To send this email to Tommee Tippee and be appalled that the advice they are giving?

[TheDetective]

Copied and pasted from the email I have just sent...

"I visited your consumer site, as a parent, but I am also a Midwife.

I am contacting you because you are giving incorrect advice regarding the correct way to prepare infant formula.

Your website states:

'Health guidelines recommend you make up bottles one at a time. It may be easier to store the cooled, boiled water sealed in the bottles and then add the formula at feeding time.'

This goes directly against Department of Health Guidelines. A copy of which can be found here:

www.dh.gov.uk/health/2012/08/guide-to-bottle-feeding/

The correct advice is:

'To reduce the risk of infection, make up each feed as your
baby needs it, using boiled water at a temperature of 70 o
C or above. The step-by-step guide shows you how to do this.
Water at this temperature will kill any harmful bacteria that
may be present. Remember to let the feed cool before you
give it to your baby.'

This is followed up with the following information:

'Do not boil water in advance and store it in sterilised bottles
in the fridge for later use. The water needs to be hot when the
powdered infant formula is added, to kill any harmful bacteria
that may be present.'

Please can you explain why you are advising parents directly against the government guidelines for making up first stage formulas.
I would like to know where you found the information to display on your website.

There are some formulas which require preparing with cooled boiled water, but these are specialist milks, and the majority of parents and carers will not be using these milks.

The advice you are providing can and does make babies ill. I am very shocked that you would give such ill-informed advice.

I would appreciate a speedy response to my question."

Was I being unreasonable? I'm quite annoyed at them really! Am off to see what other bottle manufacturers websites say...! One woman mission here!

I suppose you have never made a mistake then TheDetective obviously not, how silly of me to think that.

I would be more concerned that other midwives are still giving out the old information as surely these are the people that really do hold the power to influence people.

Human error is human error, it will be rectified. I'm glad you have spotted it and made them aware but really no need for the hysterics.

What's your take on the Australian/NZ guidelines, TheDetective?

I can sort of understand their reasoning that insufficiently cooled formula presents a greater risk of harm to babies through burning than insufficiently heated milk does through bacteria... Or do you think that they have got it very wrong?

Am genuinely interested in how guidelines can vary from country to country...

That's just it isn't it, it is advice! Same with weaning, advice changes every 5 years. When me and my brother were babies (early and mid 90's) advice was make up bottles for the day, and put them in the fridge, warming up when you need them, and weaning was advised at 12 weeks! I was sensible about it and as mentioned any water not used within 24hrs (usually less as I was precious about nearly everything) was thrown away. DD was sick at first but that was due to the formula she was having as soon as I swapped it for a different one she was fine!

There are no hysterics, my email was perfectly factual.

If I have made an error, I should hold my hands up, of course. But something makes me think TT will not. I'd like to be pleasantly surprised.

I suspect the reason why some HCP's may be giving incorrect information is because we no longer get training in preparing feeds. We give the DOH leaflet to parents, and ask if they understand it.

As far as I am concerned, I have never been shown or told how to make formula correctly. I sought out the information myself, using the DOH website, as I would expect TT and other manufacturers of infant feeding equipment to check their advice against.

Dingle I personally make mine up for the day. I've read the information and made an informed choice. My baby isn't predicable with his feeds, and the screams while he waits are ear shattering.

I've just started using SMA Staydown as advised by my HV, and this formula requires you to actually do the opposite of the guidelines. You have to make up the bottles of cooled boiled water, and add the powder cold. I'm a little wary of this way, as it goes against everything ingrained in me, but it is to do with the reconstitution of the formula I am led to believe.

Still makes me though.

tether Do you have a link to their guidelines?

Some info here but not sure of impartiality of source!

Tommee tippee make bottles. They don't make milk. I would have been a bit more if it was cow and gate or some other milk company with the wrong information.

Your email is long winded, slightly hysterical and rude. A simple "Hello! I thought I'd let you know that the information you have about making up milk feeds is out of date. Can you please refer to xx for the new guidelines as I wouldn't want other parents to be given wrong information via your website. Thanks."

See? No need for the rudeness and asking for "speedy responses".

Dingle i used to do exactly as you did. ds took bottles at room temperature. never heated. filled up bottles with cooled boiled water on kitchen counter and added formula as needed. everyone i know does this. i did not heat his bottles. and will be doing the same on future children.

