Totally confused about sterilising bottles - HELP!

(54 Posts)
havingastress Wed 21-Nov-12 13:22:32

Ok - so I have checked through back threads, and tbh, that's just confused me further!

Baby is 3 weeks old. Have just stopped bf'ing (upsetting, but just couldn't continue, health issues) so am onto bottles sadly.

We have a tommy tippee steriliser. It says once you open the steriliser the bottles are no longer sterile! Sooo....what are you supposed to do?

This whole boiling the kettle half an hour before the feed is not conduicive to feeding a hungry tiny 3 week old baby.

Can I take ALL of the bottles out of the steriliser, make the bottles up, fill up with cooled boiled water, leave on the side and simply ADD the powder as and when we need them?

OR do we make up all the bottles into milk, leave to cool and then store the bottles in the fridge?

OR do I simply sterilise a bottle at a time and make up just for that feed?

BF'ing was definitely less confusing!!!

HELP PLEASE KNOWLEDGEABLE MUMSNETTERS!!!

ginmakesitallok Wed 21-Nov-12 13:25:27

It's the bugs that might be in any left over milk that need to be killed - so once they are sterilized once they are OK to use. Once out of the sterilizer they are no longer clinically "sterile", but the harmful bugs will have been killed.

Remember that you are boiling the water so that it kills the harmful bugs in the formula powder. You are not boiling the water to sterilise the water.

I think you can make up bottles with the hot water and formula and cool them, but definitely do not make up formula with water that is under 70 degrees centigrade. It's a rare risk, but babies have died, even in Western society, due to contaminated powder.

CMOTDibbler Wed 21-Nov-12 13:30:59

If you assemble the bottles when you take them out of the steriliser they'll be fine.

You need to make the bottles up fresh each time - it is important that the powder is added to water over 70'. This does not mean you need to leave the kettle for half an hour though - you can make up the bottle straight away then run it under the cold tap, or use a wine chiller sleeve to reduce the temperaturee

FirstTimeForEverything Wed 21-Nov-12 13:36:10

Message withdrawn at poster's request.

JackThePumpkinKing Wed 21-Nov-12 13:37:23

Yes, take the bottles out of the steriliser when they are finished and put them together. Just don't touch the teats with bare hands (you should have tongs). We used to take them out when they were still hot (asbestos hands developed v quickly!) and it was fine.

FIll up a thermos at the beginning of the day with fresh boiled water - then you don't need to wait for the kettle. You'll have hot water ready to go. Just make sure it's still steaming hot and it'll be hot enough to safely make up formula.

Use cartons for out and about though - SO Much easier.

JackThePumpkinKing Wed 21-Nov-12 13:38:10

Do NOT add formula to cool or slightly warm water though.

DuelingFanjo Wed 21-Nov-12 13:45:47

FirstTimeForEverything - I think that you're supposed to pour the hot water (no less than 70 degrees) onto the formula.
If you put it in the fridge it cools and is no longer hot enough to kill the bacteria in the formula so not a safe way to make bottles up.

I think it's ok to put the hot water onto the powder then cool it down and store in the fridge for a while? But putting cold water (Even if it has been previously boiled) is not safe.

FirstTimeForEverything Wed 21-Nov-12 13:46:40

Message withdrawn at poster's request.

Firsttime Can I just ask why you're bothering to boil the water at all if you're going to let it cool completely before adding formula?

DuelingFanjo Wed 21-Nov-12 13:47:28

"I take out one of the bottles from the fridge and put in a jug of hot tap water for about 5 mins to warm up a bit"

sorry - this bit. Are you sure that's safe?
Your midwife said to do this?

Marrow Wed 21-Nov-12 13:49:47

Firstyimeforeverything - Your midwives should not have confirmed that this is the correct method. The water needs to be at least 70degrees when you add the formula to kill any bugs in the formula. The safest way to make up bottles is as they are needed with water that is at least 70 degrees. The next safest is to make them all in advance ( again with hot water) cool rapidly and store in the back of the fridge. The way you are doing them is the riskiest as it sounds like you are adding formula to lukewarm water.

