Formula feeding

Principles and schedule

Since modern formulas closely mimic the composition of breast milk, basic nutritional approaches are largely similar. The main difference lies in the regimen: artificial feeding does not involve feeding "on demand".

Basic rules:

• Mandatory adherence to a strict schedule.
• The time interval between feedings must be at least 3 hours.
• Elimination of nighttime feedings.

Types of infant formula

Infant formulas are divided into groups based on the child's age and needs:

1. "Pre" formulas: specially designed for premature infants. Used from birth to 4–6 months (or until target growth and weight parameters are achieved).
2. "Initial" (starter) formulas: for full-term infants from birth to 4–6 months.
3. "Follow-on" formulas: for feeding in the second half of life (from 6 to 12 months).
4. Universal formulas: suitable for the entire first year of life (from 0 to 12 months).

Acid-whey / fermented milk formulas constitute a separate category. This is specialized medical nutrition prescribed for food allergies, atopic dermatitis, or stool issues. They prevent lactase deficiency, feature reduced protein antigenicity, and improve intestinal microbiocenosis. Important: fermented formulas are used only in combination with standard (regular) formulas in a 1:1 ratio.

Calculation of feeding volume

The amount of formula depends directly on the infant's age.

In the first 7–10 days of life (early neonatal period), O.V. Zaitseva's formula is used:

• Daily volume (ml) = 2% of birth weight (in grams) × current day of life.
• Volume per feeding equals the daily volume divided by the number of feedings.

For children older than 10 days, volume-based or caloric methods are applied.

Volume-based method (fraction of actual body weight):

• From 10 days to 2 months: 1/5.
• From 2 to 4 months: 1/6.
• From 4 to 6 months: 1/7.
• From 6 to 9 months: 1/8.

Caloric method (energy requirement):

• 1st half of year: 115 kcal/kg/day.
• 2nd half of year: 110 kcal/kg/day.

Knowing the total caloric requirement and the caloric density of the formula (usually 680–700 kcal/L), the required volume in milliliters is calculated.

Feeding frequency and formula switching

The number of meals decreases as the child grows:

• Up to 2 months: 7 times (night break — 6 hours).
• 2–4 months: 6 times (night interval — 6.5 hours).
• 4–12 months: 5 times (night break — 8 hours).

Changing formula without good reason is a serious mistake. Switching to a new product is justified only in cases of allergy, failure to thrive, dyspepsia (stool changes), or if the infant persistently refuses to eat.

Class and exam questions

What else to study on this topic

• Clinical forms of dystrophy in children under 2 years of age (hypotrophy, paratrophy, hypostature)
• Types of dystrophy in children over 2 years of age (obesity, nutritional marasmus)
• Classification of dystrophies by time of onset (congenital, acquired, mixed)
• Primary and secondary dystrophies by mechanism of development

Other topics in "Chapter 3. Adaptation, Early Childhood Nutrition, Rickets"

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.