Life threatening infections in newborns have been traced to contamination with pathogenic bacteria, such as Enterobacter sakazakii, found in powdered formula ( 15). Powdered infant formula is not a sterile product, and may be unsafe in other ways. However, the qualitative differences in the fat and protein cannot be altered, and the absence of anti-infective and bio-active factors remain. During the manufacturing process the quantities of nutrients are adjusted to make them more comparable to breast milk. Infant formula is usually made from industrially-modified cow milk or soy products.
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After 6 months, infants can receive boiled full cream milk ( 14). For infants under 6 months of age, animal milks can be home-modified by the addition of water, sugar and micronutrients to make them usable as short-term replacements for breast milk in exceptionally difficult situations, but they can never be equivalent or have the same anti-infective properties as breast milk ( 13). From day 7 to 14, the milk is called transitional, and after 2 weeks it is called mature milk.Īnimal milks are very different from breast milk in both the quantities of the various nutrients, and in their quality. On the third day, an infant is normally taking about 300–400 ml per 24 hours, and on the fifth day 500–800 ml ( 12). Milk starts to be produced in larger amounts between 2 and 4 days after delivery, making the breasts feel full the milk is then said to have “come in”. Other feeds given before breastfeeding is established are called prelacteal feeds. It is important that infants receive colostrum, and not other feeds, at this time. Colostrum provides important immune protection to an infant when he or she is first exposed to the micro-organisms in the environment, and epidermal growth factor helps to prepare the lining of the gut to receive the nutrients in milk. Vitamin A is important for protection of the eye and for the integrity of epithelial surfaces, and often makes the colostrum yellowish in colour. Colostrum is rich in white cells and antibodies, especially sIgA, and it contains a larger percentage of protein, minerals and fat-soluble vitamins (A, E and K) than later milk ( 2). It is produced in small amounts, about 40–50 ml on the first day ( 12), but is all that an infant normally needs at this time. Colostrum is the special milk that is secreted in the first 2–3 days after delivery.
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