I
FELTY’ S SYNDROME
BREAST- OR BOTTLE-FEEDING
During the first four to six months,
most of the nutritional requirements of
babies
are
satisfied
by
milk
alone,
whether by
breast-feeding
or by
bottle-
feeding
.
Both human milk and artificial
m ilk contain carbohydrate, protein, fat,
vitamins, and minerals in similar pro-
portions;
however, human milk also
contains
antibodies
and
white blood cells
that protect the baby against infection.
From six months of age, supplementary
vitamins A, C,
and
D
should be given to
breast-fed babies. (Formula milk already
contains vitamin supplements.)
Cows’ m ilk should not be given in
the first year of life. From one year, it
is safe to feed with full-fat cows’ milk.
INTRODUCING SOLIDS
Solids, initially as fruit or vegetable
purees and wheat-free cereals, should
be introduced between four and six
months
of age,
depending
on
the
baby’s birth weight, rate of growth, and
contentment with feeding. From six
months, the baby should be eating true
solids, such as chopped-up meat and
vegetables, and at this stage can start
eating well-cooked eggs. A baby under
one year should not be given honey or
products containing nuts. Salt and sugar
used in home-prepared meals should be
kept to a m inimum to prevent kidney
problems and dental decay, respectively.
FEEDING PROBLEMS
A few babies have an intolerance to cer-
tain foods, such as lactose or cows’ milk
protein (see
food intolerance
;
nutritional
disorders
) .
Reactions can include vom-
iting, diarrhoea, or rashes. Difficulties
associated
with
m ilk
usually
appear
w ithin the first month; solids should be
introduced one by one so that any foods
that cause problems can be identified.
Prolonged crying after feeds may
mean that the baby needs help bring-
ing up w ind, that artificial m ilk is not
being digested properly, or that the
baby has colic (see
colic, infantile
) .
felbinac
A
nonsteroidal
anti-inflammatory
drug
(NSAID) that is used for the relief of
pain and inflammation in injuries such
as sprains or bruising. Felbinac is ap-
plied topically as a gel or aerosol foam.
Rarely, it may cause localized skin irrita-
tion. As some of the drug is absorbed in
the bloodstream, felbinac should not be
taken by anyone with an adverse reac-
tion to oral (taken by mouth) NSAIDs,
such as worsening of asthma.
Felty’s syndrome
A disorder that is characterized by an
enlarged
spleen
and an abnormally low
white
blood cell
count. Felty’s syndrome
occurs in some people with
rheumatoid
arthritis
,
but the exact cause is unknown.
Symptoms of Felty’s syndrome may
include general malaise, fatigue, loss
of appetite, weight loss,
anaemia
,
joint
swelling and stiffness, and recurrent
infections. Possible signs of the condi-
tion include an enlarged spleen and, in
some cases, swollen
lymph nodes
.
Treatment is the same as for rheu-
matoid arthritis.
Splenectomy
(surgical
removal of the spleen) may be needed
in some cases.
FEEDING AN INFANT: INTRODUCING SOLIDS
The age at which an infant should be weaned on to solids depends entirely on the
individual. There is no real need to feed solid foods to an infant below the age of
six months unless he or she is consistently hungry. The following is a flexible guide:
Age
Time
Food
4
months
At second breast-
or bottle-feed
Breast milk/formula. Offer one or two teaspoons of
pureed fruit or vegetables or rice cereal.
4
1
/2
months
At second breast-
or bottle-feed
Breast milk/formula. Offer two teaspoons of rice cereal.
At third breast-
or bottle-feed
Breast milk/formula. At third breast- or bottle-feed offer two
teaspoons ofvegetable or fruit puree.
5
to
6
months
Early morning
Breast- or bottle-feed.
Breakfast
Two teaspoons ofrice cereal, followed by breast- or bottle-feed.
Lunch
One teaspoon of meat puree with three teaspoons of
vegetables. Offer water instead of milk.
Mid-afternoon
Mashed banana or other soft fruit, followed by usual milk feed.
Dinner
Breast- or bottle-feed if the baby is still hungry.
6
to
7
months
Early morning
Breast- or bottle-feed.
Breakfast
Two teaspoons of cerealwith well-cooked scrambled egg.
Offer breast- or bottle-milk from a cup.
Lunch
Offer minced or mashed food instead of pureed. Give meat
or fish with some vegetables, then offer yoghurt and fruit.
Give a drinkofwater or well-diluted fruitjuice.
Late afternoon/dinner
Meator cheese sandwich. Milkfrom a cup.
7
to
8
months
Early morning
Offer a drinkofwater or well-diluted fruitjuice instead of milk.
Breakfast
Cereal and hard-boiled egg with wholemeal bread and butter.
A drinkofmilk.
Lunch
Cheese, fish, or minced meatwith some vegetables. Pudding
or fresh fruit. A drinkofwater or well-diluted fruitjuice.
Late afternoon/dinner
Meator cheese sandwich. A drinkofmilk.
9
to
12
months
Early morning
A drinkofwater or well-diluted fruitjuice.
Breakfast
Cereal, then well-cooked egg or fish with wholemeal toast
and butter. A drinkofmilk.
Lunch
Chopped meat, fish, or cheese, with vegetables. Pudding or
fresh fruit. A drinkofwater or well-diluted fruitjuice.
Late afternoon/dinner
Meator cheese sandwich. A drinkofmilk.
W ARNING
Avoid eggs, fish, and citrus fruit (including juice) before six months. Nuts should not be given to
babies under six months, and whole nuts should not be given under five years. Avoid gluten before sixmonths.
Parents should be especially carefulabout feeding their children foods containing gluten or peanuts because
serious allergies to these products are common.
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