Guidelines are totally unreasonable with a baby anyway - never met anyone who followed them. And the whole sterilising thing is usually a farce by the time a tired parent has dropped the tongs for the hundredth time etc. In the end we felt we were going through the motions partly out of superstition and partly out of misplaced guilt that I wasn't bf.

Never warmed mine up either, DD wouldn't take them warm! I think its cause the ready made bottles we were provided with in hospital after breastfeeding failed were room temp not warmed up she got used to it and must have preferred it.

I am planning to attempt breastfeeding this time round as well but yes if it does not pan out I will be using same method again. :)

As for midwives giving out -of -date advice - that is down to the individual. I can only talk about where I work - we as standard give out the DH leaflet either breastfeeding or bottlefeeding at discharge/on PN as appropriate.

Sometimes leaflet guidance can change but staff are not made aware of changes (as I mentioned earlier, guidance didn't use to cover making up feeds if out of home - it now does) . Thankfully I was giving out correct guidance (from our infant feeding co-ordinator) but nice to see it is now in the official leaflet.

However - giving out leaflets is not a great way of passing on information as many of us never read leaflets - to busy being a new mum!!

YANBU. It's hard enough to get decent advice about how to make up formula without major corporations giving incorrect advice like this. Your email seemed reasonable to me. It was an email to a company, not a personal message to an individual. You were quite right to express your concern - this is potentially dangerous advice.

I think my midwife must have taken pity on us since she showed us how to do it as well as giving us some leaflets. Maybe I looked dumb

And I don't think the guidelines are that unreasonable. We've followed them the whole way through because the two times we did make bottles in advance (after being nagged by my mum to try it), dd threw them back up which was more hassle than making the bottle fresh haha!

tether I actually came across the Infant Nutrition Council earlier today. They are the Australia/New Zealand formula manufacturers. I would take that with a huuuuuuge pinch of salt.

Of course they want to make the preparation of formula as easy as possible. I suppose they think more people will be put off if it as seen as a faff to prepare a feed.

Dingle, I did bottles the same. I had no advice from midwife / health visitor so bumbled along with the instructions from the back of the sma tin. He always had room temp feeds so as not to cause problems if I couldn't heat it.
Each of my friends seem to do it differently.

I used to make up eight bottles every morning, boiling water and formula, and store them in the fridge until they were needed, which is when they would be heated in the microwave.

I microwaved the night feed before I went to bed and left it by my bed until it was needed.

I don't know what my point is really. Probably something about people being able to read the guidelines and use their common sense accordingly.

The instructions on the tins of Hipp and Cow and Gate formula are both wrong too.

IIRC tthey say to boil kettle then leave to cool for half an hour.

Baby Milk Action are on it but the formula companies simply don't care what people do once they've handed the money over.

I get so [grrr] when I see dismissive posts in repsonse to ff questions - along the lines of How hard can it be - the instructions are on the side of the tin.

YAsoNBU to contact them, it makes me so angry. These fucking companies really do not care.

Please also contact Baby Milk Action about this.

Since TT don't make the milk, only the bottles, it'd be better if they didn't bother with FF preparation advice at all really. Less risk of inadvertently falling behind with changes o best practice.

Without being inflammatory, may I ask if the danger is a theoretical one or are there actual documented cases of illness from incorrect bottle preparation?

And in the case of illness, is it proven that it was caused by incorrect preparation, rather than poor hygiene, or sterilisation of feeding equipment?

Genuinely curious.

How many times have these guidelines changed? When DD (16) was a baby you could make them up in advance. Then it changed to cooled water (I was always baffled by that, would the formula dissolve in cool water)and the heat them? And now it's something different.

You can't blame some people just getting on with it however they want. Guidelines always seem to chop and change and sometimes revert back to how things were. Not just on about formula here.

Their advice became outdated almost a decade ago. YANBU. In fact, well done for pointing it out to them.

Barley formula is not sterile. Incorrectly prepared formula can cause a variety of problems for babies, and there have been recorded deaths from e sakazakii bacteria.

As for the changing of guidelines, that's mainly because it was only in the mid 90s that formula companies actually had to start declaring what was going into artificial milks.

Yes, thankyou Sirboobalot, I understand that. What I would like to know is how common are these serious infections - why do we never hear about them?