As a lot of what we discuss here in TB2K has to do with what we fear will be long-term scenarios lasting months, maybe even years, I think the subject of infant nutrition is an important one.
The following is taken from my book <i>The Prudent Pantry: Your Guide to Building a Food Insurance Program.</i> I've tweaked it a bit to reflect the passage of time since I originally published it.
<center><big><b>Infant Formula</b></big></center>
Infant children are not merely miniature adults who haven’t yet learned to talk. Their dietary and nutritional needs are different from us grown-ups or even older children. The high levels of fat and cholesterol we find beneficial to avoid as we get older are actually necessary for children under age two as they require a high calorie intake relative to the actual volume of food they’re able to consume. The same is true for many vitamins and minerals. Unlike adults who can generally make up for a nutritional deficiency at a later date by consuming foods rich in the missing nutrient, infants need certain nutrients at particular levels at particular times for building their bodies. If the nutrient isn’t there when they need it, they may not be able to make up for it later. This could mean they’ll be left with a permanent consequence of that deficiency no matter how much of it they may consume afterwards. <i>There is simply no room for half-assed preparation when it comes to planning for infants and very young children.</i>
Fortunately, it’s not as bad as I’ve just made it sound - you just need to give a little special care to what you are doing.
Until the child is at least six months old there is NO better food supply than what God, Mother Nature and Evolution intended for that baby to eat and that is human breast milk. In fact, breast milk can be the major part of the child’s diet until age one and an important supplement to it all the way up to age two. There are those that nurse their children even longer, but I’m merely stating this as an observation, not as a recommendation.
A lactating human woman can eat a far wider range of foodstuffs than an infant is able to handle. Having eaten them, she can then digest and produce from them in her breast milk the perfect nutritious food for human infants and it will be fresh to boot. Barring any medical difficulties of the mother or the infant, if mama is well-nourished then the baby will be well-nourished.
If, for whatever reason, the mother should be unable to nurse her baby the next best solution is another healthy lactating human female, in other words, a wet-nurse. Admittedly, this is not as common in the United States as it once was, but it was not so unheard of in earlier days and there’s no reason it could not be done again. It’s still done in many of the undeveloped nations that don’t have the luxury of easily available commercially made infant formula.
Finally, failing any possible source of human breast milk, we come to commercial infant formula. Infant formula is second best to breast milk, but there are times when there is nothing else to be done for it if the child is to eat. Fortunately, the quality of infant formula has been steadily improving over the decades and many of the problems encountered in the 1950’s and ‘60’s have been surmounted. It’s not the quality food breast milk is but at the same time it’s also better than it ever has been before.
<b>Note!:</b> Here is a long standing group for breast feeding support and information to which I commend anyone who would like to know more about it:
<u>La Leche League International</u>
1400 N. Meacham Road
Schaumburg, IL (USA) 60173-4808
Phone (847) 519-7730 or 1-800-LALACHE (US)
Fax (847) 519-0035
http://www.lalecheleague.org
E-mail:
LLLHQ@llli.org
Another useful document is a draft of a work developed by the World Health Organization, <i>“How to Breastfeed During an Emergency”</i> which may be viewed at:
http://athagan.members.atlantic.net/Index.html
<big><b>Use Forms of Infant Formula</b></big>
Like milk, infant formulas can be found in a variety of different packagings and forms. There are three basic use types commonly found on the market. Which one is best for you will depend on your lifestyle and the conditions under which you expect to be working in your scenario planning. All three forms will have a plain <i>use-by date</i> on the outside of the can and should be rotated out before they expire. Note that all three are low in fluoride. If your local water supply or water storage is not fluoridated you may wish to consider infant vitamins that contain fluoride which requires a doctor’s prescription. <i>Store all three as you would dry or canned milk -- cool and dry.</i>
<b>Powdered concentrate:</b> Nutritionally equivalent to the other forms <i>when reconstituted with the proper amount of water.</i> As it weighs the least and takes up the smallest amount of space to ship, it’s also usually the cheapest of the three. Purely in terms of storage this is your best bet, but it requires clean, safe water to mix with. If safe water is likely to be in critically short supply, then this may not be the best way to go.
<b>Liquid concentrate:</b> A concentrated form to which you’ll have to add more water in the proper amount. It’s somewhat more expensive than powder, but usually cheaper than the ready-to-feed below. In terms of preparedness it has the disadvantages of both powder and ready-to-feed with the advantages of neither. You’ll still have to come up with clean water to dilute it with, it weighs more than powder and requires more space to keep. Once opened, the can will need to be refrigerated or used up within the day. In the every day world it offers convenience without too great of an expense which may offset some of the disadvantages. Read the directions for reconstituting it carefully, not all are the same.
<b>Ready to feed:</b> The most expensive to buy and requiring the most storage space, but it is ready to use straight out of the can. It would cost quite a bit to store in quantity, but has the advantage of not needing clean, safe water to mix it with. It has definite advantages for Immediate Crisis Kits (bug out bags).
