SCIENCE INSPIRED BY NATURE
SMA Gold Prem® 2
Food For Special Medical Purposes
Post-discharge formula, for preterm low birthweight infants. This product must be used under medical supervision.
Product description
PARTIALLY HYDROLYSED PROTEIN
100% whey, partially hydrolysed protein for improved tolerability1,2
HELPS PROMOTE SOFTER STOOLS3,4
due to its SN-2 palmitate fat blend. The only PDF to contain SN-2 2,5
LOWEST OSMOLALITY2,5
of all UK and Ireland post-discharge formulas – 309 mOsmol/kg.
As of July 2023, the iron levels in SMA Gold Prem® 2 will increase from 0.8mg/100ml (1mg/100kcal) to 1.2mg/100ml (1.6mg/100kcal) for both the powder and liquid formulations.
The updated formulation will come into circulation gradually and will be differentiated from the old formulation by a pink flash on the front of the label stating "UPDATED RECIPE"
Please amend iron supplementation guidelines accordingly.
Even when premature babies are discharged from hospital, they may still require extra nutrients to ensure optimal growth. ESPGHAN recommends breastfeeding for post-discharge infants where possible and if formula-fed, infants should be given a post-discharge formula (PDF) until at least 40 weeks, and possibly up to 52 weeks, post-conceptional age.6
SMA Gold Prem® 2 is a PDF that can be prescribed up until 6 months corrected age.
It is important that preterm infants who are given a PDF are regularly measured (proportional growth of weights and lengths) and overfeeding is avoided once a steady growth velocity has been achieved. Once the infant has reached an appropriate proportional weight, PDF is no longer needed and this infant should receive a standard term formula.7
SMA Gold Prem® 2 Post Discharge Formula Feed & Gaviscon Infant
For preterm babies prescribed both SMA Gold Prem® 2 powdered formula and Gaviscon Infant, we advise parents to make up the Gaviscon Infant separately and give it to baby part way through each prepared feed of SMA Gold Prem® 2 powder. To avoid mixing issues, do not mix Gaviscon Infant directly with SMA Gold Prem® 2 powdered feed. However, you can mix Gaviscon Infant directly with SMA Gold Prem® 2 liquid. View the Preparation section to find out more.
Available on prescription (UK only):
PIP codes (UK only): 371-0530 (200 ml bottle), 416-2418 (800 g tin)
90 ml hospital bottle is available for hospital use only:
NHS Catalogue code (UK only): ABC013
800 g tin is available to order in hospital.
NHS Catalogue code (UK only): ABC016
Available in Ireland
Nestlé Supplier Code:
12422354 (90 ml bottle)
12299420 (200 ml bottle)
12425014 (800 g tin)
Partially Hydrolysed Protein
Helps promote softer stools 3,4
Lowest Osmolality
Data card
Formats
90 ml bottle
Available for hospital use only
NHS Catalogue code (UK only): ABC013
Nestlé supplier code: 12422354
200 ml bottle
Ready to use liquid milk available in 200 ml bottle
Available for post hospital discharge use. On prescription in UK only (also available over the counter in the UK and Ireland)
PIP code (UK only): 371-0530
Supplier code (Ireland only): 12299420
800 g tin
Available for post hospital discharge use.
On prescription in UK only (also available over the counter in the UK and Ireland)
NHS Catalogue code (UK only): ABC016
PIP code (UK only): 416-2418
Nestlé supplier code: 12425014
Comparison charts
Preparation
Information for you to give to parents
How to open and prepare your baby's feed.
SMA Gold Prem® 2 – 90 ml liquid
Special Safety Feature
Reject bottle if the foil under cap is missing or damaged prior to opening.
Failure to follow instructions on preparation and storage may make your baby ill.
Wash hands well.
SMA Gold Prem® 2 can be fed at room temperature. If required to heat, stand the bottle in warm water.
Shake bottle well and remove cap and aluminum foil. Unwrap SMA® NUK® orthodontic pre-sterilised teat and holding the teat ring, screw directly onto the bottle.
If warmed, test temperature by shaking a few drops of milk onto the inside of your wrist – milk should be lukewarm.
Preparing and giving a bottle
This downloadable helpsheet is available in multiple languages.
SMA Gold Prem® 2 – 200 ml liquid
Special Safety Feature
Reject bottle if the foil under cap is missing or damaged prior to opening.
Failure to follow instructions on preparation and storage may make your baby ill.
Wash hands well. Wash and sterilise all utensils according to manufacturers' instructions.
Check best before date. Shake bottle well. Pour required amount into sterilised baby's bottle.
SMA Gold Prem® 2 can be fed at room temperature or warmed if desired. Check temperature of feed and feed immediately.
SMA Gold Prem® 2 – 800 g tin (powder)
Whilst this product is made under strict hygienic conditions, it is not sterile. Failure to follow instructions on preparation and storage may make your baby ill.
Pull the safety seal and open the lid. The scoop is provided under the lid. Lift the tab, pull on the foil seal, carefully and safely remove the seal and dispose of it.
