics can also shorten the amount of time your baby will have to suffer with a stomach bug, as the good bacteria will more quickly bring health back to the digestive system.

Breast milk does a better job of supporting production of good bacteria in your baby than formula, but even breast fed babies can benefit from the addition of supplementary probiotics.

How Should I give My Baby Probiotics?

Some new formulas contain probiotic cultures, but if your baby is not using formula, or you do not wish to use that type of formula, there are other ways to add probiotics to your baby’s diet. Probiotics capsules can be opened and added to baby’s bottle or even put directly into baby’s mouth. If your baby is eating solid baby foods, you can add probiotics to purees or also choose foods that naturally provide probiotics.

The most commonly known food that provides probiotic benefits is yogurt. Many commercial yogurts, however, have been heated to extend shelf life. To truly reap the probiotic benefits of yogurt, you should look for one that has not been heated, usually available in health and natural food stores. Many other foods are now showing up on the shelves that have had probiotics added, as their popularity rises due to the new research.

Although probiotics are believed to be safe for use in very young babies, you should always discuss any supplement or medication with your baby’s doctor prior to using it. Your doctor can recommend the best way to add probiotics to baby’s diet as well as the appropriate amount of the supplement for the most benefit.

The Right Water for Formula Preparation

There is some disagreement as to whether or not boiling the water to mix with formula is necessary. It was once generally believed to be necessary, but the recommendation has come and gone in the past few decades. Whether or not you should boil the water for your baby’s formula depends mainly on the quality of your tap water.

Fluoride in Tap Water

Fluoride is added to tap water in most locations, and while it is generally good for your teeth, too much fluoride can actually cause staining on a baby’s teeth. These white lines or spots on teeth are known as enamel fluorosis, and it occurs when baby teeth are exposed to too much fluoride while they are still in the gums. While it isn’t actually harmful to baby, the marks on the teeth can not be removed.

Boiling does not remove fluoride from tap water, so if you live in an area with a high level of fluoride in the water, you might want to consider using bottled water instead. There are some filtration systems available for home use that will remove the fluoride.

Other Problems With Tap Water

Tap water quality varies greatly from area to area. Some cities have very high quality tap water while other cities may not. Rural areas vary as to whether they receive water from a municipal source or from a well. The best thing to do when deciding whether or not to boil the water for your baby’s formula is to talk to your baby’s doctor.

If your baby has any kind of medical condition that weakens the immune system or is premature, it is a very good precaution to boil the tap water prior to using it. Babies with weakened immune systems may not be able to handle any potential bacteria found in your water source.

If you don’t plan to boil your tap water before use, you should take the precaution of running the water on cold for several minutes prior to using it to reduce levels of lead or other potential minerals contaminating the water.

How to Boil Tap Water

If your doctor recommends that you do boil the water, simply bring it to a boil on the stove top and let it cool. It isn’t necessary to let it boil for long. Before using it, let it cool, and then either use it right away or store it in sterilized bottles for future use. It should be kept in the fridge and tightly sealed to avoid recontamination.

Bottled Water

If you decide to use bottled water, use caution when selecting it. You want water that is sterile, and many bottled waters are not. Do not use spring water, which is exactly what it sounds like – water from a natural source. There is no way of knowing what could be in the water. Most other bottled waters are from the same municipal sources that provide our tap water, although they have been through further purification processes.

In order to be absolutely safe, choose water that is labeled for use in preparing formula. Many major supermarkets and also baby supply stores will carry this type of water. It is more expensive than using tap water of course, but will give you peace of mind and save you the time involved in boiling.

Proper Handling of Breast Milk and Formula

Because your baby’s system is very delicate, caution should be used when handling and preparing bottles of both breast milk and formula for your baby. Cleanliness and attention to temperature are vitally important steps in feeding your baby a safe, healthy bottle.