<big><b>Choosing A Specific Formula</b></big>
We breast fed our child, but in making the contingency plans every person who’s been long into preparedness makes, we stocked a judicious quantity of infant formula as well and have kept some put away ever since - duly rotated as necessary. I have read everything on infant formulas I’ve been able to find. These sources have ranged from the US Food and Drug Administration, American Academy of Pediatricians, American Medical Association to the World Health Organization. In addition, I have carried on an extensive conversation with a board certified neonatologist (a pediatrician specializing in newborn infants) about emergency and expedient food preparedness for the nursing infant. Having said all of that, do keep in mind that I am not a medical doctor and <i>what I say is not to be construed as medical advice.</i> If you suspect your child is having a feeding difficulty consult with your pediatrician or family practice doctor.
The following is what we have developed:
<u>If the baby you’re planning for is already on the scene</u> then your infant formula concerns are much simplified. You’ll have plenty of opportunity to find a formula that agrees with your child. My recommendations are either Enfamil With Iron by Mead Johnson or Similac With Iron by Ross Laboratories (Abbot Labs). Both are based on cow’s milk and are essentially identical in nutrient content and price. The only real difference between the two is that with Similac the baby will have a stooling (feces) pattern very close to what they would have with breast milk. With Enfamil the <b>appearance</b> is much different, but this is of no significance. Chances are that the baby will tolerate either very well. The problems encountered with iron in infant formulas in the 1950’s have long ago been worked out and no longer cause difficulty so be sure to make sure it has iron in it unless advised otherwise by the child’s doctor.
If, for some reason, your child does not tolerate these formulas you’ll need to determine <i>why</i>, preferably in consultation with the child’s doctor. Chances are the culprit will be <i>lactose intolerance.</i> Lactose is a carbohydrate (sometimes called ‘milk sugar’) found in both cow and human milk. Most nursing infants tolerate lactose quite well, but a small minority lack the necessary enzyme, lactase, required to digest it. This can lead to abdominal distension (bloating), nausea, vomiting and diarrhea. Should this be the case you’ll need to find a lactose-free formula. Until recently, this meant a soy-protein formula, but lactose-free cow's milk formulas called Lactofree from Mead Johnson and Similac Lactose Free from Ross Laboratories have come onto the market. They are essentially the same as ordinary cow’s milk formulas but with the lactose removed. From price comparisons made at a number of local stores in my area the lactose-free formulas are much cheaper than the soy-protein formulas by the same manufacturers and I believe them to be the better choice.
Although less likely to occur than lactose intolerance there is the small possibility that the baby may have an allergy to beta-lactoglobulin, a protein found in cow’s milk, but not in human milk. Its symptomology can be very close to that of lactose intolerance and can make distinguishing between the two difficult. If this has been diagnosed then you’ll have no choice but to forego any formula based on cow’s milk and will have to rely on a soy-protein formula. Two very acceptable formulas are ProSoBee by Mead Johnson and Isomil by Ross Laboratories (Abbot Labs).
In spite of what some will have you believe, soy-protein formulas are not hypoallergenic (allergen free), they merely contain a different allergen, soy protein, instead of cow’s milk protein, to which the child may possibly become allergic. Now chances are ridiculously small that your baby would be allergic to both cow’s milk and soy-proteins, but it has been known to happen.
<u>If the baby you’re planning for has not yet arrived</u> then you have a more difficult proposition. What I recommend doing is foregoing Enfamil or Similac and storing a lactose-free formula. As I mentioned above, lactose intolerance is the primary culprit in formula intolerance, but that won’t be a problem for 90-95% of infants. Storing the lactose free formula is a just-in-case precaution in case the child turns out to be in that minority. There is, of course, the very small chance the child will have an allergy to cow’s milk protein, but there’s also a chance he’ll be allergic to soy-protein as well. It’s not possible to entirely eliminate risk, but you can plan for the likely problems. Store lactose-free formula and be certain you have a safe water supply for the child.
<big><b>Spitting Up</b></big>
Sometimes it’s not always clear what is normal or not-normal behavior in feeding an infant. In an attempt to help allay anxiety and forestall possibly needless changing around of infant formula (or spur an indecisive parent into action) here are some tips about what you should take in stride or be alarmed about:
In conferring with mothers, grandmothers, doctors, and nurses it is a rare baby that never spits anything up. Many babies spit up partly digested or undigested breast milk or formula with every feeding and others do it with varying degrees of frequency. What matters is how much the baby spits up and the way they do it. If it looks like the child is spitting up everything he eats, <i>first be sure that he is.</i> Try pouring a measured teaspoonful of formula onto the spit cloth or blanket the baby spits up on and comparing the size of spot it makes to what the child spits out. Keep in mind that the child probably consumes at least 12 teaspoonfuls at a feeding even when newborn and maybe as much as 48 teaspoonfuls when they’re just a few months old. A mere teaspoonful or even a tablespoonful is nothing to be concerned about.
