Can someone please talk to me about making up formula

[splatt]

At 6 weeks DD has very poor weight gain due to a mixture of posterior tongue and poor supply and a viscious circle. Have been advised to top up all day time feed with formula. However, as a feed takes about an hour as it is I think it's going to be increasingly tricky and DH and I have essentially decided to slowly switch to formula.

This has been very hard thought, emotional and heartrenching for me so please I DO NOT NEED anyone telling me to persevere, that breast is best and that everyone can and should breast feed. I have tried, I really really have.

What I do need is someone to enlighten me as to how they go about making up formula feeds when out and at night. The carton says boil kettle, wait 30 mins, make feed, cool and give immediately. So how do you go out for the day? And in the night what do you do with screaming baby while you wait half an hour for the water to cool to 70 degrees. All input greatly appreciated. I never thought I'd be in this situation, my close friends have all breast feed to at least 6 months so can't advise.

[MoonUnitAlpha]

If you go out it's probably easiest to take ready made cartons.

It's not ideal, but the best way to make up powder in advance is to make the bottles in accordance with the packet (70c water) then cool them quickly and keep them in the fridge - you must use them within 24 hours.

[BertieBasset]

Hi there

DD 15 months and I was doing this until about 2 months ago.

I had a flask so would boil kettle, leave 30 mins when baby wasn't screaming and fill flask.

I'd then make as many bottles as needed, as and when from flask. When baby was tiny I'd redo flask every 3 hours or so.

When out I would either take water in a little thermos and seperate powder, or more usually would take a carton as easier.

At night I would do flask last thing at night, and feed during night and then redo in morning, usually around 6 hours. Water was always fine for temp though. Otherwise again you could use a carton.

Hope that helps

Ps I know some people make bottles up in advance but I have not done this as I found the flask easier, or as easy.

[SlightlyTubbyHali]

When people go out for the day they take a thermos of water, or they make the bottle up, leave and make sure it gets used sometime in the next 2 hours.

Alternatively you can use cartons.

I suspect that you can make the formula with boiling water - the formula packet I have seen suggested waiting for the water to cool a bit due to "risk of splashing" - and then cool it quickly under the cold tap.

People I know also make up bottles of water and add the powder when it is needed, but this is not what you are meant to do, apparently.

HTH

[MoonUnitAlpha]

The important thing is making up the powder with 70c water, so if using a flask it would need to be able the keep the water that hot.

[anothernewname09]

Well done for trying so hard with the BF.

Its completely up to you but I always just filled all the bottles up with boiling water and then added powder as and when needed. I used these when out and about.

Its not strictly correct but many people do it this way.

The best alternative to that is the flask.

It will get easier when you find a system that works for you.

[splatt]

Thanks ladies.

TBH the health visitor said that it was fine to take water in bottles that had already boiled and mix the powder when needed, even though that means the water will be cooler. I know friends do this for nursery but with older babies.

AM going to get a flask I think. Only problem then is that mix the powder with the 30 mins cooled water that has been stored in the flask but it then needs to be cooled further before being given. I suppose when you get used to feeding at certain times rather than on demand this gets easier?

[MumNWLondon]

I make up milk in advance, cool it and use these:

www.amazon.co.uk/Vacuvin-Rapid-Ice-Mini-Cooler/dp/B0001MEKAS/ref=sr_1_1?ie=UTF8&qid=1291232923&sr=8-1&tag=mumsnet&ascsubtag=mnforum-21

Keeps the milk fridge temperature for several hours.

Am surprised at what the health visitor said, this goes against NHS and WHO advice - I would perhaps do for older baby if necessary but for younger baby would use carton.

If you get flask of hot water then just need to find cold tap to run over outside of bottle. With my method (chilled milk) I need to find bottle warmer/hot water.

If using a flask think you'd have to pour water straight from boiled kettle to flask as the water in the flask does cool down a bit if left for a couple of hours and if it started at 70c would soon be too cold to be safe and then you may as well follow health vistors advice.

