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'm just starting to ff my 6mo DS in the day, and am so, so confused about making bottles when out :(

Bottle, carton and scissors to open it.

The advice I've been given by hospital is;

Boil kettle, put correct no of oz in bottle

Put correct no of scoops in seperate sterile container

When need feed, reheat water and mix. Then cool to safe feeding temperature.

Can't afford cartons

Sch, as long as water over 70 degrees hot is in contact with the POWDER to kill the salmonella and other life-threatening nasties, that's the main thing. Sterilised bottles and utensils and water are all very well but the powder itself does need to be heated, even if you do half the bottle with hot and half cold from the fridge.

I've bought a sugar thermometer to test. Making up feeds at home is no problem, its when out & about I worry. Up till now he's been ebf so I've never had to worry about it before!

I just dont think that people realise that its not the water with the bacteria in it, its the formula powder. A lot of people think that as long as the water has been boiled at some point then its ok, but its not. The other problem is that everyone says...'well I did it with mine and they are ok', so this is a go ahead for other people to do it when the reality is that gastrointestinal probems in babies is rife for this very reason..its just that nobody realises it. The people that do know about it, my sister has said this herself, is that its all very well and good cooling to 70 during the day, but like you say, at night who can be faffed, yo're just too tired. It genuinely makes me wonder, that if Mums had the right information about how dangerous formula can be when made incorrectly, whether breastfeeding rates would increase, because one of the most common reasons people give for formula feeding is so they can have a break at night and get their partner to give a bottle, OR, that they think it will make the baby sleep longer...the reality is that everyone feeding on demand had to make the bottles correctly at nightime, theyd get no bloody sleep at all. No better reason to breasfeed I would say. YANBU the hcp's need some retraining.

I found some kettles on Amazon that will heat to 70 or 80 degrees, most are pretty pricy but this was the cheapest I could find

Is a quick dunk in 70c water enough to completely destroy any bacteria in the powder though, really? I mean with food arent you meant to bring it to temperature and have it at that temperature for a certain amount of time to kill the nasties.

What if it didnt kill all the bacteria, there was some left in the pre prepared bottle and it multiplied in the fridge or in your change bag? It may not have been at dangerous levels before, but is now?

It just seems a bit strange to me that something resistant to the dessication process could be destroyed by a quick dip in some really quite cool water.

Also, are there any stats on how many babies are getting these very dangerous forms of food poisoning? It just seems incredulous to me that a product could be so contaminated and there hasnt been a public outcry?

'Nobody does it' the correct way according to a friend of mine

I don't agree that bacteria in the dry formula is the only significant risk - though it's the most worrying because illness relating to it can be severe.

Dirty bottles and teats are a problem too. Made up formula is an excellent medium for growing bacteria. If there are traces of it left in the teat or bottle which are not adequately removed before reusing the bottle you can end up with a very sick baby.

Hospitals are not required to collect or report this info, they don't even record how babies are fed when they are admitted with infections. They usually don't ask about formula or get a sample to test.

It's only when a specific piece of research is undertaken that the increased rates of infection (all infections but esp gastro bugs) are seen in formula fed babies.
www.unicef.org.uk/BabyFriendly/News-and-Research/Research/Gastro-intestinal-illness/

The trouble with E. Sakazakii is it adheres to silicon, latex and polycarbonate so it's a bit more difficult to shift - hence why bottles should be sterilised for newborns at least.

It is heat sensitive though as this study shows here that there is a reduction in bacteria no. when reconstituted from formula powder in

I do make each of my DS's feeds up fresh, except on the odd occasion where I am out somewhere where I can't make a fresh one over his mealtime and then he has a pre-made carton.

I don't think it's fair to say sane mothers don't make every feed up fresh OP

I do think the guidance on the cartons is pretty clear, but it doesn't help when healthcare professionals give contradicting advice. I would always have trusted what my HV told me.

Cherry blossom, the boiled water should not be cooler than 70 degrees when you mix it with the powder. The water has to be hot enough to kill the bacteria in the powder.

Also, it would have made no difference to me BFing or not. I didn't BF because I couldn't for various reasons.

And I did make every night feed up fresh. Fortunately, my son worked to his own 4hour schedule (one of the "benefits" of him being in SCBU) so we always knew when he would need feeding, which I guess made the process easier.

YANBU. My HV did recoimmend using water that had been previously cooled but I didn't trust the advice and kept doing it the way I'd been doing it.

I also stopped using cartons when one of them contained off milk due to a bearly noticable line cut in the packaging (We think cause by a knife used to open the pallates). we realise that it was probably a one-off but till wouldn't buy cartons again as we got a big fright.

I have a question, if people buy the big premade cartons what do you do with them once open and you've decanted one feed's worth? Do you put the rest into sterile bottles in the fridge? Or do you store the carton open in the fridge like a carton of juice?

They are supposed to be good for 2 days in the fridge when opened, *Pesto"

Supposed to be... but after what happened with our carton i'd say it depends on how well the cartons have been handled.

I used to work for SMA, they produced booklet after booklet, information sheets in 7 different languages, videos about breast and bottle feeding. Do you think the HV's and midwives would listen, oh know they carried on dishing out advice about how their own mothers made up bottles in 1977.
It's really frustrating because they simply cannot be entitled to an opinion on matters concerning their professional role but so so many did and of course the new mothers thought it was the gospel truth.

Interestingly no one has explained how the bugs get into the formula.

They are not there when the tin is opened as it is thoroughly pasturised, so to be honest more care should be taken when handling the powder rather than the hot water suggestion. An acquaintance of mine (food microbiologist) explained that using gloves and sterilising the scoop and keeping the powder sealed would be more beneficial than damaging the formula by overheating.

The result being that I used boiling water in hot newly sterilised bottles daily letting them cool before use each morning and then used a sterilised dispenser when out and about.
All the hygine precautions were a faf, but they were worth it to maximise nutrition and minimise risk.

As another said we all do risk assessments every day, some of us are better informed than others, but we all do the best we can.

Donnella, the powder is not sterile.

The bacteria is there before you even open it.

It is pasturised not sterile I did not state that it was sterile.... the most concerning bacteria are introduced by inappropriate handling.
If they were present in raw form (e.g campilobacter) the powder would not be fit for human consumption and not be sold.
It is not sterile, but it is not harmful either.