The problem these days is that most HCPs aren't given training on making up bottles as they can't seem to be promoting bottle feeding. It makes me mad that mums then go to seek their advice and are given dangerous, outdated information.

Spiritedwolf Wed 21-Nov-12 13:49:48

BF is less confusing once you get the hang of it, but I guess you'll get into the swing of bottles too. The thing about asking on MN is that people do different things and not all of them would be reccomended.

I believe official advice is: make up each feed when you need it, always use boiled water cooled to no less than 70 degrees to mix with the powder and put the water in first (so that the volume is accurate).

I'm not bottle feeding, so I don't know all the best practical tips. I have heard of mums putting the hot water into a thermos for night feeds so that they don't have to wait for the kettle to boil, I suppose you could use a thermometer to check the temp of the water to see if it would work, and then add a pre measured out amount of powder. But it still needs to cool down obviously to drinking temperature - cold tap?. In this case you may as well just sterilise what you'll need for the next feed and when you take out your bottle put the next lot on to be sterilised.

The reason why you need to mix the powder with 70 degree plus water is because the Powder is not sterile. So using cool boiled water won't work.

Mums have different opinions on the sterilisation of bottles and premaking feeds. I don't know the ins and outs of these aspects.

Not an expert, just didn't want to leave you hanging. Hope you and your baby are well with regards to the medical issues. Congratulations on your new baby.

FirstTimeForEverything Wed 21-Nov-12 13:50:19

Message withdrawn at poster's request.

DuelingFanjo Wed 21-Nov-12 13:51:17

"You can add formula to steralised warm water as I do abovd, I called the maternity unit to check this recently and HV also said it was fine last week. I called them after the last debate on here about this a few weeks ago. If you can't make up each bottle from scratch then they said what I do is a safe alternative, they keep cooled water bottles in the fridge on the ward"

I might be a bit confused then. I have checked the NHS guidelines and you add the formula to the water.

is the water still 70 degrees or above when you remove it from the fridge to add the formula?

NHS guidelines here

FirstTimeForEverything Wed 21-Nov-12 13:52:20

Message withdrawn at poster's request.

DuelingFanjo Wed 21-Nov-12 13:53:25

maybe read them the NHS guidelines?

Marrow Wed 21-Nov-12 13:55:30

First - if you look at the box of formula or in your birth to five book it gives all the correct guidelines there. As I said a lot of HCPs are giving outdated advice and have not been trained in the new guidelines which have changed in the last few years.

raininginbaltimore Wed 21-Nov-12 13:55:51

Firsttime the water must be above 70 degrees. You can make formula in advance if you make with hot water, flash cool (i use ice cubes) and store at back of fridge. Must be used within 24 hours.

The thing I do when out and about is fill bottle with 3oz cold water and take flask of hot. I pour cold water into lid of flask, then 2oz of hot water in bottle. Add powder, shake and then add cold water. You must measure the cold water out first though.

DuelingFanjo Wed 21-Nov-12 13:58:11

beware of Hipp though giving bad advice against health guidelines.

firsttime I know we are supposed to trust healthcare professionals, but time and time again on Mumsnet we have seen instances of poor and/or dangerous advice. I'm really sorry but the nurses are telling you the wrong thing and I would ask them why they are giving out advice like this in direct opposition to World Health Organisation guidelines. (though I suspect they will mutter something about WHO guidelines only being relevant to countries which don't have clean water - thereby displaying their gross ignorance of the issue.)

The World Health Organisation believe that formula contamination is a big enough issue to have specific guidelines written on how to prepare it safely:

WHO guidelines

There is separate research here about how widespread bugs in formula are.

Research into formula contamination

Marrow Wed 21-Nov-12 14:01:48

How can Hipp get away with that?!

FirstTimeForEverything Wed 21-Nov-12 14:03:27

Message withdrawn at poster's request.

FirstTimeForEverything Wed 21-Nov-12 14:06:50

Message withdrawn at poster's request.

Startail Wed 21-Nov-12 14:07:03

Like raining I'd work out with a thermometer once how much cold boiled water and how much boiling water I needed to end up at 70 0C in the size of bottles I was using.

Life is too short to l waiting for kettles to cool.

