A community pharmacy environment that fosters teamwork ensured high levels of consumer satisfaction. This series of articles is designed for you to use as guide to assist your team in focusing on meeting ongoing CPD targets and to identify any training needs in order to keep the knowledge and skills of you and your team up to date.
Table One: Milk for Infants
The below information, considerations and checklist provides support to enable you to run a team training session and identify opportunities for learning within the topic of Infant Feeding.
Parents welcome the advice of healthcare professionals for infant feeding and the community pharmacy will be the first call when looking for guidance.
Feeding in the first 2 years of a child’s life are particularly important: research has shown that adequate nutrition during this time decreases morbidity and mortality, reduces the risk of chronic disease, and contributes to optimal development.
Breast milk, when it is the sole source of nutrition for infants in the first six months of life, plays a critical role in development.
Pharmacists and their teams are ideally placed to provide advice and support to mothers when it comes to infant feeding. From giving practical tips and support on breastfeeding to identifying and advising on potential problems, the pharmacy team can make a real difference to young families in those early months.
Informed choice must be promoted, many maternity and infant experts advise.
Formula Feeding
There is a range of infant formulas available over-the-counter and either a whey or casein based formula is a suitable choice for infants from birth to the age of 12 months. Follow-on formulas, which contain more iron and vitamin D than ordinary formulas, are available for infants over the age of six months.
Cows’ milk is not suitable as a main drink for children under the age of 12 months. It contains little iron and vitamin D and may lead to intestinal blood loss in some children. Skimmed and semi-skimmed milks should not be used in infancy because of their low energy content. Semiskimmed milk may be used from the age of 2 years where it is the milk used in the household and the infant’s diet is varied. However, skimmed milk should not be used under the age of 5 years. Fruit juice is not necessary, but helps the absorption of iron from fruit, vegetables and cereals.
It is important to remember that many parents do not receive instruction on appropriate techniques for making up bottles; if formula preparation is not done properly, the baby may be at risk of dehydration and over- or under-nutrition.
Parents who bottle-feed can feel that they are not given enough impartial information about formula milks. Pharmacy teams should know the differences between the different types of milks, as this can be bewildering for new parents. While leaflets on bottle feeding are essential, so are one-to-one discussions.
Whey Based Formulae – These are similar to breastmilk because the protein content is made up of more whey than casein. However, the total protein content of infant formulae is higher than breastmilk and as a result, infant formulae are not as digestible as breastmilk. These formulae are the most suitable for newborn and older infants.
Casein Based Formulae – Babies fed casein based formulae may have to work harder to digest each feed. This means that baby may sleep more – All babies need time every day to be awake and alert, in order for them to grow and develop.
“Follow-on” Milks – These are made from modified cow’s milk with extra iron and vitamins.
Soya Based Formulae – Soya based formulae and other specialised formulae should not be used without the advice of a dietician or doctor. All infant formulae on the Irish market must conform to the same EU standards and provide the same nutritional value. There should be no reason to change a baby from one “type” of formula to another.
Specialist infant formula is one area where pharmacists could provide a valuable service to those mothers who are unable to breastfeed and whose babies have an intolerance or a sensitivity to regular formula milk, or for those women whose baby has problems such as reflux, colic or constipation.
Many pharmacies can benefit from adopting a merchandising approach, with clear signposting to ‘Ask the pharmacist for advice.’ There has been an increase in the number of babies who do not thrive on standard formulas, which is why much of the growth in the infant formula market over the past year has been driven by an increase in purchases of specialist milks, aimed at addressing feeding problems.
Consider:
- Am I aware of the regulations around infant and follow-on formula?
- The differences between different types of infant formula?
- Is the pharmacy area set-up for discreet conversations with customers?
– Do we stock an efficient range of formula? Do I, and my team, know enough about them to recommend them?
- Are we are of the permitted sources of protein on which formula is based?
Key Points:
Check your pharmacy team are aware and understand the following key points:
- The age of use appropriate daily reference intake values
- The recent reduction in Vitamin D
- Permitted carbohydrates and required minerals and vitamins
– Labelling requirements and the promotion of breastfeeding over formula
Actions:
– Ensure the pharmacy team are aware of the benefits of breastfeeding and the different formulas on the market
- Ensure efficient sign posting to discreet consultation areas within the pharmacy for further help and advice
– Check that all pharmacy team members are able to understand the different stages of feeding, infant nutrition and development at each stage
– Keep products merchandised together, along with related products
– Ensure that this important category is fully stocked at all times and merchandising plans are amended based on time of year
– Train the team to meet all the above considerations
Read IPN September Here
