SMA Pro Gold Prem Number 2 Baby Milk, 400 g

Product Information

Daly S.E et al (1993) Degree of breast emptying explains changes in the fat content, but not fatty acid composition of human milk. Exp Physiol;78(6) 741- 55 Following individual clinical assessment, infants may commence feeds at 60-90ml/kg/day divided into 3hly feeds as soon after delivery as possible. King. C. (2009) What's new in enterally feeding the preterm? Arch. Dis. Child. Fetal Neonatal Ed. Doi:10.1136/adc.2008.148197 Trophic feeds, defined as initial milk feeds of up to 1ml/kg/hr, aim to prepare the gut for subsequent advancement of enteral feeds. SMA Gold Prem ® 2 is a special catch-up formula intended for the dietary management of preterm low birthweight babies who are not solely fed breast milk. It is a nutritionally complete formula for use on discharge from hospital or when a low birthweight formula is no longer appropriate. It is suitable for use as the sole source of nutrition up to 6 months corrected age.

Gastric residuals up to 2ml in infants <750g and up to 3ml in infants 750g – 1500g were treated as normal in the studies by Mihatsch and Bertino(54,16).

Objectives

Infants (>6 months to 2 years) with Cow’s Milk Protein Allergy unable to tolerate a first line extensively hydrolysed formula or second line amino acid formula and where the family would usually qualify for Healthy Start vouchers Davis T., Fiorotto M., Suryawan A. (2015) Bolus versus Continuous Feeding to Optimize Anabolism in Neonates. Curr Opin Clin Nutr Metab Care Jan;18(1):102-108. Continue Probiotics until around 34 weeks corrected age (earlier or later discontinuation at consultant discretion) Factors contributing to nutrient deficits are numerous, though fluid restriction is often the greatest contributor. The majority of infants will meet their nutritional requirements with between 150 and 180ml/kg of an appropriate feed, therefore interruption and reductions in feeds to below 150ml/kg should be minimised. Where prolonged fluid restrictions are unavoidable in the older formula fed infant eg cardiac disease, consideration should be given to the use of nutrient dense term formulas such as SMA High Energy or Infatrini. Anderson D.M., and Kliegman R.M. (1991) The relationship of neonatal alimentation practices to the occurrence of endemic necrotising enterocolitis. Am J Perinatol, 8, 62-7

They also comment that when infants are able to absorb colostrum through the oral mucosa they also absorb maternal antibodies and anti-inflammatory substances which are protective against disease and infection. (9) De Ville K. et al (1998) Slow infusion feedings enhance duodenal motor responses and gastric emptying in preterm infants. Am J Clin Nutr, 68, 103-8 Even when premature babies are discharged from hospital, they may still require extra nutrients to ensure optimal growth. ESPGHAN recommends breastfeeding for post-discharge infants where possible and if formula-fed, infants should be given a post-discharge formula (PDF) until at least 40 weeks, and possibly up to 52 weeks, post-conceptional age. 7 Wash hands well, shake bottle before use, remove lid and aluminium foil and attach a hygienic teat.SMA Gold Prem 2 Post Discharge Formula is part of the SMA Gold System. This is an advanced range of specially designed formulas to help meet the nutritional needs of babies and young children. Every product has a a tailored nutrient profile for each stage of growth and development. Brown J, Embleton N, Harding J, McGuire W. (2016) Multi-nutrient fortification of human milk for preterm infants. Cochrane Database Syst Rev CD000343 SMA Gold Prem 2 is a nutritionally complete formula with Omega 3 and 6 LCPs, which provides higher levels of energy, protein, vitamins and minerals compared to typical infant milks. SMA PRO Gold Prem 2 Post Discharge Formula is specially balanced for your baby's needs if they have been born low birthweight or preterm.

Second choice for severe cow's milk protein allergy or when an extensively hydrolysed product (e.g. Althera, Nutramigen, Aptamil Pepti) does not resolve symptoms Caple J. et al (2004) Randomised controlled trial of slow versus rapid feeding volume advancement in preterm infants. Pediatrics, 114 1597-600 Speak to parents and offer them written information (this guideline or PIL or both if they would like). Specific written consent is not needed but information should be available for parents so they understand why we choose to use probiotics and then document this in the notes (as we do for blood transfusion.)DEBM is recommended for all infants <1500g and would be strongly advocated in those infants <1000g and/or <30 weeks gestation. Bertino E. et al (2009) Necrotising enterocolitis: risk factor analysis and role of gastric residuals in very low birth weight infants. Journal of Pediatric Gastroenterology and Nutrition, 48(4):437-442 As residuals vary so much in the early stages of feeding significant increases should not be used in isolation when deciding to limit advancement of feeds(1). Gastric residual volume and colour of aspirate may indicate level of gut maturity rather than gut dysfunction and as volumes vary in the early stages of feeding significant increases should not be used in isolation when deciding to limit advancement of feeds.