I would then cool them stick them in the fridge and microwave carefully when needed. Purist can shoot me, I am not faffing about with boiling water at 3am.

FirstTimeForEverything Wed 21-Nov-12 14:15:31

Message withdrawn at poster's request.

havingastress Wed 21-Nov-12 14:36:03

Wow..so it wasn't a totally daft new mum question then!!! Seems there is a lot of confusion over this matter!

Just back from my walk out..hmmm...Right...I think I'm going to take the bottles out of the steriliser and put them together and get a flask! Totally now understand that the reason for the hot water is because of the powder, so cool boiled water won't work.

Will defo be using ready made stuff out of the little cartons if I'm out and about I think! (presume then given that the bottle is sterilised, I can just pour the ready made stuff into it and feed to baby?!)

JackThePumpkinKing Wed 21-Nov-12 16:28:16

Sounds v sensible havingastress

This topic is much argued on MN - there was an epic long thread on it once IIRC - it all got very heated!

Here's what I do:

- Boil kettle
- Pour required amount into 4 bottles (that's how many my baby has during the day, a younger baby may need 6)
- Wait for them to cool to 70 degrees. Because they are in bottles, not kettle they will cool faster than 30 minutes.
- Add formula
- Shake bottles well
- Put all bottles into very very very cold iced water
- Once cold (take about 5 mins) straight into fridge.

I don't warm my bottles, but if I did, I would just stick them into a bowl of hot water for a couple of minutes, just to bring them to room temperature. I wouldn't use a microwave

I use cartons when out.

havingastress Wed 21-Nov-12 19:39:03

thank you visualise...your routine makes sense! I can do that!!!

Just make sure they're not warm at all when they go into the fridge, this will help breed bacteria.

I do think it's a good idea to make sure your baby can take milk at room temp since it's not always easy to make it warm (especially if you're out etc).

Just make sure you always have icecubes! So as soon as you've taken them out of the cold water, add more ice cubes to the freezer.

FirstTimeForEverything Wed 21-Nov-12 20:55:35

Message withdrawn at poster's request.

I know, I was never even ASKED if I knew how to make a bottle up, luckily I learnt through my mum.

Oh, forgot to add - don't keep a feed for any longer than 24 hours - I actually prefer to use them within 12 hours. So if I was bottle feeding at night as well as the day, I would get up in the morning, make 4 bottles for the day, then before bed make another 2 or 3 smaller ones for over night.

If baby feeds from a bottle, but takes only half or so, you must throw the feed away within 2 hours.

JackThePumpkinKing Wed 21-Nov-12 22:13:38

FirstTime smile

It's terrifying how so many health professionals don't have a clue about this sort if thing. My HV woukdnt give me any advice because she wasn't allowed to, so I asked on here.

loveisagirlnameddaisy Wed 21-Nov-12 22:22:19

FWIW, I put the made up bottles straight into the fridge. Haven't had any problems doing this with my now 4 month old.

JackThePumpkinKing Wed 21-Nov-12 22:23:50

Much better to cool them first. It minimises the amount of time they spend at the temp that bacteria can multiply. It really is better to get them down to less than 5C asap.

RightUpMyRue Wed 21-Nov-12 22:25:24

Super simple guide to making up a formula feed

Start for Life guide to bottle feeding

Anyone who says anything different to these guidlines is wrong, don't listen to them.

HTH smile

MadhouseMama Wed 21-Nov-12 22:32:07

I used to keep a jug of pre boiled water in the fridge and then when I needed to make a feed boil the kettle, use a small amount of the hot water to sterilise and dissolve the formula and then top up with the cooled water to give a perfect temp bottle for screaming baby who isn't interested in waiting for bottle to cool down!

Always keep some ready made cartons around the house and one in nappy bag.

Poor DS2 hardly had anything sterilised, all went in dishwasher and that seemed to do the job just fine.
Like above, as long as you use hot water on the powder to sterilise I think everything else will be just fine wink

JackThePumpkinKing Wed 21-Nov-12 22:53:43

If you keep bottles in the fridge you need to sterilise.

If you're making them up fresh each time then there really is no need to bother. Dishwasher is great, good wash in hot soapy water and air dried also fine.

