Managing the diet - GAL

Diet calculations of a newly diagnosed infant^1,2
Diagnosis	Classical Galactosemia
At the diagnosis of classical galactosemia	Immediate and complete transition to a lactose free infant formula
Protein recommendation	Age adequate, depending on bodyweight
Energy provision	age adequate, depending on bodyweight
Volume	age adequate, depending on bodyweight 6-8 feeds in 24 hours/on demand
Lactose free infant formula	Standard solution: 3 scoops of Galactomin 17 + 90 mls water provides 100 ml lactose free infant formula ( soy based/elemental infant formula)
Breast feeding	Breastfeeding is not recommended
Lactose-free infant formula	Preparation of the lactose free infant formula as indicated. Mostly 6-7 feeds are advised daily, the total daily amount is divided by the amount of feeds.
Transition to solid products/weaning	In line with recommendations on food introduction for healthy population Start the introduction of vegetables and fruit in line with local recommendations for Classical Galactosemia Gradually introduce more texture and lumpier lactose free foods, starting at 6-8 months Finger foods can be introduced from 7 months onwards From 9 months the low protein pasta, bread and potato (products) can be introduced

Dixon M, Macdonald A et al. Disorders of carbohydrate metabolism, In; Shaw V (ed) Clinical paediatric dietetics, 4^th John Wiley & Sons ltd. Sussex, 2015:526-539
Bernstein LE, Calcar S. In: Nutrition Management of Inherited Metabolic Diseases. 1^st ed: Springer International Publishing Switzerland 2015:285-293