[MoonUnitAlpha]

Hmm... it's not considered safe to make it up with cool water as formula powder isn't sterile and can contain bacteria that need to be killed. Doesn't sound like great advice from the HV. It's safer to make the feeds up in advance with 70c water and reheat than to make with cool water as and when - it's the formula powder that is potentially dangerous, not the water.

Guidance from the DoH and Food Standards Agency is here www.dwrcymru.com/English/library/publications/milk%20guidance/english.pdf

IMO it's like the listeria risk from brie in pregnancy, or infant botulism from honey - it's up to each individual parent to decide if they want to take the risk or not, but it's important to be aware of why the guidelines are there.

[mousesma]

Agree with the above 2 posters, the method suggested by the HV is just plain wrong and dangerous.

The water must be above 70C (but not boiling) in order for the bacteria in the powder to be killed. I can understand why people get confused because the packet instructions are misleading and could lead you to believe it is the cooling part of the process and not the 30 mins part that is the important bit. However for your HV not to know this is shocking.

[NikkiTwinkle]

Hi
When I bottle fed by DS I would sterilise all the bottles, and put together. Boil the kettle and fill the bottles up to 6/7/8 oz depending on how much he took. The water would then cool throughout the day which was fine. When my DS needed a bottle I'd add the powder (you can get powder carriers from ADSA etc) and heat the bottle using microwave or standing the bottle in boiling water.

I'd do the same thorugh the night too.

Well done for trying with the BF, it's a hard decision but one that's got to be best for you.

Hope it all goes well.

[BertieBasset]

You won't need to wait to feed if you allow cooling time before it goes into the flask. You can then effectively make a fresh bottle each and everytime that is ready to go.

Get a good quality flask and you'll be fine. As said the temp is important to kill any bacteria in the powder, the water is okay to use.

If you worry about the temp in a flask get a thermometer and you can measure when it starts to fall but we never had any probs replacing every 3 hours ish (and that was me being over cautious tbh).

As an aside I also give/gave my dd cooled boiled water anyway as a drink which she likes. Just a thought if you have been bf'ing you won't have had to think about that necessarily.

[theborrower]

Moonunitalpha is right - the important bit is making up the feeds with 70c water in order to kill any rogue bacteria that may be in the powder, as formula isn't sterile.

There are guidelines out there on the safe preparation of formula in advance (perhaps search mumsnet for 'who guidelines' as they've been posted quite a lot recently), so it can be done, although yes, the official advice is to make it up as you go along.

We were advised by our midwife that it was ok to make up feeds in advance providing that 1)they were made up with freshly boiled (that is, it was fresh out the tap when put in the kettle) water that was left to cool for approx 20 minutes 2)they were stored in the coolest part of the fridge (bottom at the back) 3) they were used within 24 hours. And, of course, make sure that you sterilise everything, you wash your hands properly and your work area is very clean. And remember that once it's been offered to discard after an hour (or is two? We go by one) and never keep it for the next feed.

We make up only a few feeds at a time (not a whole day and night batch), to ensure that they are always used up well within the limit, and store them in the fridge. We also use cartons when out and about, but I believe it's fine to transport a feed in a good thermos holder (tomee tippee do them) if you use it within an hour or so (and is definitely still cold when you come to take it out). Handy if you're popping to a cafe or something and you know you need to feed the baby within the hour.

PS - I understand your predicament, sounds fairly similar to mine. And don't worry, you'll get used to making them up, even if it seems like such a faff at first x

[HelenLG]

I'm sure I've seen somewhere that you have to boil 1 litre of water or more for it to still be at 70 degree's after 30 minutes...

TBH, if I make formula, then I tend to boil the kettle and only wait about 15-20 minutes before making up the formula (which is about the time it takes to sterilise a bottle).

If DH does a night feed he uses a carton though, because even if there is expressed milk in the fridge DS wont drink it cold and it's just as much of a pain to try and warm it up (not in a microwave due to hot spot) as it is to make from scratch. DS will drink the carton at room temp though.

[MoonUnitAlpha]

Nikki - leaving the water to cool isn't ok, it has to be made up hot.

