thickened formula question

[maggie]

Hi

MY DS is on the breast during the day, but DH and i have decided ot give the odd bottle of formula at night.. we have bought the WYETH brand, for AR thinckened, due to reflux.

On the instrucitons, it sayd to put the formula in the cold boiled water. is it then safe to microwave or should i boil on stove. DS who is 9weeks will not take it cold.. also what TEAT is the best to use with this brand, as so thick i couldnt use the normal AVENT teat. thanks

[Soph]

Hi Maggie

DD was on this formula too. I use to heat it up just by sitting it in hot water, but Sarah's DS on here was on this too and apparently she said it's not suppose to be heated (just mixed up at room temp as you need it). It thickens as it gets warm in bubs tum and that's what helps keep it down.

[Melinda]

We use the Avent #4 teat (the fast flowing ones for 6 months plus!). They do the trick (Ruby is on S26 AR and is 7w old).

We heat her bottles up in the microwave.....so far so good.

[{sarah}]

You aren't supposed to heat thickened formula at all - this is the advice from 2 Drs, 3 ECHNs and also from the Wyeth careline. It defeats the purpose, the heat thickens the milk. It is supposed to be pretty similar to normal formula as they drink it & then thickened up in their tummy which makes it heavier in there & less likely to be thrown up. If it's thickened beforehand they are less likely to drink as much as they need, it's harder to drink so they will get frustrated & it can lead to them sucking in air as they struggle to get it through the teat.

I really really recommend that you don't heat bottles of thickened formula. Room temperature is not cold and over summer it can be quite warm....
And for that matter if you are heating bottles of any sort of formula in a microwave, it's recommended to heat the water first and then add the powder so none of the nutrients get zapped away.

[bigbird2girls]

Hi,

i use the karicare sensi kare thickened formula HA-AR. Tayneesha has been on this since she was 5.5mths old when i weaned her. It was the only formula she liked. I have no problems at all with it and i also heat it in the microwave to be luke warm. She is now nearly 8 mths old and she tends to drink it cold anyway now so i don't worry too much. She has the avent bottle with the avent free flow teat it is a combination of teats 1 - 4.
The dr and midwife have told me it is fine to heat up in the microwave so i think qualified people must go by the olden days and also the modern times. just do what you think is best and what your baby likes as it can't be harmful to them, nothing has happend to my little one and she is as fit as a fiddle. The mother knows best anyway.

hope this helps.
jen

[lilly*]

Oh thats another thing...the thickened formula will chubba your bubba up more than if they were on reg. formula.

Just wanted to add in that my paed and baby nurse both have agreed that this is not true.

There are no more calories or nutrients in thickened formulas than other formulas. Basically thickened formula has an ingredient which causes the milk to thicken when it hits the baby's warm stomach, therefore making it harder to regurgitate.

I would hate for any mothers using thickened formula's to start "cutting down" their babies bottles for fear of them putting on too much weight. (not that I actually believe a little baby can "put on too much weight" anyways)

[lilly*]

B456 I think you misunderstood my post. I realise nobody was suggesting cutting out on a babies bottles. I noted that because on other mothers forums that I visit, many mothers are very conscious of their formula fed babies putting on weight. I don't know why this is or why they would have a problem with a gorgeous little bubba gaining weight happily......I just note that I have read it in several posts on these sites and found it alarming. Many of those women talk of reducing the amount of formula they put in the bottles and do not make them up as recommended. That is why I made that note.

I guess we will have to agree to disagree on the thickened formula putting on weight thing. I can totally understand that it may be the case for your baby and probably many babies. I am just saying that based on the nutritional info provided by the formula makers for AR and no AR formula's, there is no scientific proof of this.

I understand your reasoning for the baby less likely to regurtitate so more stays down and they are having more - but that is due to the amount of milk they are drinking - not the nutritional compounds of the formula and that is what I was referring to.

I think it is wonderful having a happy, healthy and chubby baby. How cute are their little legs in the short grow suits!!! As I say as long as our babies are happy and healthy, what more can we ask for?

[Jacci PG]

My little boy is on S26 AR - he got really really Chubby, - I don't know if it is the formula or not.

Sarah - I didn't know that you were not meant to heat the thickened formula. That is very interesting - so the milk gets thicker in there belly.

[Jacci PG]

B456 - I lov my chubba bubba - he is bald and chubby and toothless and just sooooo cute!