Handling Breast Milk

When pumping breast milk, be sure to wash everything thoroughly, including your hands before handling pump parts and bottles. Pumped breast milk can be left out at room temperature for some time, from four hours to up to 8 hours. Fresh breast milk contains the highest level of nutrition, as some compounds can be damaged by cold temperatures. If your baby will be feeding soon, it’s best to leave it out. If you aren’t planning to use pumped breast milk soon however, you should get it into the fridge immediately, or freeze it for later use. Breast milk can be kept in the fridge for up to 5 days.

While it’s normal to shake up a bottle of formula to dissolve powder into water, you should never shake breast milk. Shaking can damage the delicate molecules and affect the composition of breast milk. You will notice that the fat separates and sits on top of the milk when it is refrigerated. This is normal. The best way to recombine the fat into the milk is to wait until the milk is warmed and then gently swirl it around. This will provide enough agitation to get the fat back into the milk without damaging it.

Once you have thawed breast milk that has been frozen, you should not refreeze it. Frozen breast milk is good for about 3 months in the freezer section of your fridge, and 6 months in a deep freezer.

Handling Formula

Formula is a little different from breast milk. As long as it remains unmixed, powdered formula is good for quite a while. Check the expiration date on the can to know how long it will be ok unopened – an open can is good for about a month. Once mixed, however, formula has a shorter shelf life. A bottle of mixed formula should not be left out at room temperature for longer than an hour, and should be discarded after 48 hours in the fridge.

Always mix formula according to the manufacturers directions. Formula should not be diluted with extra water. The best choice for mixing formula is water that has been boiled and then cooled.

Tips for Bottle Feeding

Whether the bottle contains formula or breast milk, you should always discard what is left in the bottle after feeding. Bacteria can get into the bottle from baby’s mouth and cause the leftover liquid to go bad, so don’t save it for a later feeding.

Bottles should be warmed carefully using a bottle warmer or warm water. Never microwave a bottle as it can create dangerous hot spots in the liquid and lead to burns. Microwaving breast milk can also damage its composition. Don’t forget to test the temperature of the liquid inside the bottle – feeling the outside of the bottle is not an accurate measure of how hot the breast milk or formula inside might be.

Make sure that the bottles and nipples are clean and sterile before adding the breast milk or formula, and wash everything in clean soapy water after use. If you dump the leftovers immediately after a feeding, the likelihood of it being fed to baby by accident will be lessened. Also, you can wash the bottle immediately before the contents can start to go bad.

DHA and ARA in Infant Formula

In recent years there has been a great deal of talk about the importance of certain fatty acids known as DHA and ARA. These fatty acids are found naturally in breast milk, and can be made by the body from other fatty acids in the diet. They are believed to be essential for proper eye and brain development in babies, and a synthetic version is now added to nearly every baby formula on the market.

What are DHA and ARA?

DHA (docosahexaenoic acid) and ARA (arachidonic acid) are polyunsaturated fatty acids that are naturally found in some foods such as fish and eggs, as well as in breast milk. Also called lipids, these are essential to the body, and are known to be present in large quantities in the eyes and brains of newborn babies.

What are the Benefits of DHA and ARA?

These fatty acids are part of a group of fats known as Omega-3’s, which are considered to be the healthiest fats for the human body. Omega-3’s have been connected with a reduction in heart disease in adults. The evidence for the benefits of adding these substances to infant formula is mixed. Some studies suggest that the additives can have a short-term positive impact on visual and neural development. Because these additives are fairly new, however, there is not much in the way of long-term evidence of benefits to baby.

DHA and ARA in Formula

Because breast milk contains natural DHA and ARA, and babies who are breast fed have higher levels of the important lipids in their systems, formula manufacturers have started adding the synthetic forms of DHA and ARA to their products. Although they claim this makes their formula a lot closer to breast milk, it is important to recognize that the versions of the fatty acids being added to formula are not the same as the natural version found in breast milk.

Until more research is done, it is difficult to say whether or not these additives are beneficial or even safe. There is some concern that the synthetic versions of fatty acids could cause some side effects. The FDA has approved these additives for use in infant formulas, however, and at this time almost all formulas do contain them.