[Dalrymps]

Something to bare in mind is that recently some research was carried out and it was found that 3 out of 4 tins of formula contain the 'harmful bacteria' that the 70 degree water will kill.

IMO that's to big a risk to take so I think your hv was wrong to advise against current guidelines. Obviously people have done it the 'old' way and everything has been fine but that is just anecdotal, best to stick to the research/facts.

I used to use a flask as others have said ad make a few bottles from it then cool each one in cold water as needed. The cartons of ready made milk are made using a different process so are sterile and easier to use on the go.

[splatt]

Again, thanks.
My health visitor knows I'm very sensible. I think her point was that the guidelines are in constant flux. What they say now is different to what was said a few years ago which was different to a few years before that. My mum used to make up a days worth and have them lined up in the fridge door.
Anyway will get a flask and see how we get on

[toddlerwrangler]

Cartons for out and about and night feeds - relly helps if your baby learns to take it at room temp (some babies prefer it that way).

A bit of organiation and learning feeding patterns (or in my case, implimenting a routine!!!!!) makes it easy to have a kettle boiled up to make feeds at home at the right time. Bit of cooled boiled water that you prepare in the morning can alys be added to bring the temp down.

It SEEMS like a big fat scary faff to begin with, but it all gets routine and nice and easy soon enough :)

[MoonUnitAlpha]

Guidelines change as we understand more though, it's not like they change randomly. No one used to know smoking was harmful for example.

Making up a day's worth and storing them in a fridge is better than making them up with cold water.

[toddlerwrangler]

Yes, you can make a days worth of feeds up in the morning with the hot water, but cool ASAP and keep in back of fridge!

But I freely admit to being a carton whore .

[Flossie69]

What I did with DS1 (now 11 yrs) was to sterilise bottles and boil kettle. Take out bottles, fill with almost boiling water, and add correct amount of formula. Then cool v. rapidly in cold water, and store in fridge until needed. Then when baby is hungry, take out and heat in microwave - GASP. Secret magic solution for hot spots - shake the bottle .

This worked very well for me and now am doing the same for DD, who is 6 months. I saw all the new guidelines, and figured that if it worked before, it should be fine now. I am scrupulous about sterilising, never keep the bottles after 24 hrs, and discard unfinished feeds.

I agree to do whatever works best for you, but some rules / guidelines are taken too seriously (ie microwave heating).

[toddlerwrangler]

Word of warning with the microwave - Dr Browns Bottles nnnooooooooooo like the microwave, OR very hot water for that matter. Goes everywhere!

[TheSugarPlumFairy]

flossie69 what you did then is still fine to do now and is recognised as such in the DoH guidelines quoted somewhere up the thread.

I microwave cold bottles too, and give them a good shake. much less faff than heating in hot water.

[galonthefarm]

all v good points above about water having to be above 70 degrees. I know so many people who do the cooling down boiled water and then add powder, but personally don't think its worth the risk.Taking a flask out and about works, but I find cartons waaay easier especially at night. It is more expensive but if you're like me in the middle of the night I'm not very clever with boiling water!

Just remember the bottle of formula once made up will last for 2 hours, so if you aim for half an hour earlier than when you think your LO will be hungry, you will still have 1 and half hours until it is "dead".

Don't feel guilty about the bf thing, but if you are able to express and keep giving bf once a day for a bit longer, it may make you feel a bit better. I will bump a thread I started about "support for formula feeders" hope you find it useful. SOrry for the essay!

[Flossie69]

When I had DD it wasn't at all clear to me that what I did before was in accordance with the guidelines - most places I looked said don't make them up beforehand.

I have also found cartons very handy when I have been away for weekends - and then I just scald the bottles in boiling water beforehand - this is fine if bottles are used straightaway. There was a thread somewhere about not needing to sterize at all. I don't like to use cartons for too long though, as my DD finds the milk richer than powder.

When going out, I find most places are more than happy to provide some hot water to heat a bottle up. However, in emergencies, my DD will drink her milk cold, bless her :)

[tabouleh]

WHO leaflet

DOH/FSA preparation leaflet - includes advance preparation

fucking shite health visitors

Sorry for brief post will try to pop back onto it later.