I found a pair of judgey pants I never knew I had...

[strawberrycake]

Just had a girls night in, talking about how we make up formula and getting into the usual debate about how to do it. I don't really care much..until my mate said 'I just make the batch in the morning and leave it out on the side in the kitchen so I know it'll be at room temperature when she wants it'. My judgey pants came and found me, I get that there's a million and one ways to do it...but that's just going too far isn't it? So for the first time ever I told someone how I think they should bring up their own child. Simply because I rather like the child and don't want harm. AIBU to temporarily morph into one of those women who actually cares how others parent? Or is it always a no no?

For the record I said (with surprise)

"You can't do that, it's so unhealthy..do blah blah' and stuff along those lines.

That's me to a tee, welliemum

OP - did you ask her why she keeps any food in the fridge which she later wants to eat warm?!

FFS - there is a reason that babies who are FF have more D&V and why thousand of babies in the thirld world die due to unsafe FF practices.

However, having said that and looking at the science this may not be as bad as it initially seems:

If you look at these slides from a WHO/FSA meeting - especially page 15 - you will see a range of scenarios of making up formula (contaning the nasty bacteria) with different temps and holding times.

The baseline scenario was making up with water which is 30 degrees and feeding immediately. In all cases using water at 70 degrees led to a reduction in risk of more than 100,000 times - this was regardless of the time between preparation and feeding.

This was also the case for "No refridgeration, re-warming and an extended holding time" - however you'd need to be bloody sure that the water was 70 degrees because in that scenario with water which was 50 degrees the risk was increased 97 times compared with the base line.

OP - are you aware if she is definitely using water which is at least 70 degrees - this means 1 litre of water boiled and left for 30 minutes.

So those who are horrified by this but not using water which is 70 degress may be being more risky than OP's friend.

Also that experiment relates to the Enterobacter sakazakii bacteria and not any other bacteria which may be in the bottles etc. Just to be clear I am not recommending the approach!

Dept of Health/Food Standards Agency guidelines for HCPs.

Very well worth a read because it explains how to make the bottles if you can't make them fresh each time - still using water at 70 degrees but rapidly cooling and storing in the fridge. Also keeping a flask of hot water.

PassMeTheKleenex - the above link will answer your question.

Also the WHO guidelines.

welliemum

And I'm puzzled about cheese and yoghurt - they were evolved over millennia as a way of keeping milk safe and edible before the invention of fridges. They keep longer in the fridge, OK, but why would they suddenly become a hazard at room temperature?

Some thoughts:

Babies immune systems are undeveloped. This is why FFing is more risky. Millenia ago all babies would have been BF - so not need to worry about milk/foods being at room temp. When baby grows up and immune system developed - other foods introduced (but eaten freshly).

I suspect cheese and yogurt has been around for substantially less time that this. After hunter gatherers became "farmers".

Milk would have been drunk very soon after it had been "milked".

In great-grandparents time - i.e. before fridges there were larders/cold rooms. Ice was sometime bought. Holes dug to make a cold storage place.

OP - to actually answer your Q - YANBU.

I would suspect that your friend has not read either of the documents I linked to above. So as her baby is at a much greater risk of illness I think it would be reasonable to suggest she at least looks at them.

Then you can judge her afterwards - depending on whether she changes her mind. .

MWL - yes, you should say something if you see someone making up bottles with cooled water - so long as you know what the correct proceedure is and why. Lots of people have been making up bottles for previous DC or other children and haven't heard the guidelines have changed, what is now the safest proceedure and why... you just have to say it in a way that is polite and not judgemental :)

It may not be a 'parenting decision' if the person hasn't heard that things have changed! Breast v Bottle, Disposable V Cloth, Smacking v Naughty Step - all things to keep your mouth firmly shut about - something that could put a childs life at risk and the parent may not even know it - speak up.

If the parent tells you that they know, but choose to do it this way all you can do is say 'Oh right, I just thought as the bacteria can kill babies I'd let you know in case you weren't aware of the risks of doing it that way'... and hope they at least give it some thought.

"MWL - yes, you should say something if you see someone making up bottles with cooled water - so long as you know what the correct proceedure is and why. Lots of people have been making up bottles for previous DC or other children and haven't heard the guidelines have changed, what is now the safest proceedure and why... you just have to say it in a way that is polite and not judgemental."

Sorry no I don't think its appropriate to say anything unless PERHAPS if its a really good friend AND you can say it in a non judgemental way AND you are sure they don't know the new rules.

The 2 circumstances this weekend were:
a) on a picnic - invited by a friend who also invited another friend (has a child in DD's class but I didn't know them) - child around 1 year old.
b) at a children's farm place, family I didn't know. Small baby.

Neither times appropriate to say anything. Just not my place.

If it really is so dangerous there should be a BIG warning inside the pack of formula.

THERE IS A WARNING!

It explains how to make the bottles and says that "failure to follow the instructions may lead to your baby becoming unwell".

I agree that it could be worded much much better and there should be advice on the alternative methods etc.

It really is worth mentioning it for premature babies/newborns/babies with particularly compromised immune systems - since they are at the greatest risk.

However I wouldn't tell someone I did not know I don't think - unless maybe the baby was very very young.

For a one year old I would be less worried.

We will never change opinions one person by one person. The NHS needs to get the message across to Doctors/HVs/Midwives.

