Assessment of the adequacy of breastfeeding in infants and the features of the introduction of complementary feeding
https://doi.org/10.51793/OS.2025.28.4.008
Abstract
Background. The dynamics of body weight is one of the main criteria for the adequacy of breastfeeding in newborns and infants. In the neonatal period, the loss of body weight (BMI) of a child after birth is assessed. Indicators of BMI greater than 10% of birth weight, as well as the retention of BMI over the age of 10 days of life may indicate a child's malnutrition. The average daily weight gain in children under 3 months of age should be 26-30 g., at the age of 3 to 6 months – 17-18 g. With adequate feeding, infants' urine should be light, transparent, odorless, and urinate at least 5-6 times a day. With insufficient nutrition, children may develop hypoglycemia, jaundice associated with insufficient intake of breast milk, hypernatremia, polycythemia, and dehydration. With the progression of dehydration, there is an increase in plasma osmolarity, total serum protein, an increase in the relative density of urine, and oliguria. It should be remembered that many clinical signs are not specific and may be associated not only with malnutrition, but also with defects in child care and the development of diseases.
Conclusion. Medical professionals must have the professional knowledge and competencies to perform differential diagnosis. A child with signs of malnutrition should be prescribed additional nutrition or supplementation in a timely manner. Mother's expressed milk, donor milk, and children's adapted milk formulas can be used for additional feeding. The introduction of supplementary feeding is necessarily carried out against the background of support and stimulation of lactation in the mother. If there are signs of dehydration, you can give the baby extra water between feedings. In children aged 4 to 6 months with malnutrition, complementary foods may be prescribed, preference is given to industrial baby porridges.
Keywords
About the Author
A. F. KiosovРоссия
Andrey F. Kiosov - Cand. Of Sci. (Med.), Head of the Department of Pathology of Newborns and Premature Babies, State Budgetary Healthcare Institution Regional Clinical Hospital No. 2; Associate Professor of the Department of Pediatrics, Federal State Budgetary Educational Institution of Higher Education South Ural State Medical University of the Ministry of Health of the Russian Federation.
18 building Gagarin str., Chelyabinsk, 454010; 64 Vorovsky str., Chelyabinsk, 454092
References
1. Program of optimization of infant feeding for the first year of life in the Russian Federation. Union of Pediatricians of Russia. М., 2019. 156 p. (In Russ.)
2. National program for optimization of infant feeding in the Russian Federation. Project. Union of pediatricians of Russia. М., 2024. 202 p. (In Russ.)
3. Neonatology: national guide: in two volumes. Edited by N. N. Volodin, D. N. Degtyarev. Т. 1. Moscow: GEOTAR-media, 2023. 752 p. (In Russ.)
4. Nutriciology and clinical dietetics: national guide. Edited by V. A. Tutelyan, D. B. Nikityuk. Moscow: GEOTAR-media, 2020. 656 p.
5. Bartick М., Hernandez-Aguilar М. Т., Wight N., et al, and the Academy of Breastfeeding Medicine. ABM Clinical Protocol #35: Supporting Breastfeeding During Maternal or Child Hospitalization. Breastfeeding medicine. 2021; 9 (16). DOI: 10.1089/bfm.2021.29190.mba.
6. Flaherman V. J., Maisels M. J., the Academy of breastfeeding medicine. ABM Clinical Protocol #22: Guidelines for Management of Jaundice in the Breastfeeding Infant 35 Weeks or More of Gestation – Revised. 2017; 5 (12): 2017. DOI: 10.1089/bfm.2017.29042.vjf.
7. Kiosov A. F., Pischalnikov A. Yu. Supplementation of infants with water. Lechaschi Vrach. 2023; 2 (26): 92-95. (In Russ.)
8. Organizational principles of creating an individual breast milk bank in medical institutions and at home. Edited by Lukoyanova O. L., Borovik T. E., Fisenko A. P. M.: Business printing, 2023. 60 p. (In Russ.)
9. Eglash A., Simon L., and the Academy of breastfeeding medicine. ABM Clinical Protocol #8: Human Milk Storage Information for Home Use for Full-Term Infants, Revised 2017. Breast feeding medicine. 2017; 7 (12). DOI: 10.1089/bfm.2017.29047.aje.
10. Technical Regulation of the Customs Union "On the Safety of Milk and Dairy Products" (TR CU 033/2013) dated October 9, 2013 N 67. (In Russ.)
11. Kiosov A. F., Pishchalnikov A. Yu. Liquid and dry infant formulas: advantages and disadvantages. Lechaschi Vrach. 2023; 2 (26): 68-71. (In Russ.)
12. Ulfman L., Tsuang A., Sprikkelman A. B., Goh A., van Neerven R. J. J. Relevance of Early Introduction of Cow’s Milk Proteins for Prevention of Cow’s Milk Allergy. Nutrients. 2022; 14: 2659. https://doi.org/10.3390/nu14132659.
13. EAACI guideline: Preventing the development of food allergy in infants and young children (2020 update) Pediatr Allergy Immunol. 2021; 32: 843-858.
14. Kiosov A. F., Pishchalnikov A. Yu. Introduction of complementary foods to premature infants. Lechaschi Vrach. 2024; 5 (27): 36-41. (In Russ.)
Review
For citations:
Kiosov A.F. Assessment of the adequacy of breastfeeding in infants and the features of the introduction of complementary feeding. Lechaschi Vrach. 2025;(4):54-58. (In Russ.) https://doi.org/10.51793/OS.2025.28.4.008
JATS XML



















