How do people ACTUALLY prepare formula??

[Tinaland]

Hi

I have had to start feeding my 3 week old formula. Just wondering how people ACTUALLY prepare it??

I know the instructions say make each bottle as needed with freshly boiled cooled water; do not store the boiled water or made up formula etc, but what do people do in the real world?

Do you store boiled water - in the fridge or not? Do you store made up feeds??

What about going out and about?

Thanks xxx

I use ready made cartons, it is an expense that I we can't really afford but I didn't want to make a mistake at the expense of ds's digestive system.

I really don't think it is a big ask for the tins to have this information on them, why isn't it law?

I've done some research on what the different producer's say on their websites:

Hipp website instructions

"Boil freshly run tap water and leave to cool for less than 30 minutes." then a bullet point "?Prepare feeds freshly and not in advance. Powdered milk feeds are not sterile and reconstituted feeds are at risk of infection with E.sakazakii "

Aptamil website instructions

"Boil freshly run tap water and leave to cool for 30 mins, unless otherwise indicated on pack."

SMA website instuctions

"Boil fresh tap water in the kettle and allow it to cool to no less than 70 degrees C (this means leaving water to cool for betweeb 25 and 30 minutes after boiling)."

Cow and Gate website insructions

"Boil freshly-run water. Leave the kettle to cool for 30 minutes. Do not use artificially softened or repeatedly boiled water."

So it looks like SMA has the best description.

(And of course in my webchat Aptamil were spouting on about 70 deg being the "optimum" - but wouldn't explain why this was not on the packs!)

Baby Milk Action talked about this issue nearly three years ago. (NB I guess the info on that link about HIPP is now out of date).

The NCT issued a press release about it over 2 years ago - it looks like some change have been made to talk abut the 30 mins, but not in most cases the 70 degrees.

According to the FSA website in 2007 "The Agency is continuing to work with industry to develop an acceptable and appropriate form of words to appear on packs of formula explaining that powdered infant formula is not sterile.

Im in dubai and bought formula (just in case needed) and just read that it says to add at 40 degree's...Also said on the tin that it's imported from the uk

ok just peeled of the uk imported label and its all in arabic underneath ...aptamil by the way.

So do i follow the uk guidelines or the one on the tin?

Lola, what's your problem? You've been on other threads getting all narked about imagined slights.

Just because you can read and understand the label with its teeny writing and lack of essential info, doesn't mean everyone else can. I'd like all babies to be fed milk that's as safe as possible. Doesn't everyone?

Barbie, I'd follow the WHO guidelines. I doubt very much that non-UK formula factories have removed the bacteria somehow but not told anyone about it.

I'm shocked about how crap the info is, I really am.

btw, in the US you can buy "nursery water" - just ordinary non sterilised water in a big bottle. The implication is that you can use it to make up feeds as is

barbie1 - I think you should read the WHO guidelines and decide for yourself.

What I would do is have ready to feed for a newborn or failng that I would definitely make up with water which is at least 70 degrees C.

You could try ringing the Aptamil careline in the UK - but you will get the same nonsense which I did.

It really is shocking.

Thanks, to be honest im still ebf but i have it has a back up...i will follow the uk guidelines as and when i use formula.

Reading the back of the tin (under the peeled off label) it says made in holland

'Nursery water' is often sold in areas where there are still lead pipes. It's why a lot of people in France use mineral water instead of tap.

I hate the way people think that just because it's mineral it has magical bacteria killing powers though.

The 40C is for alledgedly probiotic formula so you don't kill the 'good' bacteria. But you don't kill the bad either. IMO if you're that concerned about probiotics then speak to your doctor about adding acidophilus or something to cool milk, don't risk not killing the deadly bacteria in formula milk. D&V from a gastro bug is obviously a risk but less that ES.

I have a tin of SMA, and the instructions are:

1. Wash hands well, sterilise all utensiles accoridng to manufacturers instructions.
2. Boil kettle filled with fresh tap water. Allow boiled water to cool for between 25 - 30 minutes before measuring out the required amount of water (see feeding guide) into the sterilised bottle, carefully - the water is hot. Do not use artificially softened water or repeatedly boiled water.
3. Using the scoop provided in this can, add the correct number of scoops of powder(see feeding guide), levelling off each scoop with the back of a clean dry knife. Replace lid on can.
4. Place the sterilised teat and cap on the bottle and shake well. Cool bottle under cold running water until lukewarm. Test temparature by shaking a few drops onto the inside of your wrist.

If you follow the instructions the powder will be added when the water is 70c, however, NOWHERE does it give the reason for doing so, or say it is dangerous not to! Surely this should be a legal necessity?!