Although formulas already contain other fats that the body can use to create DHA and ARA, they will not reach the same levels as breastfed babies. Adding the synthetic version of the lipids brings the levels of DHA and ARA in a formula fed baby up to a level nearly on par with a baby who receives them through breast milk.

The bottom line: if you are really concerned about the DHA and ARA your baby needs, the best choice is to breast feed, as your baby will receive the natural version of the fats that is the same as those the body produces. If it isn’t possible, then infant formulas fortified with fatty acids are a good alternative. Until much more research is done, however, it is impossible to know for sure that these additives are providing any real long-term benefit to babies.

If you would prefer to feed your baby a formula that does not contain DHA and ARA additives, there are some still available, but you might pay more for them. Discuss the benefits and possible risks of the options with your baby’s doctor in order to make an informed decision.

The Proper Method of Warming Baby Bottle

Whether you are warming a bottle of breast milk or of formula, you need to take special precautions to make sure that you don’t overheat the contents, or destroy precious nutrients. There are a couple of safe options for warming baby bottle.

A Word on the Microwave

The microwave oven has become a staple of the modern kitchen because of its fast cooking and convenience. As wonderful is your microwave might be for warming up leftovers, you should never use it to warm a bottle of formula or breast milk. Microwaves can create hot spots in the liquid that might not go away even with careful stirring or shaking. This can cause serious burns to your baby. Microwaves can also damage the nutritional makeup of breast milk. So though it might be tempting, skip the microwave when warming baby bottle.

Baby Milk Bottle Warmers

There are a number of devices on the market specifically designed for warming up a baby’s bottle. The two main types both use water to warm baby bottle, but while one actually heats up the water that the bottle is sitting in, the other flash heats the water to create steam, which heats the liquid in the bottle. Both are effective, but the steam type tends to be faster.

The main problem with either of these baby milk bottle warmer designs is that it can be difficult to get just the right level of heat. Most of them have an alarm that tells you when the bottle is done, but that doesn’t necessarily mean it’s at the right temperature. The amount of milk or formula in the bottle, the type of bottle, and the amount of water in the machine can all affect the end temperature. You might find your baby waiting impatiently while an over heated bottle cools – not a good thing in the middle of the night.

Some baby milk bottle warmers also have a cooler section to keep milk cold, allowing you to store bottles in baby’s room or your room overnight instead of heading to the kitchen to get one from the fridge when baby is hungry.

The Old-fashioned Way

Many people still prefer the pre-bottle warmer method of heating a bottle. Simply place the bottle in a larger vessel filled with hot tap water, and wait. You will have to check it repeatedly, and may have to replace the tap water with hotter water to continue warming baby bottle. This method may take longer than the baby milk bottle warmer, but it is less likely to cause overheating.

Because the water in the surrounding vessel is slowly cooling, at some point it will have heated the bottle as much as it possibly can, and heating will stop. Baby milk bottle warmers, on the other hand, often continue to apply heat, causing the bottle to overheat.

The other advantage of the old-fashioned method is that it doesn’t cost a thing, unlike baby milk bottle warmers which can be expensive.

No matter which method you choose, always test the temperature of the milk or formula on the inside of your wrist for appropriate temperature before feeding it to baby. It should not be much more than lukewarm, and definitely not hot. Grown ups may enjoy a steaming cup of coffee, but your baby’s sensitive tongue can’t handle that kind of heat. When warming a bottle of breast milk or formula, be sure to gently swirl the contents of the bottle around.

baby milk bottle warmer

Proper Measurement and Mixing of Formula

Although a can of powdered formula comes with a special scoop that should make it easy to measure and prepare a bottle properly, there remain a number of parents who make serious mistakes when putting together a bottle. Infant formula has been specifically designed to be fed to baby with a certain ratio of powder to water, and failing to follow the instructions can have consequences for your baby.

Measuring Properly

For most infant formulas, the ratio will be one scoop of powder to every two ounces of water. Even if your baby will not eat the full amount, it’s better to make an extra ounce rather than trying to eye what comprises a half-full scoop of formula in order to come up with an uneven number of ounces. If your baby normally takes 5 ounces, you should go ahead and make six in order to be sure your measurements are accurate.

