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Young Parents Magazine
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Formula for success
by Elisa Chia

Our experts:

  • Cynthia Pang is a senior lactation consultant at KK Women’s and Children’s Hospital.
  • Dr Irene Chan is a paediatrician at iKids Paediatric Practice, a member of Pacific Healthcare (
  • Dr Lim Kwang Hsien is a consultant paediatrician at Kinder Clinic at Mount Alvernia Hospital.
  • Professor Alan Lucas is a director of the Medical Research Council Childhood Nutrition Research Centre at University College London’s Institute of Child Health.

1) Q: My seven-month-old is often consitpated. Is it because she's drinking iron-fortified formula?

A: Dr. Lim Kwang Hsien: This common misconception probably arose because adults who’re on iron supplements sometimes suffer from constipation. Extensive studies have shown no link between constipation and iron-fortified formula.

To stimulate your child’s bowel movement, try daily exercises like tummy massage and bringing her knees up to her chest. You can also start a chart detailing the frequency and consistency of your baby’s stools. If your child regularly has hard, infrequent stools, consult your paediatrician.

2) Q: The formula tastes very sweet even though I prepare it according to the instructions. Can I add more water? And will the sweetness cause phlegm?

A: Dr Lim: Formula milk is designed to mimic breast milk in terms of its nutritional value. It is not advisable to dilute the formula as your little one will be getting fewer calories, proteins, carbohydrates and fat.

In fact, you might even interfere with the mineral balance in her body.

Phlegm is generally not caused by the sweetness of milk, but by things like cow’s milk allergy or environmental factors.

3) Q: Should I alternate brands of follow-on milk every month so my child gets the best of everything?

A: Dr Irene Chan: There is no harm in switching brands, however, there is also no great benefit in doing so. The differences in all ironfortified cow’s milk formula are small.

Of course, if your baby suffers from more gas after consuming one of the formulas, stop feeding her with it. For some babies, switching formulas may cause loose or very hard stools, so you should stick to one brand.

4) Q: What’s the right way to mix breast milk and formula? Do I use breast milk in place of water to prepare formula?

A: Cynthia Pang: Instead of mixing them in a bottle, you should give whatever amount of breast milk you have to the baby first. This is to maximise the benefits of breast milk for your baby and to avoid wasting your breast milk if she can’t finish the bottle of milk. When preparing formula, water should be used.

5) Q: I want to wean my daughter from breastfeeding but she seems to be rejecting the bottle. Could it be due to the taste of the formula?

A: Cynthia: It is unlikely to be an issue of taste although, sometimes, it may be related to the type of teats used.

Change to a softer latex teat if you are currently using a silicone teat, and use breast milk instead of formula to ease the transition from breast to bottle.

Another possible reason? Your child enjoys bonding with you during breastfeeding and therefore doesn’t want the bottle. Arrange for another caregiver to feed her.

During these sessions, do not expect her to take the full amount of milk from the bottle; give her time to adapt to the change.

6 ) Q: My family has a history of lactose intolerance. Should I skip cow’s milk and offer my child a soyabased formula instead?

Professor Alan Lucas: A soya-based formula should never be used as first milk for baby. Offer it only after a professional has established that your child is allergic to cow’s milk. Cow’s milk formula is much closer to breast milk, which is best for babies.

7) Q: Is goat’s milk formula suitable for babies?

A: Prof Lucas: Some parents give goat’s milk to their lactose intolerant children. But the milk protein from goats and cows are so similar that if you’re allergic to one, you’re likely to be allergic to the other too.

And while cow’s milk has undergone intensive scientific research, goat’s milk hasn’t. I wouldn’t feed my baby a formula that hasn’t been well-tested.

8) Q: What’s the ideal water temperature for formula mixing? Some electronic vacuum flasks suggest 60 deg C.

A: Dr Chan: Some studies suggest that mixing powdered formula with water of at least 60 to 70 deg C will ensure that bacteria is killed. In Singapore,

it’s safe to use tap water that’s brought to the boil and cooled.

9) Q: My child can’t finish her bottle of milk. Is it safe to store it in the fridge until her next feed?

A; Dr Chan: If she doesn’t want the balance after one hour, discard it – bacteria from the baby’s saliva can contaminate the milk even if you keep the bottle in the fridge. Freshlyprepared milk can be stored in the fridge for about 48 hours. But once the milk has been warmed, pour it away after two hours – even if she didn’t touch it.

10) Q: My 16-month-old still wakes up at night for her bottle. My mum-in-law suggests adding cereal to the milk before bedtime to curb my baby’s hunger pangs. Will that work?

A: Dr Lim: A growing child normally wakes up at night for feeds out of habit and not because of nutritional needs.

Thus, adding cereal to her milk may not make a difference. Some parents offer water at night, or slowly dilute the night feeds until she learns to skip them.

Get a copy of the Sept 2009 issue of Young Parents for expert advice and local tips to make you a better mum or dad. Young Parents, published by SPH Magazines, is available at all newsstands now. Check out more stories at Young Parents online,

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