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bottle feeding

Baby Poop: What’s Normal and What’s Not?

Posted 10.28.10 | Mallory West

During the first months of life, parents pay close attention to their baby’s bowel movements. Any variation from what they perceive as a “normal poop” can cause a lot of anxiety for a parent. So what exactly is a “normal poop or bowel movement”? The answer is complex; every baby is different so what is considered “normal” will vary from baby to baby.

The color, consistency and frequency of bowel movements may differ. It will depend on if the baby is breast-fed or formula-fed, as well as the mom’s diet or the type of formula used. Below are some general guidelines to help you with your diaper expectations.

Color & Consistency:

  • Breast-fed babies: An exclusively breast-fed baby’s stools will be a light mustard color and often will have seed-like specs. In terms of consistency, stools may range from very soft to loose and runny.
  • Formula-fed babies: For a baby consuming standard (milk or soy-based) infant formula, stools are generally tan or yellow in color. When it comes to consistency, a breast-fed baby will have comparatively firmer stools but usually not firmer than a peanut butter consistency.
  • Neocate babies: If your baby is on an elemental formula, like Neocate, stools may be greenish in color and are often relatively dark (but not black, black can indicate blood in the stools so always contact the doctor if you see this). This is completely normal and is due to the special composition of Neocate and the way it is digested in the body.

Regardless if your baby drinks breast milk or formula, blood in the stool is not typical so if you see this, you should let the physician know right away.

Frequency:

The frequency of bowel movements varies greatly from baby to baby. Some newborn babies may have a bowel movement after each feeding and others may go once a day or even once every two days. During the first weeks of life, before you have learned your baby’s pooping pattern, it is generally advised to call the physician if the baby goes three or more days without a bowel movement.

  • Breast-fed babies: After the first month, breast-fed babies usually have fewer bowel movements than before. It some cases, it is normal for a baby to have only one bowel movement a week. Breast milk leaves little solid waste so bowel movements are less frequent However, as long as the stools are soft (no firmer than peanut butter) and the baby is healthy and growing, there is no reason for concern.
  • Formula-fed babies: Formula-fed babies typically have one or more bowel movement a day. If you are concerned that your baby has infrequent bowel movements or notice that he/she is straining to pass a bowel movement, this may indicate that he/she is constipated so check with the doctor.
  • Neocate babies: Because Neocate is so broken down, it is very easily digested and there is very little waste leftover. Therefore it’s normal for bowel movements to decrease in frequency once you switch to Neocate. As long as stools aren’t overly hard and dry and the baby doesn’t seem to have trouble passing them, this is perfectly normal.

Constipation:

Regardless if your baby is breast-fed or formula-fed, hard or dry stools that are difficult to pass may indicate constipation. Talk with the doctor about what you can do to help. Sometimes the solution is as simple as providing additional fluids. Other times, the doctor will prescribe a laxative to make it easier for your baby to pass bowel movements.

Diarrhea:

Because a newborn’s stools may be soft and slightly runny, it may be difficult to tell if they have diarrhea. A significant increase in frequency or an extremely liquid bowel movement are signs to look for. Severe diarrhea can cause dehydration so if you are concerned that your baby has diarrhea, contact the physician.

With Baby Poop, Normal Depends on the Baby

The general message for this post is that every baby has their own “normal poop” and what’s normal for one baby may not be normal for another. The key is to look out for any sudden change in your baby’s normal bowel movements. Keep in mind that occasional variations are normal, especially once a baby begins taking solid foods.

Hopefully this gives you some guidance for what to expect at diaper changing time. Keep in mind that you know your baby best, so if you’re ever concerned about your baby’s bowel movements, contact the physician just in case. What have you experienced? What advice would you share with other moms?


Neocate BPA Update

Posted 11.29.11 | Rob McCandlish, RDN

 

Over the past few years, a lot of attention has been paid to bisphenol A, or BPA – which was commonly used in food packaging.    As we’ve mentioned in previous blog posts, BPA is still out there due to a lack of suitable replacements, though is a lot less common as a result of public concern.  Many manufacturers have been able to remove BPA from their food packaging materials as well as from plastic dishes and containers.  You may have recently seen items like baby bottles and water bottles labeled as being BPA-free.

