To send this email to Tommee Tippee and be appalled that the advice they are giving?(115 Posts)
Copied and pasted from the email I have just sent...
"I visited your consumer site, as a parent, but I am also a Midwife.
I am contacting you because you are giving incorrect advice regarding the correct way to prepare infant formula.
Your website states:
'Health guidelines recommend you make up bottles one at a time. It may be easier to store the cooled, boiled water sealed in the bottles and then add the formula at feeding time.'
This goes directly against Department of Health Guidelines. A copy of which can be found here:
The correct advice is:
'To reduce the risk of infection, make up each feed as your
baby needs it, using boiled water at a temperature of 70 o
C or above. The step-by-step guide shows you how to do this.
Water at this temperature will kill any harmful bacteria that
may be present. Remember to let the feed cool before you
give it to your baby.'
This is followed up with the following information:
'Do not boil water in advance and store it in sterilised bottles
in the fridge for later use. The water needs to be hot when the
powdered infant formula is added, to kill any harmful bacteria
that may be present.'
Please can you explain why you are advising parents directly against the government guidelines for making up first stage formulas.
I would like to know where you found the information to display on your website.
There are some formulas which require preparing with cooled boiled water, but these are specialist milks, and the majority of parents and carers will not be using these milks.
The advice you are providing can and does make babies ill. I am very shocked that you would give such ill-informed advice.
I would appreciate a speedy response to my question."
Was I being unreasonable? I'm quite annoyed at them really! Am off to see what other bottle manufacturers websites say...! One woman mission here!
Yes, thankyou Sirboobalot, I understand that. What I would like to know is how common are these serious infections - why do we never hear about them?
Manti, I did the same as you with all 3 of mine. I made up 6 bottles in advance and just kept them in the fridge.
taggie I thought that if you boiled a full kettle of water and then left for 30mins = 70degs
I find all the 'oh I did this and it was fine' attitude bizarre. Why are people so casual about taking a risk with their baby's health?
Fair enough if you followed what were the guidelines at the time, because you can only base your choices on information available. But why not follow the current advice?
YANBU - but doesn't it show how they don't give a shit - to have allowed this massive error to be overlooked?
I phoned Cow and Gate once and complained about their rep quietly dumping huge piles of formula advertising leaflets
not very cunningly disguised as helpful advice on all aspects of feeding, including breastfeeding in the parent craft room at the local hospital.
Especially as the booklet implied that constipation was common in all babies and not just those being ff, and stated that bf babies should be given water in between feeds in hot weather.
They were utterly uncaring - had no intention of withdrawing the leaflet and frankly sounded annoyed that I'd phone to complain.
copied and pasted from TT website
Making up a Feed in Advance
Warm milk is a breeding ground for bacteria so making up bottle feeds in advance is no longer advised. As it is not easy to anticipate when a baby is going to wake up (and therefore when to boil the kettle and let the water cool), it may be easier to put a measured amount of formula aside in a sealed container (Milk Powder Dispensers are ideal) and have a flask of cooled boiled water ready to make up the feed. You can re heat the cooled boiled water and then add the formula prior to feeding. You should only mix the formula once you are happy the water is at the correct temperature as this minimises the amount of time within which bacteria can grow.
I would love to know how many people actually make up every feed as and when required. I'll hold my hands up and say I don't. I leave a little cooled boiled water in the bottle and then top it up to the right amour with freshly boiled water when needed. This makes it warm enough for the powder to dissolve but not too hot that it takes ages to cool for DS to drink - it's usually fine by the time I have taken him upstairs to change his nappy and come back again. Was told I could do this by a paed nurse.
Gotta say though - have been given various bits of advice from MW/HV and nurses - all contradicting each other. some say to use all cooked boiled water and warm bottle a little in a cup of warm water, some say to make up completely and store in fridge - none of them can agree. Also, its a bit of a pain that the guidelines change (for everything - feeding/sleeping etc) on a bloody whim so is it any wonder people don't necessarily listen to them.
ItsAll that does seem to be implied by the DoH guidelines linked to above - fill kettle with a litre of water, leave 20-30 mins.
There was a poster on here once who had spent big sums on a kettle that monitered or regulated temperature. The price was high, but I'd certainly get one if I ever needed to make up bottles.