But if you're keeping bottles in thd fridge, please do sterilise (yes, I said it twice)

JackThePumpkinKing Wed 21-Nov-12 22:57:27

RightUpMyRue - the trouble is that people just don't follow that advice. It's impossible to follow when you have a screaming child demanding feeds at 3am. It's about finding the safest alternative if you don't think you can follow those guidelines.

Also, rinse bottles with cold tap water as soon as they've finished!

Fairylea Thu 22-Nov-12 11:39:13

I do the same as visualise. Have done with my two dc.

RightUpMyRue Thu 22-Nov-12 16:35:26

JackThePumpkinKing - The answer to that is to use ready mixed cartons at 3am when hungry child demands.

JackThePumpkinKing Thu 22-Nov-12 18:26:13

Yes, I know that. I'm just saying that if you ARE going to use an alternative method, then the more you know about risks etc the better smile

If people are going to make up bottles in advance, as they may well decide to do, then there are ways to make it safer. Obviously the ideal is that they make up on demand, or they use cartons. Clearly not everybody is going to follow that advice to the letter or there wouldn't be so many threads about it.

RightUpMyRue Thu 22-Nov-12 18:37:31

Have you read the Start for Life leaflet? It says it's permissible to store made up bottles for up to 24 hours in the back of the fridge, if you must, but it's preferable to make them up as needed.

"A feed should be freshly made up when it is needed to reduce the risk of infection that can make your baby ill. If you have no choice and need to store a feed, it should always be stored at the back of the fridge and for no longer than 24 hours.
Any infant formula left in the bottle after a feed should be thrown away. Infant formula that has not been used and has been kept at room temperature must be thrown away within two hours. Bacteria multiply very fast at room temperature. Even if a feed is kept in a fridge, bacteria can still survive and multiply, although they do this more slowly. The risk of infection increases over time so that is why it is important to make up the feed each time your baby needs it.

KEY FACT
• If made-up formula is stored in a fridge: use within 24 hours
• If made-up formula is stored in a cool bag with an ice pack:use within 4 hours
• If made-up formula is stored at room temperature: use within 2 hours"

This is a relatively new leaflet though. Hopefully it's clear enough and full of enough information to make it easier for parents (and professionals!) to understand and follow.

JackThePumpkinKing Thu 22-Nov-12 18:44:35

But that's what people are saying confused

RightUpMyRue Thu 22-Nov-12 18:52:25

The guidance is clear enough to not have to listen to any anecdotal advice that is always bandied about on all and any thread about infant nutrition:

"I did X,Y and Z with my kids and they're fine" for example.

Much better for the OP and anyone else reading subsequently to have the evidence based research and guidance given by the DOH.

raininginbaltimore Thu 22-Nov-12 20:11:11

My daughter is on neocate, so there are no ready made cartons.

JackThePumpkinKing Thu 22-Nov-12 20:18:55

Yes Right. I know!

Emmie412 Fri 23-Nov-12 08:21:30

I struggled with the same but ended up using cartons rather than powder all the way. The cartons are sterile to start with so no need to faff so much. More expensive for sure but at the end of the day I wanted it to be as safe and easy as possible.

I couldn't afford to use cartons all the time - especially now baby is pretty much completely on formula. He has the equivalent of 4 cartons a day. At about 70p a carton, that's £3.80 a day!! Whereas one tub of powder is £8.00 ish, and would last all week.

havingastress Fri 23-Nov-12 14:12:39

rightupmyrue thank you so much for the links. Very clear. Oh I do wish money was no object and I could just buy the ready made stuff!!! Why is it so goddamn expensive?!

However, will be taking ready made out with me with a sterilised bottle for sure! smile Thank you wise mumsnetters!

RightUpMyRue Fri 23-Nov-12 14:36:51

You're very welcome havingastress. smile

Hopefully your baby will fall into a feeding pattern pretty quickly so you'll get to know when a fresh feed is likely to be needed so you can get it ready before any major crying has to happen.

raininginbaltimore Sat 24-Nov-12 14:48:11

You stil can't predict the night feeds though, unless you set your alarm for an hour before you think they might wake. I make my day feeds as needed, but night one have to be made in advance.

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