In This Edition;

Hot Milk-January 2012

In this edition;

Update on Infant Formula page 1

Aptamil infant milks pages 1-2

Cow & Gate infant milks pages2-3

Mead Johnson infant milks page 3

SMA infant milks pages3- 4

UNICEF Statement on vitamin D supplementation for breastfed babies page 4

Update on Infant Formula

In last month’s Hot Milk we listed a number of ways a parents could explore how they are making up and giving infant formula. Following requests in this month we list the most common brands being used. The companies are listed in alphabetical order, and in blue are IFIT comments. This is not an exhaustive or infallible list so if you do spot a mistake or have some extra information please contact us.For more detail go to the excellent document produced by the Caroline Walker Trust, in particular Chapter 4 (page 36)

Aptamil infant milks (owned by Danone)

Aptamil 1 First infant milk from birth (blue shape and “1” on tub) Whey: Casein ratio 60:40
Aptamil 2 Hungry infant milk(pink shape and “2” on tub). Whey: casein ratio 20:80. There is no evidence that babies settle better or sleep longer if given these milks. At least one study showed no difference between casein and whey dominant formulas in terms of settled behaviour and sleep. They are not CURRENTLY recommended in the UK for young babies although the can states that they are suitable from birth
Aptamil 3 Follow On milk (green shape and “3” on tub) it is not necessary and may bedisadvantageous to move babies on to these milks after 6 months of age. Whey: Casein ratio 50:50.
Aptamil Growing Up milk 1+yr (yellow shape and “1+yr” on tub) . There is no evidence to suggest this cow’s milk product is superior to regular full cream cow's milk for babies over one year of age, as part of a healthy diet. Too much formula at this age can mean children do not progress to a balanced diet of a wide variety of foods.
Aptamil Growing Up milk 2+yr (amber shape and 2+yr” on tub). There is no evidence to suggest this cow’s milk product is superior to regular full cream cow's milk for babies over one year of age, as part of a healthy diet. Too much formula at this age can mean children do not progress to a balanced diet of a wide variety of foods.
Aptamil Comfort baby milk,(blue lid, white on container) , this a partially hydrolysed protein formula. IFIT have asked to see any independent evidence to support the inference that this milk is less problematic for babies with colic and constipation than regular formula
Aptamil Pepti 1 baby milk from birth(mid-purple shape and ‘1’ on tub)an extensively hydrolysed formula. See local guidelines for diagnosis and management of cows’ milk protein allergy before using.
Aptamil Pepti 2 baby milk from 6 months,(grey shape and “2” on tub) an extensively hydrolysed formula. See local guidelines for diagnosis and management of cows’ milk protein allergy before using.
Aptamil Preterm milk (usedonly in hospital – ready to use bottles with green shape on them)

Cow & Gate infant milks (owned by Danone)

Cow & Gate 1 First infant milk from birth(red & green tub)Whey: Casein ratio 60:40
Cow & Gate 2 Hungry infant milk (red & blue tub). Whey: casein ratio 20:80. There is no evidence that babies settle better or sleep longer if given these milks. At least one study showed no difference between casein and whey dominant formulas in terms of settled behaviour and sleep. They are not CURRENTLY recommended in the UK for young babies although the can states that they are suitable from birth
Cow & Gate 3 Follow On milk (red & purple tub) It is not necessary and may bedisadvantageous to move babies on to these milks after 6 months of age. Whey: Casein ratio 20:80.
Cow & Gate Growing Up milk 1-2 years(red & white tub). There is no evidence to suggest this cow’s milk product is superior to regular full cream cow's milk for babies over one year of age, as part of a healthy diet. Too much formula at this age can mean children do not progress to a balanced diet of a wide variety of foods.
Cow & Gate Growing Up milk 2-3 years(red & white tub). There is no evidence to suggest this cow’s milk product is superior to regular full cream cow's milk for babies over one year of age, as part of a healthy diet. Too much formula at this age can mean children do not progress to a balanced diet of a wide variety of foods.
Cow & Gate Comfort baby milk,(red & yellow tub)this a partially hydrolysed protein formula. IFIT has asked to see any independent evidence to support the inference that this milk is less problematic for babies with colic and constipation than regular formula.

Cow & Gate Pepti-Junior (white lid, pink, white & blue tub)see local guidelines for diagnosis and management of lactose intolerance or cows’ milk protein allergy before using.
Cow & Gate Infasoy, is a soya based milk (red & orange tub)* note CMO concerns on this milk- should only be used in exceptional circumstances and only under the recommendation of a doctor
Cow & Gate Nutriprem 1 (used only in hospital – ready to use bottles with purple writing)preterm and low birth weight formula
Cow & Gate Nutriprem 2 Catch-up formula for Preterm and low birth weight infants Note IFIT are currently investigating the evidence for this milk as there is a Cochrane review that comments on this.