[Baby~amore`]

What is AR formula

AR stands for AntiRegurgitation

What do the manufacturers use as thickeners?

Some manufacturers use:

Pre – Cooked corn starch

Carob Bean

Carob bean flour is not broken down by the enzymes in the mouth or the gastric acid and so retains its thickening properties. It is a soluble dietary fibre and adds volume to the bowel motions.

Rice flour

Rice flour is not as common in NZ/Australian manufactured AR formulas.


What are casein and whey?

Whey and casein are the two main types of protein found in milk. Breast milk is whey predominant and cow’s milk is casein predominant. AR formulas (including Karicare AR and S26 AR) are casein predominant as the casein protein helps to increase the viscosity of the feed in the stomach.

Whey is watery and bluish in colour. Whey is digested more quickly than casein.


Breast milk

Breast milk is whey dominant and has the perfect blend of fats that are easily digested. Although breast-feeding a baby with Gastric Reflux can be stressful and time consuming it is nature’s complete, perfect food. GRSNNZ has a story on breastfeeding if you need to know that your concerns are understood and shared.


How does AR formula work?

AR formula has a thickener: cornstarch, carob bean, or rice flour. The thickening agents differ in their action; some thicken in the infant’s stomach, others are already thick and maintain the consistency of the feed all the way to the stomach. The theory behind all is that the thicker stomach contents are harder to regurgitate and there is a reduction in the symptoms of reflux.

Some thickened formulas such as Karicare AR lower the fat content of the formula to enhance gastric emptying and reduce the likelihood of regurgitation – digestion and absorption of nutrients is not compromised.

Although breast milk is a thinner consistency it is very easily digested and the absorption process commences immediately.




Do I need different feeding equipment when using AR formula?

Yes
Ordinary plastic, glass, feeding bottles of any brand are fine.

AR formula is thicker in consistency and baby may find it hard work to get the feed fast enough and may object to the slow flow or fall asleep trying. To solve this problem parents have recommended a variable flow teat, which has a slow, medium, and fast setting. Avent have a variable flow teat if you have chosen to use a wider neck style of bottle. If you have chosen to use a narrow neck bottle, NUK Anti–colic Cereal teats would be very helpful. NUK have a medic Pro range of teats - some come with the Anti – colic valve which keeps the air flow consistent between the inside and outside of the bottle and prevents large amounts of air being gulped down and encourages uninterrupted feeding. In turn this constant flow prevents the teat being sucked flat during feeding. NUK also have teats for Cleft lip, jaw and palate.

Karicare recommend the use of a medium or fast flow teat for Karicare AR.



How do I mix AR formula?

· Follow the manufacturer’s instructions.

· It is not recommended to make any formula in advance for food safety reasons.

· Water should first be boiled and allowed to cool. Refrigerate if desired. To save time you can have a supply of bottles filled with the correct amount of cooled boiled water. The bottle for a feed can then be heated to feeding temperature and the formula powder added just before feeding.

· Wyeth who makes S26 AR offers a water temp indicator strip, (on a magnetic card that attaches to the fridge when you’re not using it) which is wrapped around the outside of the bottle of water and indicates when the water is the right temperature. Water thermometers can also be purchased – try your local pharmacy or baby shop.

· Do not add powder if the water is not the correct temperature or it will not disperse properly and could become lumpy and set before the feed can commence.
· Add the exact amount of powder to water.

· Apply cap and shake well.

· If warming formula before feeding, take care not to over heat, or premature thickening will occur. Discard any remaining formula after the feed.

· AR formula will start to thicken straight away.

DISCLAIMER: This information on AR artificial feeding is provided for general information only and is not a substitute for professional medical advice. GRSNNZ are not responsible or liable for any diagnosis or action made by a user based on the content of this Fact sheet. GRSNNZ does not endorse any commercial product or manufacturer mentioned in this fact sheet. Always consult your own doctor if you are in any way concerned about your child’s health.

From Cryingoverspiltmilk - support group for parents of Gastric reflux.

We add thickener to EBM for Joel and I heat it and it doesn't seem to make it any thicken but you can see little beads in the milk.It does sometimes have thicker gulgy bits or bits leftover in bottle after feeding -like glue.

It does add a few kj to his breastmilk but not a lot.

The recommendation from almost every website is not to use microwaves to heat bottles