Wash hands well. Wash and sterilise all utensils according to manufacturers’ instructions.
Boil 1 litre of fresh tap water. Allow boiled water to cool for no more than 30 minutes. Measure the required amount of water (see feeding guide) into a sterilised bottle, carefully – the water is hot. Do not use artificially softened or repeatedly boiled water.
Using only the scoop provided, add the correct number of scoops of powder (see feeding guide) levelling off each scoop with the back of a clean dry knife. Store the scoop in suspension inside the can and replace lid.
Place the sterilised teat and cap on the bottle and shake well until powder is fully dissolved. Cool bottle under cold running water or in a bowl or jug of cold water until lukewarm, do not immerse the teat. Test temperature by shaking a few drops onto the inside of your wrist.
SMA Gold Prem® 2 Post Discharge Formula Feed & Gaviscon Infant
Gaviscon Infant should only be used under medical supervision
For preterm babies prescribed both SMA Gold Prem® 2 powdered formula and Gaviscon Infant, we advise parents to make up the Gaviscon Infant separately and give it to baby part way through each prepared feed of SMA Gold Prem® 2 powder. To avoid mixing issues, do not mix Gaviscon Infant directly with SMA Gold Prem® 2 powdered feed. However, you can mix Gaviscon Infant directly with SMA Gold Prem® 2 liquid.
Please see recommended instructions provided below.
If you wish to use Gaviscon Infant with SMA Gold Prem® 2 powdered feed, we recommend that Gaviscon Infant be used and prepared in the same manner as if being used with breast feeding. These instructions are provided below, but we also suggest you check directly on the Gaviscon website in case these instructions change in any way.
- Mix each Gaviscon Infant sachet with 5 ml (1 teaspoon) of cooled boiled water until a smooth paste is formed.
- Add another 10 ml (2 teaspoons) of cooled boiled water and mix.
- Give Gaviscon Infant part way through each feed using a spoon or feeding bottle.
Once the preterm baby has reached the appropriate size (as agreed with their health care professional) they can move from SMA Gold Prem® 2 to a standard infant formula. If they are still experiencing regurgitation issues, we recommend moving to SMA® Anti-Reflux, a starch-thickened formula which has shown efficacy in reducing the number of daily regurgitation episodes.
Feeding guide
Information for you to give to parents
Feeding guide – powdered milk
|
Approx. weight of baby |
Preparation for single feeds |
Feeds in 24 hours |
|||
|
Cooled, freshly boiled water |
|||||
|
kg |
lb |
Level scoops |
ml |
fl. oz. (approx.) |
|
|
1.8 – 2.5 |
4 – 5½ |
1 |
30 |
1 |
8 – 9 |
|
2.5 – 3 |
5½ – 7 |
2 |
60 |
2 |
5 – 6 |
|
3 – 4 |
7 – 9 |
3 |
90 |
3 |
6 |
|
4 – 5 |
9 – 11 |
4 |
120 |
4 |
6 |
|
5 – 7 |
11 – 15 |
5 |
150 |
5 |
5 |
This table is a guide only; a baby may need more or less than the volumes stated. Caregivers should consult their healthcare professional if more information is needed. Remember a baby should be fed on demand. Nutritional requirements of preterm low birthweight infants vary according to the age, weight and clinical conditions of each infant. Mix 1 scoop of powder to 30 ml (approx. 1 fl. oz.) of water. Approx. 83 scoops per can. 1 scoop = 4.8 g. Note: 3 scoops of powder added to 90 ml (approx. 3 fl. oz. ) water makes 100 ml (approx. 3.5 fl. oz.) milk.
Feeding guide – liquid milk
|
Approx. weight of baby |
Size of feed |
Approx. feeds in 24 hours |
||
|
kg |
lb |
ml |
fl. oz. (approx.) |
|
|
1.8 – 2.5 |
4 – 5½ |
35 |
1 |
8 – 9 |
|
2.5 – 3 |
5½ – 7 |
70 |
2⅓ |
5 – 6 |
|
3 – 4 |
7 – 9 |
100 |
3⅓ |
6 |
|
4 – 5 |
9 – 11 |
135 |
4½ |
6 |
|
5 – 7 |
11 – 15 |
170 |
6 |
5 |
This table is a guide only; a baby may need more or less than the volumes stated. Caregivers should consult their healthcare professional if more information is needed. Remember, a baby should be fed on demand.
Important feeding information
Information for you to give to parents
Failure to follow instructions on preparation and storage may make your baby ill.
