Forced feeding Health Dictionary

This is the natural way to feed a baby from birth to WEANING. Human milk is an ideal food, containing a proper balance of nutrients as well as an essential supply of antibodies to protect the infant against infections. Breast feeding also strengthens the physical bond between mother and child. For the ?rst few weeks, feeding should be on demand. Di?culties over breast feeding, discouragement from health-care providers and the pressures of modern life, especially for working mothers, can make it hard to continue breast feeding for more than a few weeks, or even to breast feed at all. Sometimes infections occur, producing soreness and even an abscess. Mothers should seek advice from their health visitor about breast feeding, especially if problems arise.... breast feeding

In severely ill patients, the metabolic responses to tissue damage may be su?cient to cause a reduction of muscle mass and of plasma proteins. This state of CATABOLISM may also impair the immune response to infection and delay the healing of wounds. It is probable that as many as one-half of patients who have had a major operation a week previously show evidence of protein malnutrition. This can be detected clinically by a loss of weight and a reduction in the skinfold thickness and arm circumference. Biochemically the serum-albumin (see ALBUMINS) concentration falls, as does the LYMPHOCYTE count. The protein reserves of the body fall even more dramatically when there are SEPSIS, burns, acute pancreatitis or renal failure.

The purpose of enteral feeding is to give a liquid, low-residue food through a naso-gastric feeding tube. It has the advantage over parenteral nutrition that the septic complications of insertion of CATHETERS into veins are avoided. Enteral feeding may either take the form of intermittent feeding through a large-bore naso-gastric tube, or of continuous gravity-feeding through a ?ne-bore tube.

A number of proprietary enteral foods are available. Some contain whole protein as the nitrogen source; others – and these are called elemental diets – contain free amino acids. DIARRHOEA is the most common problem with enteral feeding and it tends to occur when enteral feeding is introduced too rapidly or with too strong a preparation.... enteral feeding

Habits determining the times and places of feeding and the sources of blood meals for mosquitoes.... feeding habits

A means of encouraging EXCRETION via the KIDNEYS of a compound by altering the pH and increasing the volume of the urine. Forced diuresis is occasionally used after drug overdoses, but is potentially dangerous and so only suitable where proper intensive monitoring of the patient is possible. Excretion of acid compounds, such as salicylates, can be encouraged by raising the pH of the urine to 7·5–8·5 by the administration of an alkali such as bicarbonate (forced alkali diuresis) and that of bases, such as AMPHETAMINES, by lowering the pH of the urine to 5·5–6·5 by giving an acid such as ammonium chloride (forced acid diuresis).... forced diuresis

The administration of nutrients other than by mouth, usually by way of a tube passed through the nose into the stomach or small intestine. If long-term artificial feeding is anticipated, a tube is inserted directly into the stomach or upper small intestine using endoscopic surgery. If the gastrointestinal tract is not functioning, nutrients must be introduced into the bloodstream. This type of feeding is known as parenteral nutrition.

Tube feeding may be necessary for people who have gastrointestinal disorders (for example, conditions resulting in malabsorption) or disorders affecting the nervous system or kidneys. Premature babies often require tube feeding if their sucking reflexes are undeveloped, as do critically ill patients due to their increased nutritional requirements. Intravenous feeding is usually given when large areas of the small intestine have been damaged by disease or have been surgically removed.... feeding, artificial

A baby grows more rapidly in its first year than at any future time in its life. A good diet is essential for healthy growth and development.

During the first 4 to 6 months, most babies’ nutritional requirements are met by milk alone, whether by breast-feeding or bottle-feeding. Both human milk and artificial milk contain carbohydrate, protein, fat, vitamins, and minerals in similar proportions. However, human milk also contains antibodies and white blood cells that protect the baby against infection. From 6 weeks, supplementary vitamin D should be given to breast-fed babies. Formula milk already contains vitamin supplements.

At 1 year of age, a baby can be safely fed with full-fat cow’s milk. Vitamin supplements should then be given until the baby is established on a mixed diet. Solids, initially in the form of purees and wheat-free cereals, should be introduced between 4 and 6 months of age,depending on the birth weight, rate of growth, and contentment with feeding. By 6 months, the baby should be eating true solids, such as chopped-up meat and vegetables.

A few babies have an intolerance to certain foods such as lactose or cow’s milk protein (see food intolerance; nutritional disorders).... feeding, infant

(FEV) the volume of air exhaled in a given period (usually limited to 1 second in tests of vital capacity). FEV is reduced in patients with obstructive airways disease and diminished lung volume.... forced expiratory volume

(FPL test) a test used to evaluate the *visual acuity of infants and young children by observing whether the child looks at a blank screen or one with stripes, the spatial frequency of which can be changed.... forced preferential looking test

see artificial nutrition and hydration; nutrition.... intravenous feeding

The newborn infant may be fed naturally from the breast, or arti?cially from a bottle.