I used to fill bottles with boiled water, let it cool and filled with formula and reheat when needed. My DS is healthy. Lighten up. We do live in pretty clean environment with pretty clean water.
Barley sugar , only a few babies have died in Europe from e-sakazakii in formula, but I suspect they're not entirely sure if there might be more that haven't been linked directly to formula but where formula might be implicated.
I'm going to stick my neck out and say I always prepared bottles with water and then simply added powder when needed to cool bottle. Idid this because a) I don't see how putting formula in hot water kills germs unless you are going to boil it which you don't and b) because I felt that if there was a chance of disease it started top breeding the moment the milk was dissolved. Spin was absolutely obsessive about discarding milk within 2 hours of it being prepared.
I have investigated cases of salmonella poisoning from formula powder, so yes it is a real hazard.
French it's nothing to do with how clean the water is. It's to do with how clean the formula is. Bling understands this, but doesn't believe that the problem can be dealt with by following official advice.
What I don't understand is why you ought not to use water that has been boiled before?
The boiled before water bit is because of minerals (or whatever the stuff that's in water is called) becomes more concentrated with each boil as some of the water evaporates which isn't good for the baby. Or so I was told.
Barleysugar - it is my understanding that the only deaths from the E Sakazakii bacteria have been babies who were already in NICU and who were already unwell/weakened/immuno compromised/premature.
I bottle fed my dses back in the days when it was considered fine to make up bottles 24 hours in advance and keep them in the fridge, and whilst it is not evidence, I can say that I did not hear of any infant deaths related to this way of making up formula, either amongst my acquaintances or in the press.
That said, making up bottles one at a time, with water above 70 degrees centigrade is the gold standard of how to make up bottles.
I would advise, most strongly against taking a bottle of heated -up formula upstairs at bedtime, and using it some hours later. Unless a bottle is made up, stored and handled in operating theatre style conditions of sterility, there is always a risk of contamination, and warm milk, cooling gradually at room temperature, would provide a lovely breeding ground for bacteria.
Bling - it doesn't need to be boiling, just around 70 degrees (72 actually) to kill bacteria. Luckily 1 litre of boiled water reaches this temp after the suggested cooling time. You could achieve the same effect with a thermometer and measure the time/temp exactly. But the fsa guidance is designed to be easy for everyone to follow to be safe, so instead of faffing with a thermometer they tell you to leave the water to stand.
PseudoBadger - I hope you don't mind my asking, but were the cases of salmonella poisoning from formula that you have investigated due to contamination of the formula powder, or contamination during the process of making up the formula?
Contamination of the formula, which was not made safe as the bottles were not made up in accordance with guidelines.
To clarify, EHOs all over the country are investigating illness from formula regularly - just because there's no publicised deaths doesn't mean it's not important or not a real issue. It's the same as eating raw meat without making it safe, essentially.
Yanbu. Anybody who gives advice out in print should make sure that advice is correct.
Once you have been given that correct advice it is up to you if you follow it or not but its your risk to take with your child. If someone who is in a position where they should be considered to be a authority on the matter gives incorrect advice and you follow the incorrect advice then that person has taken that risk for you.
I have a friend who HAS been given correct advice but still insists on making her bottles with normal tap water direct from the hot tap ( no modern boiling tap involved just a bog standard tap) as stupid as I think that is its up to her,but if a person that should know better had told her to do this then its different because she would be thinking she was doing the right thing rather than knowing she wasn't.
How difficult is it to make a bottle! You boil the kettle, put the water in the bottle, put the powder in, put the lid on and shake. Job done.
I'm a microbiologist and always boiled the water in the morning and stored it for the day, making up feeds as required. The water will stay sterile as long as the bottle is sealed and as long as the powder goes in at feed time bacteria will have no time to grow. The only potential danger with this system is if the powder itself is grossly contaminated.
I also wouldn't trust a few seconds at 70 degree to kill anything. We treat at 120 degree for at least 30 mins at work.
If I have understood correctly it is E Sakazakii contamination that is supposed to be the problem with formula powder contamination, Annie - do you know if this particular bacterium is killed by 70 degree water?
But I do know that bacteria and viruses are hardy, sneaky bastard.
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