Of course, any spitting up that contains blood or bile (greenish-yellow fluid) is a cause for concern. The same for projectile vomiting (vomiting it a foot or more), and persistent diarrhea or bloating. Regardless of how well it stays down, if over time the child does not appear to be gaining at least 1/2 ounce a day in weight, with 2/3 to 1 ounce better still, it will need to be investigated.
<b>Note!:</b> If lactose intolerance or milk-protein allergy is suspected and you change formulas you should give the new formula a couple of days before expecting to see significant improvement.
<big><b>Expedient Formulas</b></big>
<i>If commercial formulas are second best to a healthy mother’s breast milk then home-made formulas are way, way back there in third place.</i> The formulas given below were the state of the art at the turn of the 20th century, but we’ve had a hundred years of improvements on them since then and no longer need accept the mortality rate that came with the primitive knowledge of infant nutrition we had then. If you know there is a high probability that you will need to feed a nursing infant (assuming mama can’t or isn’t there) then either scare up a wet nurse or lay in a store of lactose-free formula.
<b>Warning!:</b> <i>Relying on an expedient infant formula when you had the time and opportunity to do better is negligence, plain and simple.</i>
The reason I include these formulas at all is for the benefit of the folks who <b>don’t</b> expect to be feeding a nursing infant, yet have one fall into their laps anyway with no way of laying hands on either a lactating human female or commercial infant formula. In a situation such as that, a poor third place solution beats Hell out of the alternative, which is letting the child starve for lack of anything suitable to feed it.
Compared to what we, as adults, need to eat to stay healthy these formulas are going to seem rather high in fat and calories. Keep in mind though, that a baby has very high calorie needs relative to the amount of food they can take in at any one time and therefore needs the concentrated calories to be found in fat. The cholesterol that we should avoid as adults is necessary for brain and neurological development in children under two years of age. If you have the choice, always give children under two whole milk. If whole milk is not available then you’ll need to increase the child’s fat intake to approximate what would be found in whole milk.
With breast milk and modern infant formulas it’s not usually necessary for a child under six months of age to drink extra water because they are both formulated with the lower efficiency of an infant’s kidneys in mind. These expedient formulas are not balanced like this so it is necessary to increase the child’s water intake to forestall the dehydration that might otherwise occur. Of course, this then presents the problem of the child taking in sufficient daily calories due to drinking the extra water, but you’ll have to do the best you can.
It was because of problems just such as these that so much research and development has gone into infant formula and part of the reason why infant mortality of the late 19th and early 20th centuries was what it was.
<b>Formula One:</b>
1 - 13oz can evaporated <b>whole</b> milk
2 - tablespoons table sugar
19 - ounces safe drinking water
1 - cc liquid infant vitamins <b>with</b> iron
<b><big>or</big></b>
1/4 - 1/2 adult daily multivitamin <b>with</b> iron crushed to a fine powder (distant second best)
Mix thoroughly, keep tightly sealed, use within the day
<b>Formula Two:</b>
3.2 - ounces dry <b>whole</b> milk powder
2 - tablespoons table sugar
32 - ounces safe drinking water
1 - cc liquid infant vitamins <b>with</b> iron
<b><big>or</big></b>
1/4 - 1/2 adult daily multivitamin <b>with</b> iron crushed to a fine powder (distant second best)
Mix thoroughly, keep tightly sealed, use within the day
<b>Formula Three:</b>
3.2 - ounces dry non-fat milk powder
2 - tablespoons table sugar
3 - tablespoons (28g) vegetable oil
32 - ounces safe drinking water
1 - cc liquid infant vitamins <b>with</b> iron
<b><big>or</big></b>
1/4 - 1/2 adult daily multivitamin <b>with</b> iron crushed to a fine powder (distant second best)
Mix thoroughly, keep tightly sealed, use within the day
<b>A final note:</b> None of the above formulas are based on the use of <b>soy milk.</b> The reason for this is that there just isn’t any way to make ordinary <b>soy milk</b> nutritious enough to be safe to use as infant formula with foods and ingredients to be found in the home. Commercially made <b>soy-protein infant formulas</b> are very different from soy milk. Please don’t be misled into thinking that any soy milk product outside of purpose made soy-protein infant formula is sufficiently nutritious to serve as a sole source of nutrition for an infant. <i>The protein and nutritional needs of infant children are not the same as adults and what will suffice for the parents will not suffice for their infant child.</i> It is for this reason why every soy milk sold commercially in the United States says somewhere on the label (in small print) that it is not to be used as an infant formula.
<b>Taken from <i>The Prudent Pantry: Your Guide to Building a Food Insurance Program.</i> Copyright 1999, Alan Hagan, all rights reserved.</b>
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