SMA Gold Prem® 2 – 90 ml bottle
|
|
Nutritional requirements of low birthweight infants vary accordingly to the age, size and clinical condition of each infant. |
|
|
Strictly follow hospital procedures. |
|
|
Check best before date. |
|
|
Feed immediately after opening. For hygienic reasons, discard unfinished feed as soon as possible, and always within 1 hour. |
|
|
After use, discard bottle, teat and remaining contents. Bottles and teats are for single use only. |
|
|
For enteral use only. |
|
|
Do not alter or add to formulae unless medically directed. |
|
|
Remember, cows' milk should not be used as a drink during the first year of life. |
|
|
Do not microwave, hot spots may occur and cause scalding. |
|
|
Do not freeze. |
SMA Gold Prem® 2 – 200 ml bottle
|
|
Check best before date. |
|
|
After opening use immediately. If storage is necessary, store only in the fridge (5 °C or below) for no longer than 24 hours. |
|
|
Feed immediately after opening. For hygienic reasons, discard unfinished feed as soon as possible, and always within 1 hour. |
|
|
For enteral use only. |
|
|
Do not alter or add to formulae unless medically directed. |
|
|
Do not microwave. Hot spots may occur and cause scalding. |
|
|
Do not freeze. |
SMA Gold Prem® 2 – 800 g can (powder)
|
|
Do not add extra powder or water to make the feeds stronger or weaker and do not press powder into scoop. Using too much or too little powder can make your baby ill. |
|
|
We recommend preparing each feed in individual bottles when required. |
|
|
For hygienic reasons, discard unfinished feed in the bottle as soon as possible. |
|
|
For older babies, made-up formulae can be added to food. |
|
|
For enteral use only. |
|
|
Do not alter or add to formulae unless medically directed. |
|
|
Do not microwave, hot spots may occur and cause scalding. |
|
|
Remember, cows' milk should not be used as a drink during the first year. |
Patient leaflet
This leaflet is for parents of babies born prematurely, who have been discharged from hospital with SMA Gold Prem® 2 – a formula designed specifically for preterm babies when they go home.
Specialist formulas for preterm babies are available on prescription from their parents’ GP. This leaflet includes a tear-off card which parents can give to their GP when they visit, so the GP understands why their baby is receiving this formula.
-
Mihatsch WA et al. Hydrolyzed protein accelerates feeding advancement in very low birth weight infants. Pediatrics 2002; 110(6): 1199–1203.
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SMA Gold Prem® 2 datacard. Currently available from SMA Nutrition UK & Ireland website (accessed January 2020)
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Lucas A et al. Randomised controlled trial of a synthetic triglyceride milk formula for preterm infants. Archives of Disease in Childhood 1997; 77: F178–F184.
-
Carnielli VP et al. Feeding premature newborn infants palmitic acid in amounts and stereoisomeric position similar to that of human milk: effects on fat and mineral balance. American Journal of Clinical Nutrition 1995; 61: 1037–1042.
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Cow & Gate Nutriprem 2 datacard. Available at https://d2yhgir88ahms2.cloudfront.net/wp-content/uploads/2019/10/29132447/Cow-Gate-Nutriprem-2-datacards2020.pdf (last accessed Jan 2020).
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Aggett PJ et al. Feeding Preterm Infants After Hospital Discharge. J Pediatr Gastr Nutr 2006; 42:596-603.
-
Teller I et al. Post-Discharge formula feeding in preterm infants: A systematic review mapping evidence about the role of macronutrient enrichment. Clinical Nutrition 2016; 35:791-801.
-
Embleton N et al. Postnatal Malnutrition and Growth Retardation: An inevitable Consequence of Current Recommendations in Preterm Infants? Pediatrics 2001; 107(2):270-273.
-
Data is correct as per SMA® PRO First Infant Milk datacard, February 2020.
ESPGHAN, European Society of Paediatric Gastroenterology, Hepatology and Nutrition.
* powder only, osmolality of liquids is 303 mOsm/kg H2O
IMPORTANT NOTICE:
The World Health Organisation (WHO) has recommended that pregnant women and new mothers be informed on the benefits and superiority of breastfeeding – in particular the fact that it provides the best nutrition and protection from illness for babies. Mothers should be given guidance on the preparation for, and maintenance of, lactation, with special emphasis on the importance of a well-balanced diet both during pregnancy and after delivery. Unnecessary introduction of partial bottle-feeding or other foods and drinks should be discouraged since it will have a negative effect on breastfeeding. Similarly, mothers should be warned of the difficulty of reversing a decision not to breastfeed. Before advising a mother to use an infant formula, she should be advised of the social and financial implications of her decision: for example, if a baby is exclusively bottle-fed, more than one can (400 g) per week will be needed, so the family circumstances and costs should be kept in mind. Mothers should be reminded that breast milk is not only the best, but also the most economical food for babies. If a decision to use a formula is taken, it is important to give instructions on correct preparation methods, emphasising that unboiled water, unsterilised bottles or incorrect dilution can all lead to illness. This product must be used under medical supervision. SMA Gold Prem® 2 is a special catch-up formula intended for the dietary management of preterm low birthweight babies who are not solely fed breast milk. It is a nutritionally complete formula for use on discharge from hospital or when a low birthweight formula is no longer appropriate. It is suitable for use as the sole source of nutrition up to 6 months corrected age. SMA Gold Prem® 2 is not intended for use with newborn preterm babies, for whom fortified breast milk or a low birthweight formula such as SMA Gold Prem® 1 is more appropriate.