AIBU to be annoyed with HCPs about formula guidelines?

[MuslinSuit]

When making up formula, it is essential to use water of above 70 degrees, to ensure that the water kills any bacteria present in the powder .

HCPs including HVs are recommending using 'cooled boiled water' to make up feeds, and are giving the ok to mums going out with bottles of pre-boiled water, now cool, and little containers of formula to add to the water. Thus any bugs in the formula will not be killed!

So, so many mums I know or come across on tinternet do this, and it annoys me! It annoys me even more that HVs actually recommend this as a safe practice!

AIBU to think that HVs should be aware of how to make up formula hygienically and safely, and that formula companies need to make it clear too? I mean it says to cool the water for 30 minutes, but not why - 30 mins is optimum for the water to be hot enough to kill bugs but not scald the milk.

So many mums think that the point of using boiled water is to kill bugs in the water rather than in the formula! Maybe formula companies just don't care, but I do feel they should be promoting safest practice.

I batch make bottles 2-4 at a time, rapid cool them and store in the fridge btw. I warm them in a tub of hot water for no more than ten mins prior to a feed. That's the safest practical way to do it other than making each one up at the time, which no sane mother does.

I keep boiled water in a thermos and a little tub of powder and sterile bottles when going out - the thermos keeps the water up to the right temp for a good few hours. Saying that, I'm rubbish at leaving the kettle to cool for longer than 5 minutes before making up a feed.

Ready made is best, agreed, but the bacteria that can contaminate when out and about actually don't tend to be so so very serious as the ones already in the formula....

I'm so confused by all the conflicting guidelines so I always make a fresh bottle- insane maybe cheers op! DS2 is on prescription dairy free formula so sadly no cartons for us.
When we go out I make a bottle I don't cool it, I let it cool naturally and ensure it is consumed within 2 hours.

It does say I can rapidly c

I think the raw chicken analogy is bloody brilliant - that's exactly what we need to bring out for all subsequent threads.

Mine are old now, so I did the CBW with pre measured pots of powder thing - I knew no better and it did seem obvious that it was safer to add powder to milk immediately before feeding so there was no time for bugs to grow (both mine drank milk at room temperature). DD had appalling gastroenteritis when she went onto powdered formula aged 8 months - she was so miserable and I felt awful - maybe it would still have happened even if I'd used the modern methods, but maybe it wouldn't.

Nothing is ever germ/bacteria free. I laugh at how much money these bottle sterilising companies make from scared first time parents. The moment those bottles come out of the steriliser and hit the air, they are unsterilised again! Bottle lids/rims/teats can easily be infected with salmonella and other bugs by being put on kitchen or other surfaces too.

I know it's not ideal, and I know it doesn't kill bacteria in the formula. What I'm saying (badly) is that if people are going to use this method, do it in a way that causes the least risk.

By using straightaway you are minimising the risk. SO many people I know make up a feed with cooled, boiled water and then stick it in the change bag for later

now THAT is dangerous.

dontask
I have a link to a very good study that was done on this. Wait, I will look for it.

I blogged about this a good while ago and still get hits from people searching for the right way to make up formula.

I've read these threads before, and I always want to ask why the powder isn't sterile?
Is there a reason it isn't?

faverolles - nothing is sterile unless you live in bubble like bubble boy. Air contact unsterilises everything.

Yes sootie, but the air doesn't have salmonella in it ( and neither does any kitchen surface that I would put a baby's bottle on). Not all germs are the same, which is why we eat rare steak but not rare pork or chicken.

I would imagine that formula is not sterile because that would cut into the manufacturers' profits, especially when they can just turn round and say "well you should have made it up properly as advised" if there are any problems....

LittleWaveyLines
That is utterly false. It is simply not possible to produce completely sterile formula.

It is up to us parents to ensure that we make the bottles up safely.

Again, going back to the chicken analogy - could we expect a farmer to absolutely 100% rule out that a hen he raised had salmonella? No, we cannot, which is why we cook it properly.

For statistic fans

If you scroll down to around the page 48 mark, you will find the results of the tests. The reheating cooled bottles that have been made up properly results in a rise in risk only in very hot climates.

Refrigerated, or in a cool bag is fine.

Here is the relevant bit about reheating bottles:

Compared with the 2°C baseline refrigeration temperature, as the temperature of refrigeration
increased, the level of risk increased for PIF that was reconstituted at temperatures of between
30° and 50°C.

? Refrigeration temperature had no impact on formula reconstituted with water at 70°C. This
holds for scenarios of preparation and use at both the cool and warm ambient room temperatures.

? In all cases explored, the increase in relative risk was less than 1.5-fold.

Somewhat about the formula i used?

Sma staydown

preparation guide
Boil water
Allow to cool
Pour in to bottles
put in fridge until fully chilled
When needed add power to chilled water
roll to mix
can be left to case to room temperature
NOT recommended to heat in anyway as powder Will thicken!!

This formula sorted out my sons reflex a treat!!!

But reading all this about bacteria in powder makes my head spin that with this sma staydown it HAS to BE made up with really chilled water!!!!

Ah fair enough - I only said I imagine... I'm too tired to think straight to be honest (I have The Baby Who Does Not Sleep - and now has a cold....)

I used to work in a food manufacturing factory -( food for adults to eat as a small part of their diet, not the entire diet of a helpless infant) - regular samples were sent to a lab to be tested.
If any of the tests showed salmonella or listeria above a tiny level, all the product from that batch would have to be recalled.

I find it very difficult to comprehend why adults are able to have faith in the food they eat, knowing that it is safe, yet powdered milk for
babies has to be prepared very carefully because there is a chance there are very dangerous bacteria in it

I've started so I'll finish... It does say you can rapidly cool the bottle and refrigerate but if I'm at home its just easier to make a bottle up IMO

@ Faverolles - because adults can usually shrug off a dose of food poisoning but it can kill babies and young children

sofuck i was just going to mention about sma staydown! My son had this and it HAS to be made with cold water. What are you supposed to do then?

I have no reason to think my kitchen work surfaces have salmonella bacteria thereon.

Sootie and others - salmonella doesn't just hang about in your house. Nothing wrong with your baby picking their rattle off the carpet and putting it in their mouth. They might get germs in their mouths ftom doing that, but unless you wipe raw chicken on your carpet they won't get salmonella. However, they could get salmonella from formula. Approx 500-700 babies die in the US alone - not the third world, but a developed country - from stomach bugs caused by incorrect formula preparation.

Formula companies don't make the risks clear because they don't want to attract negative attention to their products. That doesn't mean the risk isn't there.

sofuck
I would say that you have to go with the chilled water then, as the risks from upchucking every bottle are higher than the risk of salmonella. It sucks, but that is how I would see it.

TheBigJessie
The salmonella is not on your worktops but in the formula. IN the powder.

If you use cooled water to make up a bottle then you risk the salmonella (that might be present) making your baby ill.

Of course you could carry on and everythign would be fine and you would be lucky enough to not feed your child a bottle that contained a dangerous bacteria. That is your decision to make.

How do you know when it's 70oC? Do you get a special thermometer?

Stepford - the point I was meaning was that in food manufacturing, the level of testing is extremely high. Apart from a raw product that needs to be cooked - (following unambiguous guidelines on the packaging), foods go through rigorous tests to make sure they are safe to eat.
If one pack out of a batch of thousands is found to have a trace amount of salmonella/listeria/whatever, the whole batch cannot be used, or it has to be withdrawn from supermarket shelves.

Why is the standard so high here, yet not for infant formula?
And coming back to the op's original point, of course all HCP's should know how to make up a bottle safely.