Nutrition and HIV/AIDS: A Training Manual - Linkages Project

Exclusive replacement feeding (slide 32)Replacement feeding refers to feeding a child who is not receiving any breastmilkfrom birth to about 2 years of age with a diet that provides all the nutrients thechild needs. The following conditions must be in place for safe replacement feeding:• Access to clean water• Availability of sterilized utensils• A steady supply of commercial or home-prepared formula for meeting theinfant’s nutritional needsReplacement feeding options for children 0-6 months• Commercial infant formula is made from modified cow’s milk or soy proteinbut lacks the long-chain essential fatty acids that are present in breastmilk.Giving formula requires water, fuel, utensils, skills, and time to prepare itaccurately and hygienically. The average quantity needed to feed an infant for6 months is 20 kg of powdered formula (44 tins containing 450g each). Cupfeeding rather than bottle feeding is recommended for hygienic purposes.• Home-prepared formulas can be made from animal milks, powdered milk, andevaporated milk.Animal milks (e.g., cow, goat, buffalo, or sheep). For modified cow’s milk use 100ml cow’s milk; 50 ml of boiled water; and 10g of sugar (2 teaspoons). Homepreparedformulas are usually deficient in micronutrients such as iron, zinc, folate,and vitamins A and C. Unmodified cow’s milk increases the risk of dehydrationbecause of greater concentration of sodium, phosphorous, and other salts. Again,cup feeding is recommended for hygienic purposes.Powdered full-cream milk and evaporated milk. Full-cream milk requires theaddition of boiled water as described on the package. Increase water by 50 percentand add 10g of sugar for each 150ml of feed. Micronutrients are also required.Skimmed milk, sweetened condensed milk, cereal feeds, juices, and teas are not202