Breast feeding Unless there is a genuine contraindication, every baby should be breast fed. The nutritional components of human milk are in the ideal proportions to promote the healthy growth of the human newborn. The mother’s milk, especially colostrum (the ?uid secreted before full lactation is established) contains immune cells and antibodies that increase the baby’s resistance to infection. From the mother’s point of view, breast feeding helps the womb to return to its normal size and helps her to lose excess body fat gained during pregnancy. Most importantly, breast feeding promotes intimate contact between mother and baby. A ?nal point to be borne in mind, however, is that drugs taken by a mother can be excreted in her milk. These include antibiotics, sedatives, tranquillisers, alcohol, nicotine and high-dose steroids or vitamins. Fortunately this is rarely a cause of trouble. (See also main entry on BREAST FEEDING.)

Arti?cial feeding Unmodi?ed cows’ milk is not a satisfactory food for the human newborn and may cause dangerous metabolic imbalance. If breast feeding is not feasible, one of the many commerciallly available formula milks should be used. Most of these are made from cows’ milk which has been modi?ed to re?ect the composition of human milk as closely as possible. For the rare infant who develops cows’-milk-protein intolerance, a milk based on soya-bean protein is indicated.

Feeding and weight gain The main guide as to whether an infant is being adequately fed is the weight. During the ?rst days of life a healthy infant loses weight, but should by the end of the second week return to birth weight. From then on, weight gain should be approximately 6oz. (170g) each week.

The timing of feeds reffects social convention rather than natural feeding patterns. Among the most primitive hunter-gatherer tribes of South America, babies are carried next to the breast and allowed to suckle at will. Fortunately for developed society, however, babies can be conditioned to intermittent feedings.

As the timing of breast feeding is ?exible – little or no preparation time being required – mothers can choose to feed their babies on demand. Far from spoiling the baby, demand feeding is likely to lead to a contented infant, the only necessary caution being that a crying baby is not always a hungry baby.

In general, a newborn will require feeding every two to four hours and, if well, is unlikely to sleep for more than six hours. After the ?rst months, a few lucky parents will ?nd their infant sleeping through the night.

Weaning Weaning on to solid foods is again a matter of individuality. Most babies will become dissatis?ed with a milk-only diet at around six months and develop enthusiasm for cereal-based weaning foods. Also at about this time they enjoy holding objects and transferring them to their mouths – the mouth being an important sense organ in infants. It is logical to include food items that they can hold, as this clearly brings the baby pleasure at this time. Introduction of solids before the age of four months is unusual and best avoided. The usual reason given for early weaning is that the baby appears hungry, but this is unlikely to be the case; crying due to COLIC, for example, is more probable. Some mothers take the baby’s desire to suck – say, on their ?nger – as a sign of hunger when this is, in fact, re?ex activity.

Delaying the start of weaning beyond nine months is nutritionally undesirable. As weaning progresses, the infant’s diet requires less milk. Once established on a varied solid diet, breast and formula milks can be safely replaced with cows’ milk. There is, however, no nutritional contraindication to continued breast feeding until the mother wishes to stop.

It is during weaning that infants realise they can arouse extreme maternal anxiety by refusing to eat. This can lead to force-feeding and battles of will which may culminate in a breakdown of the mother-child relationship. To avoid this, parents must resist the temptation to coax the child to eat. If the child refuses solid food, the meal should be taken away with a minimum of fuss. Children’s appetites re?ect their individual genetic structure and a well child will eat enough to grow and maintain satisfactory weight gain. If a child is not eating properly, weight gain will be inadequate over a prolonged period and an underlying illness is the most likely cause. Indeed, failure to thrive is the paediatrician’s best clue to chronic illness.

Advice on feeding Many sources of con?icting advice are available to new parents. It is impossible to satisfy everyone, and ultimately it is the well-being of the mother and infant and the closeness of their relationship that matter. In general, mothers should be wary of rigid advice. An experienced midwife, health visitor or well-baby-clinic nursing sister are among the most reliable sources of information.

Protein Fat per Sugar Calories per cent cent per cent per cent

Human milk 1·1 4·2 7·0 70 Cows’ milk 3·5 3·9 4·6 66

Composition of human and cows’ milk... infant feeding

Active principles of Kola nut, Coca leaves (caffeine and cocaine). Chiefly used in war. To allay thirst, hunger and sustain strength under mental and physical strain. Instruction to physicians: “Cola is a stimulant, tonic and restorative, decreasing the sensation of fatigue in prolonged muscular exertion or mental effort.”

Dose: One dissolved on the tongue daily. (Burroughs Wellcome during World War I) ... forced march tablet

Infant feeding using a milk preparation usually based on modified cow’s milk.

Formula milk contains similar proportions of protein, fat, lactose (milk sugar), and minerals as those in human milk, but it lacks the protective antibodies that are present in breast milk.

Vitamins are added.

Bottle-fed babies are at higher risk of gastrointestinal infections than breast-fed babies and may be more likely to develop allergic disorders.

(See also feeding, infant.)... bottle-feeding