Feeding Guide
Breastfeeding techniques, formula types compared, solid food introduction timeline, LEAP study allergen guidance, and feeding troubleshooting.
Formula Types
| Type | Examples | Use | Cost |
|---|---|---|---|
| Standard Cow's Milk-Based | Enfamil NeuroPro, Similac Advance | 80-90% of formula-fed infants. First-line choice. | $ |
| Partially Hydrolyzed | Enfamil Gentlease, Similac Total Comfort | Fussiness/gas. NOT for true milk protein allergy. | $$ |
| Extensively Hydrolyzed | Nutramigen, Alimentum | Confirmed CMPA (2-3% of infants). | $$$ |
| Amino Acid-Based | EleCare, Neocate | Severe CMPA, multiple food protein intolerance. | $$$$ |
| Soy-Based | Enfamil ProSobee, Similac Soy Isomil | Galactosemia, lactase deficiency. NOT for CMPA. | $ |
| Anti-Reflux (AR) | Enfamil AR, Similac for Spit-Up | Reduces spit-up. Does NOT treat GERD. | $$ |
Solid Food Introduction Timeline
- 4-6 months: Signs of readiness: sits with support, good head control, shows interest in food, tongue-thrust reflex diminished
- 6 months: Iron-fortified cereals, pureed fruits/vegetables, pureed meats
- 6-8 months: Mashed/soft foods, introduce allergens per LEAP study (peanut, egg, milk, wheat)
- 8-10 months: Finger foods, self-feeding practice, sippy cup introduction
- 12 months: Whole cow's milk (not before), most table foods in small pieces
LEAP Study & Early Allergen Introduction
The LEAP trial showed that early introduction of peanut protein (4-11 months) reduced peanut allergy by 81% in high-risk infants. AAP now recommends early introduction of common allergens rather than avoidance.
- Peanut: Introduce at 4-6 months (peanut puff, thinned peanut butter). NOT whole peanuts (choking hazard).
- Egg: Well-cooked egg at 6 months. Start with small amount.
- Milk products: Yogurt, cheese at 6 months. No cow's milk as drink until 12 months.
- Tree nuts: Nut butters thinned with breast milk/formula at 6 months.
Breastfeeding Basics
- Frequency: 8-12 times per day for newborns (every 2-3 hours)
- Duration: 10-20 minutes per side. Let baby finish one side before offering the other.
- Signs of adequate intake: 6+ wet diapers/day by day 4, weight gain, content between feeds
- Latch: Wide mouth, flanged lips, chin touching breast, no clicking sounds