About prep time for powdered formula?

[MissMalteser]

Ds is 6 weeks and I am just starting to introduce the odd bottle of formula so we can combination feed, at the minute I am using the pre made bottles but i have been looking into powder and because of the gap between dc's I'm not sure if ive just forgot it was always this complicated?
So each bottle has to be made fresh as required, this includes boiling kettle, making bottle and letting cool, but each bottle also has to be sterilised, once I open my steriliser to get a bottle out the rest are contaminated and need resterilised, so by the time ds starts grunting for a feed and I actually go through the faff of sterilising bottle, boiling water, making bottle and letting it cool enough to drink it could surely take at least 45 minutes each time? Am i missing something? and aibu to think surely there is a more time effective way to do it?

[BillBrysonsBeard]

I made it hard for myself at first and used to make the bottles up as and when he cried for one.. It said on the tin not to store any. It was doubley hard as we were in the Middle East where you can't drink tap water so had to boil water on the stove!

Then I realised I'd read it wrong when it says 'discard made-up formula after 2 hours' It meant if it isn't stored. Stored can be kept 24hrs in the fridge. My life changed after that! Warming a bottle up is so much easier than cooling a boiling one down! Baby was happy...

So my process was:
Sterilise
Powder in
Boiling water
Gently stir so no bubbles
Shove in fridge
Use bottle warmer for a few mins when he wants one

[TheCatsMeow]

you only decide to follow one thing, its that the powder must be made sterile with the hot water. That is what grows the nasties.

This, so many people think you can make them with cooled boiled water, and that by making them fresh it's better.

It's better to make them in advance with boiling water!

[Ivegotyourgoat]

My logic is if you're running around making fresh bottles and cooling them quickly for a hungry, crying baby. You're more likely to make it wrong or not cool it enough and burn the baby's mouth.

Much safer to make in advance.

[KatharinaRosalie]

A bit offtopic but did you know that every other European country (at least from the random selection I checked) recommends making bottles with lukewarm water (no more than 40 degrees). Can't seem to find the info but I wonder if issues from formula bacteria are therefore a lot higher also in for example Sweden or Holland? Probably the same formula powder, after all.

[BertieBotts]

If you have a dishwasher you don't need to sterilise.

If you need to make bottles up in advance you can do. It's better to make up the bottle, flash cool and store in fridge for up to 24h. It is BEST to make up fresh every time - but only if you're using hot water.

People misinterpret the advice to make up fresh and think that making bottles with cooled boiled water is fine but it isn't. You'd be better off making the day's bottles as a batch and storing them.

Comparisons to breasts are unhelpful because it isn't the same situation. Formula milk is a friendly environment for bacteria to grow so you just need to make sure that you're:

• Reducing contamination by ensuring bottles and teats are clean, that you keep the tub closed between uses and only use the scoop provided and a clean knife to level. Also discarding partially drunk bottles after 1 hour due to contamination from baby's saliva.
  

• Ensuring formula is made with hot water to kill anything which might be present in the powder to begin with. (Or using ready mixed formula).
  

• Minimising time that bacteria has to multiply by discarding made up formula after 24 hours even if stored cooled.
  

• Seriously minimising any time in the "danger zone" of between 5C and 60C. So don't leave bottles to cool down by themselves, flash cool them, only keep at room temperature for 2 hours. Don't reheat them more than once, and use a cool pack or a thermos to keep it under 5C or over 60C if you are taking it out and about.
  

You can't reduce all elements of risk, but that's okay because babies' immune systems and digestive systems can deal with very small concentrations of bacteria. It's if the bacteria are allowed to grow that it is a problem. So a one off slip up is unlikely to cause a problem, but it's good practice to be aware of the four safety points.

[BertieBotts]

And just to put things in perspective - if your baby DID become ill from incorrect formula preparation they are likely to be just fine. We have excellent, free, accessible health care. Obviously you still want to avoid the risk in the first place, but it's not a death sentence like it might be in other countries.

[Iamnotloobrushphobic]

Anybody who is too lazy to make up bottles in a safe way should either breastfeed or use cartons of ready made formula to reduce risks.

[worriedmum100]

DS i.s 7 months.

I make up one bottle at night before bed for the 6am morning bottle. Boil kettle, leave for no more than 30 mins, pour required amount in spare bottle, powder into other bottle (this stops the powder sticking to the scoop with the steam) make up bottle, flash cool and into fridge.

Then in the morning I do the same for the two "day" bottles. When DS was younger I'd take up night feeds in a cool bag. I'm lucky that both mine were happy to have it straight from the fridge.

[crayfish]

We've got a perfect prep, although I think the jury is out now on whether they are ok.

In other situations I always have a supply of cool boiled water in sterilised containers and do the following.

