Sunday, February 22, 2015

Study group discussion: Can a child less than 6 months be given anything other than breast milk?

Hello. I had this little doubt, I'm in the second year and haven't been exposed to paeds yet. So...
Do you give a child below six months anything other than breast milk? If no, then what do you do if a mother isn't producing enough milk and the baby is still hungry?

What I learned in peds (only did one of three semesters so far) it's that there's very very rare for the mother to not produce enough milk. most of the times is a matter of wrong breast feeding technique.
But formulas can be used, if in the right proportion of formula to water.  Or even cow milk, but it also has a specific recipe to dilute it.

I'm not sure. It's probably not recommended as the milk will be different from the mother's.

You can use fórmulas, you can't give them cow Milk until they are one year old.

I learned that if the family can't afford formulas is ok to give cow milk since the birth. It has to be diluted with water and added some sugar and a drop of soy oil to make it more similar to breast milk.

It is possible that sometimes a woman other than the mother can breastfeed too.

In my peads wards, I have seen mothers giving top feeds with the not enough milk production excuse.

If the child doesn't have a mother, I think they're provided with diluted cows milk or infant formulas.
The only reason it isn't recommended in infants who have mothers who can feed their child is because they have nipple confusion / detachment and they won't consume the mothers milk anymore (Which is super important for the baby, since they have antibodies!)


  1. Also because cow's milk contains more proteins than the breastmilk which is not easily digested as the organs are not well developed enough to handle that kind of protein load.

    1. Yes and the electrolyte composition is different as well. In fact, breast milk changes it's composition depending upon the age of the baby to suit it (Breast milk produced my mother's of premature babies have composition different than that of term babies!)

      Nature is amazing.

  2. i'm in my final year of MD i assume i can answer most of ur questions...

    WHO strongly recommend 6 mths exclusive breast substitutes, no prelactals, not even water in hot summer months also!
    mostly mother finding their milk insufficient is a subjective feeling...
    points to find out the adequecy of breast feeding-
    1.after feeding child sleeps for 2 to 3 hrs.
    2. passes urine 8 to 10 times daily.
    3. gains weight adequately
    then probable whatever amount produced by mother is sufficient for the baby.
    i've seen nearly 700 women complaining about the same but good counselling & motivation from doctor, family members especially by grandmothers helps a lot...reassurance & motivation is the key factor in counselling.

    if at all u have to replace with substitute...following is the order.
    1. Milk from breast milk bank (rapidly growing in india...KEM hospital in mumbai has full fledged bank also other hospitals are taking this initiative)
    2. Formula milk in exact dilution specified by manufacturer.

    we strongly discourage to feed baby with cow milk at all till 1 year of age
    if nothing doing go for cows milk in exact dilution stated below.
    in first week, 1 is to 1 dilution,
    in second week 2 parts milk 1 part milk,
    in third week 3 parts milk 1 part milk,
    four weeks on undiluted milk...(ref..Elizabeth text book of nutrition)

    currently we discourage to add sugar to cow milk given to infant below 6 months as it increase osmolarity furiously leading to osmotic diarrhea...(no reference as such, just a practical point)

    an yeah there are circumstances (like twin pregnancy, sick mother, mastitis to mother) where u cant feed baby...if baby less than 4 months old start formula milk in specified dilution with WATI SPOON never bottle feeds as bottle feeds make the so called nipple confusion...for bottle feeds the baby is getting milk passively as the bottle is tilted, child uses his tongue to stop the milk flow where as in BF baby has to suck actively, those are totally different actions as (see infants are very very intelligent) bottle feeds are not making child work for feeds child prefers it! & leaves the BF...this is nipple confusion!

    & yea i totally agree with IkaN Nature is totally amazing!!!

    1. OMG final year of MD peds. That is so cool. Thanks for taking the time to answer all our questions. You are pure awesome.


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