Anyone got any bright ideas how to do this?

I know there is a warning but its not enough. IMO there should be a slip of paper inside every box of formula with wording like:
"this product is not sterile. it must be made in accordance with the instructions (powder added to water at 70c). do NOT add to cold or cool water or food"

Ready made cartoons/bottles say disregard after 2 hours from opening. Powder boxes also have instructions telling you to boil water, let it cool for a certain number of minutes, add power and then disregard after 2 hours.

"X action is not recommended for safety reasons if you don't follow correct procedure"

"But I do X action, that means you hate me and think my baby will die, how dare you!"

"No, nobody hates you, but you are doing something that isn't very safe if you aren't following the correct procedure"

"I tried for months to do Y action, how dare you judge me, I was, in fact, dead and kept trying, and now we are very happy to do Y action so fuck you"

This is why bottle-feeding threads explode.

Bottle feeding mothers hear the words "not very safe", don't read the thread properly and explode in a fit of rage, indignation and guilt.

MumNWLondon

You asked this:

^MumNWLondon* Sun 08-Aug-10 21:01:18...
The point I was making is that in RL many many people make up bottles with cooled water (saw someone doing this today), I see this all the time, yet I am guessing its much rarer to see someone leaving formula out all day. Would the OP have said anything if the person had said she mixed up the formula with cool water and served it immediately? Should we all be saying something?^

I answered saying yes, you should say something and you say this:

^MumNWLondon Mon 09-Aug-10 09:22:40
"MWL - yes, you should say something if you see someone making up bottles with cooled water - so long as you know what the correct proceedure is and why. Lots of people have been making up bottles for previous DC or other children and haven't heard the guidelines have changed, what is now the safest proceedure and why... you just have to say it in a way that is polite and not judgemental."

Sorry no I don't think its appropriate to say anything unless PERHAPS if its a really good friend AND you can say it in a non judgemental way AND you are sure they don't know the new rules. ^

I took it as a genuine question......?????

Riven yes that kills the bacteria in the powder (first aim), then you must store it correctly to keep it safe (second aim). As I said, I would either make it up when I need it with boiling water to powder, topped up with cold water OR make it with boiling water at home, keep it chilled and get it heated (the chill taken off for your DD) when you need it, it is more of a faff then just making it up and sticking it in a bag when you go out, but it's worth it as the bacteria can make you really ill/kill you :(

Riven

"Surely using actual boiling water, which i do, kills everything. I boil the kettle and pour boiling water onto the formula powder."

For normal infant formula using boiling water is not ok.

This is because it has been shown to destroy nutients and vitamins etc.

The 70 degrees has been shown by tests to lower the risk against bacteria to sufficient levels whilst ensuring that the formula provides the correct nutrition.

I am aware that your DD is on a different product, which presumably has different instructions etc and I assume that the packaging/dietician has directed you to use boiling water?

If you are not sure then you could ask the manufacturers etc.

Is it possible for you to not mention your method to others unless their DC are on the same formula. [Am sure this sentence has come out horribly wrong but don't know how to rephrase it.]

I would hate for people to start using boiling water and then their babies don't get the correct nutrients etc.

Riven -I am aware that the ingredients in some formulas mean that 70 degrees is not appropriate.

In those cases the best advice is to heat with the water per the package and then cool to feed immediately. If you are not feeding immediately then they can be cooled in a fridge and kept cool with ice packs and heated for feeding or a flask of water can be used to make the feeds out and about.

The benefit of the formula will outweigh the risk of it being made at 55 deg.

HOWEVER - the formula your DD is on may be sterile. It is probably a much smaller production run and may be manufactured to higher standards - especially as it is being used to feed children with weaker immune systems.

Wait and see what your dietician says.

If you haven't got a thermometer then let me know if you want an experiment doing to see how long to keep the water after it has boiled as we have an infra red thermometer.

eg
1 litre of water boiled and temp tested after increasing amounts of time:

10 mins: 80 deg C
20 mins: 77 deg C
30 mins: 74 deg C
40 mins: 71 deg C
50 mins: 66 deg C
60 mins: 65 deg C
70 mins: 63 deg C

you are suppossed to let it cool to room temprature now, arent you? I know it had changed alot in the six years since I had my second to my third

and for the record, I breastfed but occassionaly mix fed, not that it makes any difference - though I have a flatcreen tv and a free car.

sorry cross post - see above re temperature - hopefully the manfacturer would be able to tell you how long to leave a particular volume of water.

Re the nutrients - well first you'd need to ask the manufactuere and dietician if that is the reason for the advice re 55 degrees.

I will try to find some of the links to info about water being too hot being a problem.

MovingBeds "you are suppossed to let it cool to room temprature now, arent you?"

No - make with water which is 70 degrees and then cool to a safe feeding temp. Baby can drink warm which is above room temp also baby can drink at rom temp or chilled.

Please read the links to leaflets above if you are interested.

yes that is what I meant. My attention to detail isn't great tbh.

I just used to use cartons in the end as I used so little. I don't know how formula feeding mums cope with all the new regulations. When I had my first she was formula fed early on due to problems (she was eventually diagnosed with hypotonia and then didn't develop normally and is now disabled) and you just used to make a batch of formula in the morning and stick it in the fridge and then heat up in the microwave when she was hungry. How things have changed in 11 years!