Even though some of the chatter on this topic has died down, we here at Nutricia still often get questions about whether Neocate packaging contains BPA.  It’s normal for parents of children who use Neocate products to be more aware of things that other parents might not think to look for.  So, we wanted to briefly remind you and any new Neocate parents that the package linings for Neocate products do not contain BPA.

Our first blog on BPA in 2009 discussed the fact that all of the powdered Neocate products are packaged in cans that have a BPA-free lining.  But we still got questions from parents about E028 Splash, the ready-to-feed liquid elemental formula in the Neocate family.  In early 2010 we confirmed in a second blog that Splash is packaged in cartons that have a BPA-free liner.  More great news!

If your little one uses any of the Neocate products, you can rest assured that there is no BPA in the package linings.

- Rob


Transitioning from Breast Milk to Neocate

Posted 8.22.13 | Nutrition Specialist


You have always enjoyed breast feeding your little one. What could be better than some quiet time bonding with a snuggly bundle of love as many as 8 times a day? What a bonus that it’s the best source of nutrition for your little one. Recently though, it seems that the thought of weaning has crossed your mind once or twice. Maybe you’re going back to work and the long commute, crazy schedule and pumping is just more than you can bear. Or perhaps you have a very faint memory of what a full night’s sleep used to feel like and you are desperate to experience it once more.

In addition, your child may have been diagnosed with a cow milk and/or soy protein allergy and, despite trying an elimination diet for yourself, your LO cannot tolerate your breast milk. Will the transition from breast feeding to Neocate be difficult? Not necessarily. If your LO’s healthcare team has recommended Neocate and you are considering a transition from breast milk, read on. Included are our best tips for a successful transition.

  • First of all relax and be patient. The more relaxed you are, the more relaxed your baby will be.
     
  • Feeding time is more likely to be a success if it’s a pressure free zone. Your baby may need time to get used to the new formula and bottle. If he doesn’t take it in 10 minutes, try again in an hour.
     
  • A baby may be more likely to refuse a bottle if he has a choice between breast feeding and the bottle. It might be best to eventually bottle feed exclusively.
     
  • A gradual transition may be best. For instance, you can prepare Neocate Infant and mix it with expressed breast milk, gradually increasing the amount of Neocate.
     
  • A baby may be more accepting of a bottle the first time from someone other than Mom.
     
  • A baby may have a preference for a particular nipple size and temperature so consider different nipple size, shapes and warming the nipple prior to feeding time.
     
  • Your LO may be more accepting of the formula if she gets a small taste of what’s to come. Try putting a small amount of formula on her lips prior to offering the bottle.


You can find some more transition tips in 'A Guide to Transitioning to Neocate' on this page, which includes tips from a Feeding Specialist.

Do you have any ideas that have helped make for a successful transition from breastfeeding to Neocate? Please feel free to share them here.

-Yasmin

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Green is Glorious: Understanding baby poop and food allergies

Posted 1.14.14 | Nutrition Specialist


Baby DiaperOne of the most common questions we get from new Neocate Infant parents is “Is this normal?” Any difference from what they think a “normal" diaper should be can cause a lot of anxiety. So what exactly is a “normal” poop or bowel movement for a baby on Neocate? Every baby is different, so “normal” will vary from baby to baby. The color, consistency and frequency of bowel movements may differ. It can also be affected by the baby's medical condition and any solids she/he eats.

That said, we can give you some idea of what to expect. Below are some general guidelines to help you with your diaper expectations.

Color – Green is Glorious!

When a baby is on Neocate, the first stools tend to be green and can be dark - a lot of parents describe the color as hunter green (but contact your baby’s doctor if the stool looks black, which could be blood in the stool). Green is completely normal (Green is Glorious!) and is due to the special composition of Neocate and the way it is digested and absorbed in the body.

For most babies on Neocate, the green color will last for at least the first few days. It may fade after several weeks, but for some little ones stools will be green as long as they’re on Neocate. Often stools will change to a yellow/tan/khaki color if the green fades. This is normal, and is a result of the body adjusting to the way Neocate is digested and absorbed. Color can also change when solid foods are introduced into the diet.

Consistency:

The consistency of stools for babies on Neocate tends to be soft and somewhat pasty, though this can vary. For some babies the stools will be looser, and for others more solid or formed. Again, adding solid foods to the diet can affect consistency. Mucus in the stool is not typical so if you see this, you should let the physician know.

