to be really annoyed about the number of threads recently on how to prepare a bottle of formula milk

[piccalily]

I mean seriously, it's not that hard. The instructions on the side of the tub tell you how to do!!!

It even says "Because powdered milks are not sterile, failure to follow instructions may make your baby ILL"!!!

I don't know about statistics in individual countries, but I do know that Belgium hasn't adopted the WHO guidelines and several babies there got ill and even died.

There is one "rule" as in the WHO advises making up formula with 70c water, but it is up to individual countries whether they follow those recommendations. Formula companies get away with more in some countries than in others.

I think of the risk as a little like the risk of eating soft cheese in pregnancy - the chance of getting listeria is very small, I don't know of anyone who has. However, listeria could kill your baby, so most people I know did avoid soft cheese in pregnancy.

I am sure there is a risk, it's just that I have never heard of any babies here having any problems at all - and it's not like we are in a society where you wouldn't hear about these things.

Ah well, it's obviously a good thing that hardly any babies get sick and I think it is right to say it's like the risk of listeria in pregnancy - really really tiny risk, but not one you want to take as it's pretty easy to avoid.

On page 11 of this it lists some outbreaks and baby deaths in Europe, NZ, the US and Israel.

10 years ago I used to measure out water from the kettle - add formula - shake like mad til mixed. Make up bottles for the day -put them into a bowl and cool them under a running tap. Put in fridge.

Now, the HV told me this was correct, and nurses and nursery nurses from a mother and baby unit I spent some time in taught mothers to do it this way.

Ds was 8 weeks prem to boot and I STILL managed not to poison him with ff so I imagine the risk is minute.

Is there a different way now?

No that's fine valiumredhead - the important thing is that the powder is mixed with very hot water. It is mixing powder with cold water that is a problem.

YABU, I am mum to 2 boys and pg with a third. I bf mainly but when I did ff I always added formula to cooled eater and the re-heated. Seem I was wrong!
(and yes I did read instructions, but 7 years ago!)

Ok, thanks Rita :)

Must say I am amazed reading this. No wonder people are asking questions, for first timers but especially those with other children who were told different rules. When my DS was born 6 years ago the French doc said wasn't worth sterilising anything (ignored that and always sterilised bottles etc), milk was made up with Evian mineral water (under no circumstances was tap water to be used, even if boiled), then bottle heated by running under tap or in bowl of warm water. Bottles could be kept made up for 24 hrs in fridge. If I had another I would do exactly the same (or would have before reading this), probably wouldn't even bother to read the guidelines apart from the amount of milk.

Valium and Rita , yes there is a different way now. Boiling water is considered too hot and kills some of the nutrients.

I hate seeing mothers at our Children's Centre pull out their little tubs of powder and mix with the cold water in their bottles - Not because I want to judge them, but I think the staff at the Children's Centre should be educating people on safe practice, (that obviously people are free to ignore.)

[wanders off to search for this info as I know someone will ask me to state my source!]

Sorry MrsBonkers you are right - water should be not quite boiling, but not less than 70c. 70c is the temperature of a litre of water left for 30 minutes.

The only way to be sure is to use a thermometer - maybe they should come in the tubs like the scoop?

I was also told if I had a dishwasher ( which I didn't at the time) I didn't need to sterilise bottles as it is more important to be extra extra clean - which is hard to do when just hand washing but as dishwashers get so hot and are so thorough they were ok.

Rita thatis a fantastic idea. I think it would really drive home the message that temperature is important.

Rita, that's really interesting and in fact totally puts my mind at ease as it's WAY more rare than I had expected.

Sterilising bottles isn't strictly necessary, but very thorough cleaning (whether by hand or in the dishwasher) is, to remove any traces of milk. If you're a bit slapdash about washing the bottles and leave milk residue, sterilising them isn't going to do much good anyway!

Interesting the French are told to use mineral water - I'm sure we are advised specifically not to give mineral water to babies because of the sodium content.

My HV told me that it was fine to boil kettle, wait for 5 mins or so and then make bottle, as the important thing was that the powder was sterilsed by the boiling water. I had no idea that it would kill some of the nutrients.

Ozziegirly - I think those figures were just for enterobacter, salmonella is an issue to but I don't know how common it is. I read the other day a mumsnetter saying her baby got salmonella from formula though.

It's amazing how few healthcare professionals are giving the correct advice.

I guess the good thing we should take from this is that millions of babies are having their formula made up incorrectly, and yet there are around 90 cases worldwide every year.

90 cases too many. But still, even these may not specifically be due to formula milk (if I read Rita's link properly).

I've just been googling for info to back up my posts. OMG there is a lot of crap on the internet.
No wonder people are confused!!!
I've just realised why I use pre-mixed. Its more expensive,(and DH and I have economised our the rest of our shopping budget to allow for this - we're not made of money!) which is probably why the formula companies aren't in any hurry to make powdered info easier.

D'you know what? We all do our best with the info and advice we have.

I also had no idea about boiling water killing nutrients. On the packet it says that boiling water can cause scalding, and I assumed it meant it was a H&S issue for the handler. It was not until DS was 5 months old that DH (who is a chemist) explained this when I discussed it with him. (He used to make the bottles with cold water then microwave them. so i banned him from doing it).

Now I make up 4 bottles at a time. I wait the 30 mins after the kettle has boiled, i fast cool them in iced water and then place in fridge.

That has worked very very well for us. But, I think we have been lucky in that DS was never a sicky baby. No reflux, or digestion problems, he is quite robust (thank heavens). If a baby has any stomach issues I might do it differently, perhaps.

I have been on Mn for 4 years or so now, and I have no problem about people having issues or questions they want to run past other people. I occasionally look at past threads before posting something, but often I want a response to ME, to my specific issue.

Rita - re the mineral water - it has to be Evian, something in the make up of that which makes it suitable for babies (so they say). I was very ignorant about FF, had intended to BF but couldn't - had never occurred to me that I wouldn't be able to. I did think though that as in the UK boiled tap water would be fine but when I suggested it the paediatric nurse had a fit - was as though I had said I would mix it with wine! Not sure what the current guidelines are there, might have a look as quite interested to find if they now recommend boiling water

Oh, and for a while I always used UHT milks, as i was frightened of making the formula up wrong. But, it has since occurred to me that if boiling water kills certain nutrients, does the UHT process not also kill nutrients?

My son is on normal milk now, but when he had formula (from about 9 months until he was one) I would make up bottles in the morning to half full with boiling water, then leave them to cool. When it was time for a bottle, I'd top it up with fresh boiling water so it was warm, and add the formula.

I am very suspicious that the advice about not making up bottles when you're out coincided with the availability of VERY EXPENSIVE ready-made cartons.

But I tend to think that every bit of scary advice is a way of fleecing more money out of tired, emotional mothers

Well the advice hasn't come from the formula companies. If anything they seemed to drag their heels in changing packaging and preparation guidelines.

The advice has come from the World Health Organisation - formula powder should be mixed with water not cooler than 70degrees in order to kill any bacteria that may be in the powder since it is not sterile.

Where has the "boiling water kills nutrients" thing come from? I can't find it in any of the UK sources, which seem to want you to be sure to leave water to coool for less than 30 minutes.

If you did need to do it at exactly 70 degrees, frankly we'd all be stuffed. I am sure that would only work for someone with the time to stand over a cooling kettle (i.e. someone without a baby).

NCT

[[
www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4123620.pdf Dept of Health]]

Presumably if there was any serious degrading of nutrients the formula companies would say so - wouldn't be very good press if the country was overrun with extra-skinny formula-fed babies. Can you imagine the tutting then?!