Never use the scoop from an old can of formula in a new can. Each can comes with a fresh scoop, so discard the old one and use the new one. Over time, bacteria may contaminate a can of formula as well as the scoop. If you use the old scoop in a new can, you risk passing bacteria into the freshly opened formula.

Never Dilute Formula

Many parents will give their baby a bottle of formula that has been diluted; this means that they have added more water than the recommended two ounces to every scoop. Formula already contains the right amount of water for your baby’s needs. Giving a young baby too much water can actually be dangerous to their health. Too much water affect the ability of the baby’s body to absorb nutrients. There is also a dangerous condition called water intoxication that can be very serious; it occurs when the levels of electrolytes in the body are changed by too much water. Water intoxication can cause seizures and even put your baby into a coma.

Never give a baby under six months old extra water. If you have reason to suspect dehydration in your baby, contact your pediatrician right away for advice. Electrolyte beverages are the best choice for treating dehydration in babies, and will work more effectively than water.

Mixing Formula with Breast Milk

It is generally ok to combine breast milk and formula in the same bottle, whether you have been advised to do so for special reasons, or you are combining breast milk and formula in your baby’s diet. If you plan to combine them however, you should pre-mix the formula with water first, and then add the prepared formula to the breast milk. This prevents the powdered formula from making the breast milk too thick and also stops potential changes to the nutritional composition of the milk.

Because breast milk has a longer shelf life than formula, it can be wasteful to mix the two together. Any breast milk that has had formula added will need to be discarded according to the shelf life of formula and not of the milk. Don’t add formula to breast milk until right before a feeding. If possible, feed baby from two different bottles rather than mixing them. If you plan to wean from breast milk to formula, this will help baby to become accustomed to the new taste.

Shelf Life of Infant Formula

Infant formula, even in powdered form, does not keep indefinitely. It can become contaminated with bacteria that are dangerous to your baby. Make sure to be aware of formula expiration dates so that you are always feeding your baby a safe bottle.

Expiration Dates of Powdered Formula

The can of powdered formula will have a “use by” date stamped somewhere on the surface. This is the date after which the formula, even if unopened, should be discarded. When purchasing formula, check this date before you buy to make sure you will be able to use it prior to the expiration date.

Once a can of formula has been opened, it should only be used for one month and then discarded. When you open a new can, mark the date of opening on the lid so that you will know when it’s time to get a new can and throw away anything left in the old one. While many parents are a bit lax on this dating, it can be dangerous to baby to go much past the one month date. Formula is perishable baby food and is subject to the same rules as other perishable foods.

To prevent formula from being contaminated sooner, be sure to use only the provided scoop to measure your formula, and wash your hands thoroughly prior to handling it. If the scoop becomes dirty, you can wash it carefully in hot soapy water, and let it dry before returning it to the can. Every time you open a new can you should discard the old scoop and use the one included with the freshly opened can.

Prepared Formula Shelf Life

Ready to use formula will also be stamped with an expiration date beyond which it should not be used even if unopened. Once opened, any formula not being fed to baby should be refrigerated immediately and used within 48 hours.

Whether ready to use or prepared with water, formula should not be left out at room temperature for more than an hour, and should be discarded after that time. Prepared bottles will keep in the refrigerator for up to 48 hours.

Always discard any unused portion of your baby’s formula that has been left behind after a feeding. Bacteria from the baby’s mouth may contaminate the formula and even refrigeration may not stop it from going bad.

Special Considerations for Formula

Formula may go bad even faster under certain circumstances. If your house is hot during the summer, or you have been out in the sunshine, the time in which the formula may become no longer safe to consume will be shortened. When you take a prepared bottle of formula along with you for use on an errand, you should use in ice pack to keep it cold. A better choice is to bring the water in the bottle and a pre-measured portion of formula powder to be mixed when baby is ready to eat.

If your baby likes to graze on the bottle and does not finish it all in one sitting, it will be necessary to take it away and replace it with fresh formula after one hour has passed. Try to encourage baby to drink as much as possible right away at feeding time to prevent a lot of waste.