Frequency:

The frequency of bowel movements varies greatly from baby to baby. Some newborn babies may have a bowel movement after each feeding and others may have one daily or even once every two days. During the first weeks of life, before you have learned your baby’s stool pattern, the general advice is to call the doctor if the baby goes three or more days without a bowel movement.

Because Neocate is so broken down, it is very easily digested and there is very little waste leftover. Therefore it’s normal for bowel movements to be less frequent after a switch to Neocate. Most babies on Neocate have a bowel movement once every day or two, though again this varies. As long as stools aren’t overly hard and dry and the baby doesn’t seem to have trouble passing them, this is perfectly normal.

Constipation:

Regardless of whether your baby is on Neocate, hard or dry stools that are difficult to pass may indicate constipation. Talk with the doctor about what you can do to help. Sometimes the solution is as simple as providing extra fluid. Other times, the doctor may prescribe a laxative to make it easier for your baby to have bowel movements.

Diarrhea:

Because a newborn’s stools may be soft and slightly runny, it may be difficult to tell if they have diarrhea. A big increase in frequency or an extremely liquid bowel movement might indicate diarrhea. Severe diarrhea can cause dehydration so if you are concerned that your baby has diarrhea, contact the doctor.

With Baby Poop, Normal Depends on the Baby

The general message here is that every baby has their own “normal” poop and what’s normal for one Neocate baby may not be normal for another. The key is to look out for any sudden change in your baby’s normal bowel movements. Keep in mind that occasional variations are normal, especially once a baby begins taking solid foods.

Hopefully this gives you some idea of what to expect at diaper changing time. Keep in mind that you know your baby best, so if you’re ever concerned about your baby’s bowel movements, contact the doctor just in case.

What has your little one’s Neocate experience been like?

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Challenging Changes - Transitioning to Neocate

Posted 7.10.15 | Nutrition Specialist


Infancy is a time marked by rapid growth, requiring important nutrition in the form of breast milk and/or infant formula. You may need to make changes from breast feeding to Neocate, or from another formula to Neocate, due to cow milk or food allergies and related symptoms, or you may need to add Neocate to an elimination diet.

Any transition to a new formula, like Neocate, can present challenges. Many parents come to us with questions about the taste of Neocate. Infants, especially older infants, can have trouble changing to a formula with a different taste and consistency to what they're used to. We can't provide medical advice, so the first and most important thing to do is to talk to your healthcare team! We've got a great resource, below, but here are a few points:

  • Some feeding specialists and pediatricians often recommend sticking with the straight Neocate - it depends on the clinician - it often is just a matter of time for many infants to adjust to Neocate's taste. Like the unfamiliar taste of a new vegetable, it can take up to 15-20 times before they get used to the new taste of Neocate.
     
  • We can’t provide recommendations for changing the flavor of Neocate Infant DHA/ARA – formula manufacturers are prohibited from flavoring or artificially sweetening infant formulas. It’s best to discuss with your child’s healthcare team to see if they have recommendations.
     
  • Some clinicians make recommendations for changing the taste of the formula, but we cannot recommend this. Again please discuss with your healthcare team.
     
  • When it's necessary to supplement breast milk with Neocate Infant DHA/ARA, many parents see success when they express breast milk, mix it with prepared Neocate according to the healthcare professional's instructions, and feed the infant using a bottle. That way the “taste” and feeding method are consistent between feedings. A baby may be more likely to refuse the bottle if she goes back and forth from breast to bottle feeding, especially if the bottle feeds are only Neocate Infant DHA/ARA.

 

Because parents come up with lots of questions for these transition scenarios, we have worked with a Feeding Specialist in developing helpful tips to use in these transition situations. You can find two printable, 2-page documents with helpful tips titled ‘A Guide to Transitioning to Neocate’ and ‘Feeding Tips for a Successful Transition’ on this page of helpful resources.

