Infant Formulas & Colic

Question 1

Provide three benefits of breastfeeding with regards to infant health.

Answer 1

1) Decreased incidence of Pneumonia / Colds / Viral Infections.

2) Strengthened bones.

3) Reduced risk of chronic disease development.

Question 2

What is the #1 recommended nipple cream product by US lactation experts?

Answer 2

HPA Lanolin

Question 3

(2015) Why did the SHA stop taking in large amounts of free baby formula?

Answer 3

-Overreliance on formula feeding in hospitals led to poorer infant health outcomes, increased re-admission rates, & health care experts began losing valuable skills related to infant feeding.

Question 4

Provide examples of marketing tricks that products such as Similac & Enfamil use to get you to buy their products.

Answer 4

-“Iron-Fortified”… Misleading, as it suggests that the company has something in their formula that others do not. This is not true at all!

-“A+” Enfamil with Omega 3 & 6 fortification suggests that taking these formulas will make your children ‘smarter’ & enhance their development.

Question 5

T or F: Congenital Lactase Deficiency is a very common disorder amongst infants.

Answer 5

False… Very rare. Milk Protein Allergies are much more common.

Question 6

Secondary Lactase Deficiency is often the result of what?

Answer 6

Viral Gastroenteritis / Stomach Flu.

Question 7

What is an example of an infant formula that utilizes soy-based proteins in their product rather than milk proteins?

Answer 7

Similac Isomil

Question 8

What infant formula products might one go to once their baby has exceeded six months of age?

Answer 8

Nestle Good Start 2 & Follow-Up Transition

Similac Go & Grow

Gerber Rice Cereals

Question 9

Provide a percentage-based breakdown of whole milk components (ie. % Carbs / Fats / Proteins).

Answer 9

50% Carbs
30% Fats
20% Proteins

Question 10

When should whole milk be introduced to an infant’s diet? How long should we stick with it?

Answer 10

-Introduce around Yr. 1.
-Stay with it until Yr. 2.

Question 11

What is added to Enfamil A+ “Thickened” products to prevent babies from spitting up?

Answer 11

Extra Rice Starch… Gets thickened up a bit by stomach acid once it goes down.

Question 12

What are the three formulation subtypes of infant formulas?

Answer 12

Powder (cheapest)

Concentrate

Ready-To-Feed (most expensive)

Question 13

“Ready-To-Feed” infant formulas are most expensive. Why is this a problem?

Answer 13

-People living in poverty may have suspect water supplies, so jacking up prices makes it less accessible for those who truly need it.

Question 14

What’s an easy way to remember the medical definition of True Colic?

Answer 14

“Rule of Three”… 3hrs / day, 3 days / week, > 3 weeks in length!

Question 15

Provide examples of exclusion diagnosis questions that one might ask for the sake of distinguishing the root of an infant’s Colic.

Answer 15

-Teething Pain? (3rd-4th month is when Colic peaks… 4th month = Teething start)

-Does mom smoke?

-Any infant food allergies or intolerances?

-What’s mom’s diet like? Do you eat any “gassy foods” such as Broccoli or Brussel Sprouts?

-Could it be constipation (formula fed babies)? Other GI distress or GERD?

Question 16

Describe what happens with Congenital Lactose Intolerance.

Answer 16

-Lactose isn’t properly broken down in SI & goes to LI… Bacterial fermentation of Lactose causes gasses & acids to be produced, which induces flatulence & abdominal pain.

Question 17

What is Simethicone?

Answer 17

-100% tolerated defoaming agent used to relieve trapped gas & GI discomfort.

-Effectiveness is questionable at best, as it’s hard to get every gastric bubble in and amongst digested food.

Question 18

Abby (the mother of five-month-old Scott), approaches you in the Pharmacy with a bottle of Bentylol. She tells you that she read on the internet that Bentylol is a great anti-cholinergic agent for treating Colic. What clinical advice might you provide Abby with regards to a potential treatment?

Answer 18

Bentylol = Contraindicated for babies under six months of age & is actually used to treat IBS (not Colic).

Better Options:

1) Kolik Gripe Water (either original or alcohol-free options)

2) Little Remedies Gripe Water with Ginger & Fennel (anti-nauseants)

Question 19

What’s an important concept that Jeff wants us to re-iterate to patients regarding product expectations?

Answer 19

-Tamper them!!! The odds of something magically working are very low, but they are worth a shot.

Question 20

Name of the bullshit homeopathic OTC product that Jeff despises with every ounce of his being?

Answer 20

Cocyntal