Use caution and pay close attention to expiration dates so that your baby’s bottles will always be safe for consumption.

Formula Sensitivities in Babies

Formula, while it does provide all of the necessary nutrients to help your baby grow, is not what nature intended for your baby to eat. A baby has a very delicate digestive system, and breast milk is designed to accommodate that system and provide it with the easiest to digest and most complete source of food possible.

Because infant formulas will never be able to replicate the composition of breast milk, it will never be as easy on a baby’s system. Most babies, however, do tolerate it well. In some cases though, a baby may be sensitive or even allergic to ingredients found in formula.

Milk Allergies and Lactose Intolerance

Most baby formulas are made with a cow’s milk base. The proteins in this base are harder for the baby to digest, but this is not the most serious problem babies may encounter when being fed a milk-based formula. Some babies are allergic to cow’s milk, or may be lactose intolerant. These are not the same thing, but both can mean a cow’s milk formula won’t be tolerated by the baby.

Lactose intolerance occurs when the body is not able to process lactose, a form of sugar found in milk and milk products. This is caused by a lack of the enzyme lactase, which is responsible for breaking down lactose. People who are lactose intolerant experience a great deal of gastrointestinal distress when they consume milk products.

A milk allergy occurs when the immune system responds strongly to something in the milk and can be very serious. Signs may include hives, eczema, diaper rash and also gastrointestinal distress. Any signs of a response to a milk-based protein should be reported to your doctor immediately.

Other Allergies

Babies who are allergic to milk may also be allergic to soy, which is the second most popular protein base for infant formula. The signs of an allergy are similar to the reactions to milk based formulas. If you have tried both and your baby can’t seem to tolerate either, talk to your doctor about switching to a more specialized formula.

Hypoallergenic Formula

Formula designed for babies who are sensitive, allergic, or lactose intolerant is available and is known as hypoallergenic formula. Talk to your doctor before making the switch to one of these formulas. They can be very expensive, and it’s best to be sure that your baby’s symptoms are indeed caused by the formula before putting a lot of money into trying pricey hypoallergenic versions.

Some babies simply have very sensitive tummies. It isn’t necessarily an allergy or lactose intolerance, but simple a digestive system that isn’t up to the task of digesting formula. You may need to try numerous formulas before finding one that is tolerated well. Some formulas for sensitive babies now exist, which are easier to digest.

The best way to avoid formula sensitivities is to breast feed your baby. Breast milk is not only healthier for baby, but it is the easiest baby food to digest. It was made for your baby’s body, and as hard the formula companies try, they simply can’t replicate what nature has created for your baby.

For babies who can not tolerate formula but whose mother is unable to provide breast milk, especially premature babies, donated breast milk is available. Talk to the hospital or your doctor about using banked milk for your baby.

The Role of Iron in Formula

Iron is an essential mineral to your baby’s growth and development. It is vital to the blood supply, helping to create the hemoglobins that carry oxygen through the blood. Most formulas today are fortified with iron, in accordance with AAP recommendations for preventing an iron deficiency, or anemia, in babies. There are some concerns regarding iron in formula, usually in relation to constipation or other stomach problems; however, the recommendation is still to choose iron-fortified formula over low-iron versions.

Iron in Formula vs. Breast Milk

Some advocates of lower iron formulas argue that breast milk contains far less iron than the average fortified formula. This is true; however, the iron in breast milk is much more easily absorbed by and used by a baby’s body than that found in formula. Therefore a lower amount can have a greater effect. Some doctors do recommend an iron supplement for breast fed babies, but the research is not yet clear on how helpful this is in preventing anemia.

Does Iron in Formula Cause Gastrointestinal Distress?

The main reason why parents choose to switch to a low-iron formula is the belief that the iron in the formula is responsible for such problems as colic, constipation, gas and diarrhea. Because iron supplements in adults can cause constipation, it seems like a logical conclusion that iron would have the same effect on a baby. The research on the topic, however, discredits this belief. There is no evidence of any difference in any of the above issues between babies fed iron-fortified formula and those fed low-iron versions of the same formula.

