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.

Donnella -read the WHO and EFSA links I posted above. The most worrying bacteria are found in formula powder and come via contamination during the production process.

Donnella - the formula milk may be pasturised prior to dessication but E.Sakazakii can be found on manufacturing equipment and packaging materials so can contaminate the powder post pasturisation (as well as baby bottle materials it adheres to stainless steel) and E. Sakazakii is resistant to dessication plus a lot of adults carry this bacteria and can contaminate the formula either in the factory or in the home kitchen.

It is a very well adapted bacteria for the niche of growing in formula (which is desperately unfortunate) but it has had 50 years or more of adaptation.....

I;m actually a bit disconcerted that the origins of the bacteria aren't widely known but I'm not shocked. there is absolutely no education there for Mums who decide to FF. when I moved from BF to FF, all the HV wanted to know (With all 4 kids and 4 different HVs) was how many ounces I was given. There is no literature given at all.

*how many ounces I was giving.

and Donnella it says right on the back of cans of formuls "Whle every effort is made to ensure that the prouct is produced in a sterile environment, the contents of this can are not sterile*

Yes, the powder can be contaminated at source.

I seem to remember some French parents persuing a claim against a company when they discovered that the factory was the source of their baby's meningitis.

The judge ruled that the company were not responsible and parents were all made well aware that the powder could contain life threatening bugs even before opening .
France recommends liquid formula for newborn and vulnerable babies.

Would just like to say the risk is small but is reduced by making powder up correctly. I can't understand the reluctance - no one plays fast and loose with raw chicken

The more I think on this, the more pissed off that I am that there isn't any literature for Mums who choose to FF. As this thread shows, the education in that area is seiously lacking. This could be solved by the simple introduction of a leaflet during pregnancy. As I understand though, this would be against laws agasint promoting FF. If taht is true, many babies may be being made sick needlessly. I find this ery disconcerting.

I am forunate enought to know the ins and outs of preparing a sterile feed. After reading this thread I'm starting to wonder if the number of FF Mums who can say the ame is less than I would have hoped.

*by "isn't any literature" I mean in pamphelt in ante-natal care.

Agreed.

There needs to be a formula discussion with mums to be and not a brick wall 'I can't
Discuss ff with you' by hcp

I've said it before and will say it again. There is currently SO MUCH pressure
On women to choose BF that it has led to a void of FF information and instruction. The pressure to bf is so great and 'one size fits all' that often women feel pressured to do it to the detriment of their mental health and have no one to talk to about the alternative for fear of coming up against the brick wall or of being judged.

Apologies for typos. My Hunny was good enough to defile my keyboard with a can of bud tonight! Needless to say he'll be busy cleaning it tomorrow!

I think a lot of people have read the instructions but then choose to ignore them because 'my mum/aunt/friend didn't make them up like that and their babies were all fine'. I'm not sure any amount of leaflets can change the power of those influences.

HCP should discuss formula preparation with ffing mothers/mixed feeding mothers - in their own home and using the parents own equipment/chosen brand - what they shouldn't do is promote ffing to parents who want to ebf.

Showing parents who want to ffing once they have had their baby is what HV/MW should do - hence the rec for parents to bring their own ready made formula into hospital (straight after birth is not the time for a demonstration esp. as it wouldn't be using their own steriliser/bottles/powdered formula).

If they say they 'can't talk about ffing' or 'we aren't allowed to talk about ffing' they are lying, misinformed (aka couldn't be bothered to read their updates) or just plain negligent. Even hospitals/trusts going for Baby Friendly Status have recommendations on demonstrating formula best practice with parents - there is no gag order! They can't say 'Brand X is the best' or 'I used Brand Y' or 'I think you'd be better off swapping to formula' though.

I have discussed ffing with mums at baby clinic (I am a bfing peer supporter and only if ASKED and always at mum's request) though I don't have access to their homes - no home visits allowed - but our local HV don't believe in telling mums about

humble Iver much doubt that people who are set in thier ways would pay attention to literature but I'm talking about Mums with absolutely no experience the subject. If you choose to FF from birth or move on to FF, you have the back of the can to guide you and nothing more. A little education about the bacteria and the danger it poses could make a huge difference.

People are constantly being re-educated / educated for the first time in other areas of infant health. Why not this?

*I very much doubt

All the info is already on the back of the can though and people still choose to ignore it. It does say that the powder isn't sterile and that it needs to be made up with hot water but people still don't do it. Look at the attitudes on MN - everyone who is making it up incorrectly will insist that it hasn't done their child any harm. They pass that message on to their friends/neighbours etc and that personal advice is always going to trump official guidelines. It's crap and it needs to change but I just think it's going to be hard. BF has been struggling for years against similar problems where bad advice from people and myths etc continue to undermine the official guidelines that are given.

As bumbley says the instructions are on the tins - along with the statement that the powder must be made up correctly to avoid illness - people just choose to ignore it.

Leaflets given in pregnancy won't help.

Reporting HCP who knowingly give wrong advice might do, which is what I suggest Truthsweet does. The same as if they were advising parents not to bother with carseats or fireguards

I was sorting through some of my pregnancy/post natal notes yesterday and having a clearout, and I found the leaflet I was given by the hospital on making up formula feeds. It says very clearly that the water must be hotter than 70degrees. So unless my hospital is unusual, I think new parents are being told the correct method, but choosing to ignore it because their 'sister/friend/mother did it that way'

Autumnsummers the instructions for making up formula are in the NHS birth-to-five book which should be available to free to all parents in England (according to the Department of Health website).

See here pages 18-22.

The info is also contained in the NHS pregnancy book, which should be given free to all expectant mothers and parents in England:

See here pg 115-119.

Whether or not people are actually given it, read it or take any notice of it, is of course another matter.

Finally - I have mentioned it to the Infant Feeding Lead for our area but I don't know if anything will happen. I wish it would!