1. I boil the kettle
   
2. add two ounces of the hot, just boiled water
   
3. add powder
   
4. mix
   
5. then top up with the cool boiled water
   
   It takes less than a minute and is in no way complicated. I make every bottle fresh as its needed. This is the way the health visitor and feeding advisor told me to do it and it's really no bother. There is no heating or cooling of the bottles, the only thing to do is chill your batch of cool boiled water but that's hardly a problem.

[crayfish]

I am genuinely baffled by the amount of people doing it 'wrong'...

('Wrong' as in against the guidelines. You can do what you like with your baby)

[toomuchtooold]

Oysterbabe, when my ones were little (2012, in England) we used Hipp combiotic and at first it said to let the water cool to 50 deg C before preparing - I guess because it's got some stuff in it that would be damaged by high heat. I've been told on here that they've since changed the instructions to 70 deg C to be in line with the British guidelines - but in Germany the instructions still say to allow to cool to 50. No infant D&V outbreaks been reported AFAIK

[Middleclassmumnetter]

crayfish that's the method I was trying to convey upthread, although much less succinctly than you did!

[Artandco]

It's not exactly difficult is it. Boil kettle 2 mins, add 6oz boiling water to clean bottle, wait 2mins for that to cool a fraction so it's above 70 but not boiling. Add 6 scoops formula. Mix. Add teat and lid. Run whole thing under cool running water for one min to cool down to drinking temp.

Also most people know baby needs feeding every 2-3 hrs or whatever. Just start making a bit before that

[MrsTerryPratchett]

And just to put things in perspective - if your baby DID become ill from incorrect formula preparation they are likely to be just fine. We have excellent, free, accessible health care. Obviously you still want to avoid the risk in the first place, but it's not a death sentence like it might be in other countries. Again, wrong. The bacteria is very dangerous and can cause brain damage even if your child lives. It's rare, but it happens.

[Brummiegirl15]

Another vote for a perfect prep machine.

When my DD came home she had an outreach worker (as she was tube fed as 6 wks prem) and we asked this very question about every single bottle being made fresh couldn't they just go in the fridge etc?

She was very honest and said things were different now and there were no preservatives in the formula and warm milk was a haven for bacteria starting to grow so the government changed the guidelines about leaving bottles in the fridge. She said "by all means do it, but if your baby gets ill it could be the reason why"

I couldn't face the screaming from DD whilst waiting 30 bloody minutes for the kettle to cool down so we started using a flask of water which did cut the time down.

Then I bought a perfect prep machine. And not looked back.

[Brummiegirl15]

Oh and yes the minute you open the steriliser the bottles are no longer sterile although they are of course clean and safe to use. Best thing to do the hospital told me, is keep clean sterilised bottles in the fridge. Again cold temps reduce bacteria growth

[Artandco]

Brummie - the prep machine isn't great. As others have said it has been tested and doesn't get a large enough hot shot and the hot shot isn't over 70 degrees so won't kill bacteria. Midwifes don't recommend it

[Just5minswithDacreandhugeDildo]

Joining the "simpler in my day" bench and I'm not even 40 yet!

What is really confusing is I don't remember any spate of news stories about babies made ill by formula made up (correctly) in 24 hour batches and stored in fridges.

What caused the change? Foreign cases? A theoretical risk? Unreported UK cases?

[BertieBotts]

MrsTerryPratchett, what I said doesn't contradict what you said. Of course we know D+V is very serious for babies, it's one of the lead killers of babies worldwide. But with good access to healthcare complications are rare. That was the point I was trying to make. It doesn't mean that the guidelines don't matter, of course. But it does explain why people don't really think about them, because nobody has ever heard of a baby actually dying from improperly made formula, it's so rare.

I think lots of babies get D&V in their first year but because D&V infections are common in the general public nobody really wonders too much about it, so there aren't any easily accessible figures to compare between countries where the guidelines are stricter than others. The only figure I could find is that the USA has 300 child deaths under 5 years annually from gastroenteritis whereas the UK figure for the same age group for 2010 is 1. (The US population is about 200 times that of the UK.) US advice is to make with room temperature water.

[MrsTerryPratchett]

But Cronobacter, although rare, will kill and cause serious complications even with Western medical care. It has a high fatality rate. We don't hear about it because it's rare, not because the children who get it are OK because of medical care. IYSWIM.

[BertieBotts]

True, but that is not the only contaminant in formula. I do think it's important to make formula up correctly!

[BertieBotts]

Although interestingly it seems there is an outbreak in the US at the moment and so news outlets are advising people to use hot water and follow proper guidelines for storage.

[TheCatsMeow]

Again, wrong. The bacteria is very dangerous and can cause brain damage even if your child lives. It's rare, but it happens.

I remember reading the babies that caught meningitis from formula were all prem and/or low weight already.

[MrsTerryPratchett]

Yes Bertie. Horse, bolted, stable. The time to prep properly is not after an outbreak!

[TheCatsMeow]

I'm not saying it can't happen - just that the babies it happened to recently were already vulnerable