Mead Johnson infant milks

Pregestimil LIPIL (green header on tin)hypoallergenic formula for babies with poor fat absorption or diagnosed cow’s milk protein intolerance See local guidelines for diagnosis and management of cows’ milk protein allergy before using.
Nutramigen LIPIL 1, from birth (red header and “1” on tin) Hypoallergenic lactose-free formula for babies with cow’s milk protein intolerance or allergy. Extensively hydrolysed.See local guidelines for diagnosis of cows’ milk protein allergy and lactose intolerance before using.
Nutramigen LIPIL 2, from 6 months (red header and “2” on tin) Hypoallergenic lactose-free formula for babies with cow’s milk protein intolerance or allergy aged over 6 months. Extensively hydrolysed.See local guidelines for diagnosis and management of cows’ milk protein allergy and lactose intolerance before using.There is no evidencethat it is necessary to move babies on to this product.
Nutramigen AA, Hypoallergenic Amino Acid Based Formula (white tin)

For the dietary management of severe cow’s milk allergy or multiple food allergies.

Enfamil A.R.(blue banner on tin)Designed for reflux and posseting – contains rice starch as a thickener.When using this product the instructions state that cooled water should be used to mix the powder – this is therefore not able to kill any pathogens in the powdered product, as per the recommendation on reconstitution of powdered infant feeds.
IFIT have yet to see any substantive evidence to support the claims made that this milk is helpful for babies with reflux or posseting.
Enfamil O-Lac (orange banner on tin)Lactose-free cows’ milk-based milk designed for babies with temporary lactose intolerance.See local guidelines for diagnosis and management of lactose intolerance before using.

SMA infant milks (owned by Pfizer)

SMA 1 First Infant Milk, from birth (yellow lid)Whey:Casein ratio 65:35
SMA Extra Hungry Baby Milk from 6 months(blue lid) .Whey:casein ration 20:80 There is no evidence that babies settle better or sleep longer if given these milks. At least one study showed no difference between casein and whey dominant formulas in terms of settled behaviour and sleep. They are not CURRENTLY recommended in the UK for young babies although the can states that they are suitable from birth
SMA 2 (“follow on milk”) from 6 months. (Red lid). It is not necessary and may bedisadvantageous to move babies on to these milks after 6 months of age.Whey: Casein ratio 60:40.
SMA 3 Toddler milk from 1 year(green lid).). There is no evidence to suggest this cow’s milk product is superior to regular full cream cow's milk for babies over one year of age, as part of a healthy diet. Too much formula at this age can mean children do not progress to a balanced diet of a wide variety of foods.
SMA Staydown, from birth for babies with significant reflux. (Purple lid).See “Hot Milk”s May 2011, June 2011 and July/August 2011 for reports on this, IFIT did not see any evidence to support the clams made for this milk. Reflux is a symptom, and its cause needs to be identified before arbitrary changes of infant diet.
SMA Wysoy is a soya based milk (lime green lid) * note CMO concerns on this milk- should only be used in exceptional circumstances and only under the recommendation of a doctor
SMA LF (Lactose Free formula) from birth onwards(turquoise green lid, smaller tin). See local guidelines for diagnosis and management of lactose intolerance before using
SMA High Energy (from birth to 18 months) (orange-topped UHT Tetrapacks)for infants and young children with medically identified increased energy and nutrient requirements, such as faltering growth.Note IFIT have not scrutinized information relating to this milk, yet. On first principles it would seem important to diagnose the cause of any failure to thrive before adding to the metabolic load of possibly compromised infants with perhaps genetically-limited capacity to tolerate or process animal proteins and non-human fats. Thus the use of any more-concentrated formula would ideally follow rather than precede diagnosis
SMA Gold Prem 1preterm and low birth weight formula (use in hospital-ready to use bottles)
SMA Gold Prem 2 Catch-up formula for Preterm and low birth weight infants(pink lid)Note IFIT are currently investigating the evidence for this milk as there is a Cochrane review that comments on this.

UNICEF UK Baby Friendly Initiative Statement on vitamin D supplementation for breastfed babies

Following recent media coverage, the Baby Friendly Initiative has received a number of queries relating to supplementation of vitamin D for babies that are breastfeeding.
In response, we have consulted with relevant experts and produced a statement which supports the NICE recommendations as a sensible measure to prevent the rare occurrence of vitamin D deficiency in breastfed babies and to promote the health of lactating mothers.

Report from the Infant Feeding Information Team, Blackpool and North Lancashire: January 2012

For further information contact