There is, however, a difference between breastfed babies and formula fed babies in levels of constipation and gas, as well as other stomach issues. This is not because of levels of iron, however, but because breast milk is much easier for the baby’s body to digest than formula. It is also used so effectively by the body that it often leaves less waste to clog up the baby’s system.

The Benefits of Iron in Formula

Since manufacturers started adding iron to formula in the 1970’s, the rate of anemia in infants has dropped dramatically, from 20% to 3% of formula fed babies. Iron is vital to your growing baby’s health, allowing the creation of new red blood cells.

At this time, the AAP recommends that you use a formula fortified with iron, if you are not breastfeeding your baby. Formulas with higher amounts of iron are a better choice because a very small amount of the total iron is actually absorbed and used by the body. Cow’s milk formulas have an absorption rate of only about 12% of iron, while soy formulas are even lower. Compared to the 50% rate of absorption from human milk, it becomes obvious why adding iron to formula is necessary to provide baby with an adequate supply of iron.

At this time, there is no evidence to support the use of low-iron formulas, but despite efforts to educate new parents, low-iron formulas are still available and are still being chosen by parents based on inaccurate information. If you have concerns about iron in your baby’s diet, talk to your pediatrician. It is difficult to see a baby suffering from gastrointestinal distress, but blaming it on iron and removing this important nutrient from baby’s diet can have a damaging effect on health and is unlikely to improve the problem.

How to Choose a Formula

Although the AAP recommends breastfeeding your baby as the first choice for feeding, this may not always be possible. Infant formulas offer an alternative that will provide your baby with all of the necessary vitamins and minerals for growth. With a number of options available, picking a formula can be confusing, but it’s not as complicated as it seems.

The Types of Formula

There are three main types of infant formula, divided by the type of protein that forms the base of the formula:

  • Cow’s milk formula: This is the most common type of formula, and the protein comes from cow’s milk, which also provides a number of other nutrients. Most babies will do well on this type of formula, which is why it is the most popular version.
  • Soy formula: For babies who have a sensitivity to cow’s milk such as an allergy or lactose intolerance, soy-based formulas are another option. The soy provides a good source of protein and is also friendly to a vegetarian lifestyle if that is what you intend for your baby.
  • Hypoallergenic formula: For babies who are allergic to cow’s milk and soy formulas, hypoallergenic, or protein hydrolysate formula is another option. The protein in this type of formula is easier to digest. If there is a family history of milk or soy allergies, you might want to start with this type, which has a lower risk of allergic reactions

There are also other specialized formulas available for medical conditions that might require certain nutrition, such as for premature babies. If your baby requires a special type of formula, your doctor will discuss it with you.

Forms and Brands of Infant Formula

Formula is sold in three basic forms: powdered, liquid concentrate, and ready to use. Powdered formula is generally the most popular because it is the most affordable. It is available in cans and also in single serving pouches that are pre-measured. The powder must be mixed with water before using. The liquid concentrate formula is less popular because it still requires preparation with water but can be a bit messier and not as portable. Ready to use formulas can be fed to baby without additional preparation, but tend to be more expensive. All of these forms provide the same nutrition; the choice is yours based on a balance of budget and convenience.

Formulas come in a number of brands including store brands which may be considerably cheaper. The FDA monitors the manufacture of infant formula, mandating a certain level of nutrition in any formula on the market. Therefore cheaper store brands will contain the same nutrition as the name brands. Each formula has its own unique way of blending ingredients, however, and there are differences. Your baby may tolerate one formula better than the other simply because of the way it has been formulated.

Choosing the correct formula for your baby might require some trial and error and some help from your baby’s doctor. Every baby is a little different, so it can be hard to tell prior to birth which one is going to be right. There is no reason you can’t research formulas prior to having your baby and make a decision as to which one you would like to start with; however, be prepared to change to a different type if your baby does not do well on your first choice.

Page 1 of 212