Gosh that's interesting - it means that the info on the SMA website is different (as the website mentions the 70 deg C).

I agree the preparation instructions should state clearly water should be at 70 degrees or above. Not to do that is playing Russian roulette with young children's health surely? I don't think that everyone who does ff understands the difference in preparing formula now and previously and the packaging does not make it clear.

The SMA tin says "Failure to follow the instructions on preparation and storage may make your baby ill" but it crucially doesn't say which part particularly is critical.

With the exception of the probiotic formulas is there any reason why formula can't be made up with freshly boiled water that has not been left to cool? Am I being dim?

It can be made with freshly boiled water, it says leave to cool because of the risk of scalding. Frazzled mum, hungry baby, boiling water not such a good combination.

Actually I understand from what I have read that having water which has just boiled could interfere with the nutrients.

But yet again this highlights the need for proper information about this topic. People need to know not just what the guidelines are but why they are there and the different risk levels.

I stand corrected.

I phoned the SMA helpline and the woman said that its not a legal necessity to put why the water needs to be hot and they don't have enough space on the tin

I only leave water for between 5-10 mins before using. I too thought it was due to health and safety stuff that they didn't say to use just boiled.
I also think they need to state that you need a certain amount of water in the kettle to hit a cooling rate of 70C after 30 mins.
I too love cartons!

Yes - I guess it takes time and effort to put something into a Law. Shame the formula companies can't just do the sensible moral thing.

I think that they probably diagree with the WHO advice and with other countries also not following the guidance it may be that the UK is out on a limb here.

Australian Infant Feeding Council report they just state that the risk is very low and that they are worried about scalding and loss of nutrients and that people are more likely to make in advance.

Canadian information they make a distinction between premature and high risk infants and others.

It is really Hobson's choice isn't it? Too hot and lose nutrients - too cool and you don't kill the bacteria.

It could be a lot clearer on the packs though, looking at my SMA tin at least half is taken up with a picture of a joyously smiling woman who clearly hasn't had any sleepless nights and the logo. So it would not be impossible to make the instructions bigger and clearer.

Quite!

I am ff my ds, now 4 weeks, and have been doing what I did with my dd. I boil water for 5 mins, fill sterilised bottles and then leave in a cool cupboard. I make 6 at a time. Then for each feed I heat the water up and add the powder and feed. The water is warm when I add the powder but def not 70 degrees. This is how they tell you to do it in te hospitals here in Portugal. Now am worried and not sure what to do. If I part fill the bottles and then add boiling water at the time of the feed would that make it the right temp? Do I add the powder to the boiling water or is ok to mix the room temp water with the boiling water and then add ther powder? otherwise have to use 2 bottles right? am very confused as during the night I cant boil water and then wait 30 mins for it to cool down!! During day is ok as know roughly now that he is going to feed every 4 hours so can prepare in advance. any advice? also what would the ratio be of pre boiled water to boling water if he takes 120ml now?

All I can do is talk about the UK guidelines which I have done above and suggest that you read this World Health Organisation document.

You can ring the formula company and or your doctor and ask them why Portugal has not adopted the WHO guidelines.

For night-time feeding you could use ready to feed liquid cartons (these are sterile) - or you could use a flask of hot water - or you could look at the information in the guidelines for safer advance preparation.

I forwarded my webchat with Aptamil to Mike Brady of Baby Milk Action.

He says that it will be useful for their monitoring reports and he also said:

"We did succeed in getting something about this into the Guidance Notes that accompany the Infant Formula and Follow-on Formula Regulations and now powdered formula on sale in the UK does warn it is not sterile. However, the instructions are not in line with the recommendations of WHO, as you say.

We continue to campaign on this both for the UK and internationally."

I forwarded my webchat with Aptamil to Mike Brady of Baby Milk Action.

He says that it will be useful for their monitoring reports and he also said:

"We did succeed in getting something about this into the Guidance Notes that accompany the Infant Formula and Follow-on Formula Regulations and now powdered formula on sale in the UK does warn it is not sterile. However, the instructions are not in line with the recommendations of WHO, as you say.

We continue to campaign on this both for the UK and internationally."

I would, if prepping feeds in advance, take the view that once the feed is in a sterile bottle with 70C water it's safer to fridge and reheat that than add powder to warmish water.

Alternatively boil water, put a small amount into a bottle, run under tap quickly to get it to around 70, add the formula and use precooled boiled water to bring it to drinkable temperature. You only really need enough boiling water to make sure the powder is fully dissolved but that means you need to be very accurate with measuring as you top it up.

But the thing to bear in mind is powder to boiling water to sterilise the powder.

Not sure why Portugal isn't following the WHO guidlines.