 

The key strategy for many transitions is a process called 'fading.' Fading involves adding the new formula (Neocate) to the old one in increasing amounts over time. It's important to talk to your LO's healthcare team to see if they recommend fading, and if it might work for you. (Sometimes, especially if food allergy symptoms are challenging, they may not want you to keep the old formula in your baby's diet.) Here are some of the highlights:

  • First, remember that schedules and routines are important when embarking on a transition. Keeping consistent with these will have an impact on your success. Be patient and relax.
  • The overall goal is to have your child accept the new combination as they work their way into the overall change. This might require lessening the first amount of Neocate that’s introduced, however; try to avoid returning to 100% of the previous product.
  • Transition times will vary between children. Some may readily accept the new combination while others may require more time. The goal is to move forward with success even if the pace is very gradual.
  • Transitions can impact the digestive system and can be marked by changes in body outputs- stools, gas and spit-up. These might be something new, or changes to existing habits. See our FAQs page and read the ‘What you may see’ entry for more details.
  • If changes feel a little too unsettling, talk to your healthcare provider or ask them to refer you to a Feeding Specialist.

Below are links to further posts from our Food Allergy Living blog that address transitions.

As always, if you have questions about using Neocate products, please give our Nutrition Services team a call at 1-800-365-7354, Mo-Fr, 8:30am-5:00pm, EST. We can't give medical advice, but we can answer your questions about using the products!

What tips have you found helpful in your transition?

-Jody L. Benitz, MS, RDN

Image from Abigail Batchelder


Can I Keep Breastfeeding My Milk-Allergic Infant?

Posted 9.19.17 | Nutrition Specialist

Successful breastfeeding can get complicated if your baby is diagnosed with an allergy to cow milk, or when other food allergies are suspected. So, what can you do when breastfeeding your milk-allergic infant comes into question?

Chances are you have given quite a lot of thought and preparation regarding your plans to feed your new infant. Breast milk is the best source of nutrition for your baby. It is the first choice when you ask the World Health Organization (WHO), the American Academy of Pediatrics (AAP), Centers for Disease Control (CDC), and healthcare professionals worldwide. However, when your baby is diagnosed or is suspected of having a milk allergy, your baby’s diet must be free of cow milk protein.

Is it possible to manage your baby’s food allergies while sticking to your plan to breastfeed? Absolutely. Let’s look at a few scenarios and possible solutions.

My infant is reacting to the foods I’m eating.

Answer: Ask your healthcare professional for their advice.

It’s possible for small amounts of protein from foods in mom’s diet to make their way into her breast milk, which can cause allergic reactions if the infant develops an allergy to those foods.

The first option your healthcare professional should suggest in this situation is for mom to follow an elimination diet and continue to breastfeed. An elimination diet means you remove suspected allergens - both whole foods and most ingredients derived from that food - from your diet. This means protein from the potential allergen don't make it into your breast milk, thus removing the allergens from your baby’s diet.

Often the healthcare team will recommend you start by eliminating just milk, or a few items like milk and soy, and foods containing certain ingredients derived from milk and soy. Here is a short video from some of the members of our Neocate team explaining the basics of an elimination diet.

It may take up to two weeks to see if the foods you've removed from your diet have made the difference for your little one. If your baby continues to have problems tolerating your breast milk or perhaps has only a minimal improvement in their symptoms, then additional foods may need to be eliminated from your diet. This may be referred to as a “total elimination diet (TED)”. Read more about one mom Rachel, and her experience with TED.

It is key that you maintain a healthy diet to maintain your own health so that you can be well and also provide the nutrition needed for your infant through breast milk.  Eliminating some foods, especially large groups of food such as dairy, may jeopardize your health, so it is important to seek medical supervision from your doctor and/or a registered dietitian when planning an elimination diet to make sure all potential gaps in your nutrition are filled.

Supplements of certain nutrients may be recommended, depending on the number of eliminated foods. Key nutrients often obtained from dairy in the diet, at a minimum calcium and vitamin D, may be recommended by your healthcare team as supplements, for example, if you’re avoiding all dairy. They may also look for alternative foods to provide these and other essential nutrients.

Some moms have even found Neocate products to be a great hypoallergenic option to supplement their own diet and meet their own nutrition needs to continue breastfeeding their babies. This might be particularly helpful when mom is asked to eliminate multiple food items from her diet, or follow a “total elimination diet”. If this is something your curious about, you could discuss Neocate Splash with your healthcare team, although any Neocate product can be used as a supplement.

I want to continue breastfeeding but am not producing enough breast milk.

Answer: Ask your healthcare professional for their advice.

Some mothers struggle to produce enough breast milk to meet the needs of their growing baby. First, you should ask for a referral to a lactation specialist - experts in breast feeding strategies. Many healthcare professionals will recommend supplementing with infant formula so the baby still gets the benefits of breast milk while also getting enough calories and nutrients to ensure proper growth of the infant while the underlying cause of the low breast milk yield is addressed.

A hypoallergenic formula like Neocate is recommended to supplement your breast milk if your little one has reacted to your breast milk. That’s because guidelines advise that babies with food allergies, or who are already struggling to tolerate breast milk due to food allergies, should be given a hypoallergenic formula like Neocate when a supplement for mom’s breast milk is needed. (The reason? The fragments of protein from mom's diet that are found in breast milk are roughly the same size as those found in formulas made from broken-down dairy protein, which means they are likely to provoke an allergic reaction.)

Supplementing breast milk with Neocate can help you continue to provide your baby the wonderful nutrition from breast milk, while also making sure your baby gets the full amount of calories and nutrients they need to continue to grow and develop from a hypoallergenic formula. Your healthcare team, such as your pediatrician or registered dietitian, will advise you on what is needed for you and your baby specifically.  The amount of formula needed should be directed by your healthcare professional and will be unique to your infant’s individual nutrition needs. 

However, this can also present some challenges. Babies often have a hard time switching between breastfeeding and bottle feeding. I hear from many mothers in this situation that the baby will often prefer one feeding over the other, and usually the baby prefers breast milk. For example, moms have told me that their baby drinks well when they are breastfeeding but they struggle with bottle feedings. Even mothers that are exclusively bottle feeding will often say that the baby prefers the bottles of breast milk over the bottles of infant formula.

Some Tips for Moms Supplementing their Breast milk:

  • Many healthcare professionals suggest manually expressing your breast milk and bottle feeding only to help in this situation.
  • It is often recommended to add prepared Neocate consistently to the bottles with expressed breast milk. This can help with bottle acceptance because the bottles are consistently the same taste and the baby is consistently being bottle fed.
  • The amount of prepared Neocate needed should be directed by your healthcare team based the nutrition needs of your baby and your breast milk production.

Let’s say, for example, that your healthcare professional determines that your baby needs an additional 10 fluid ounces of Neocate daily and your baby is drinking 5 bottles daily. In this example, your healthcare professional might recommend an additional 2 fluid ounces of prepared Neocate added to each bottle of expressed breast milk. You would prepare the Neocate at the recipe recommended by your healthcare professional, then add 2 fluid ounces to each bottle of breast milk. This ensures the baby is getting a similar blend of breast milk and Neocate at each bottle.

Again, your healthcare professional will direct you regarding what is best for both you and your little one, so ask your pediatrician or registered dietitian for what is best for you. 

I am adding prepared Neocate to breast milk, but my baby is not gaining weight.

Answer: Ask your healthcare professional for their advice.

For some infants, the calories in breast milk or formula may not be enough to support weight gain at a normal rate. When your baby can’t consume any more breast milk or formula in a day, the healthcare team may suggest other options to help your baby gain weight and keep on track with their expected weight gain, or growth curve. (You can track your baby’s intake using the Neocate Footsteps App, so you can show the healthcare team exactly what she’s taking.)

Often an increase in calories is needed. One option your healthcare professional may recommend is concentrating the Neocate before adding it to your breast milk. This can help to increase the calories and nutrients from Neocate that your baby is consuming, on top of the breast milk. The same tips discussed above can be helpful in this situation when expressing your breast milk, especially adding the Neocate to your breast milk consistently between bottles.

Again, your pediatrician or registered dietitian will advise you what is best for you and your baby, and how exactly they want you to prepare Neocate before adding it to your expressed breast milk. It's important to only change the concentration if directed by the healthcare team, and to always follow their instructions: formula that is too concentrated can lead to dehydration and other health issues. In other words, consult the healthcare team first – please do not attempt this on your own!

What other questions do you have about breastfeeding your baby with food allergies? Please share any questions or any suggestions you might have for other mothers facing this situation in the comments below.

 

-Kristin Crosby MS, RDN, LDN

Originally posted 8.9.16, Updated 9.19.17



About Us

Food Allergy Living is a resource for parents of children with food allergies, brought to you by Nutricia, the makers of Neocate. For more in-depth information about our purpose & authors, see our About Food Allergy Living page.