Can I have the lowdown on formula please?

[ButterpieBride]

I have a 9.5mo DD who will take a bottle of ebm or ready made formula. We got a pack of the powder today and it took ages to make up- with DD1 I'm sure we just made up six bottles with cold kettle water and used them over the day.

I don't need to sterilise the bloody bottles do I? I'm sure I read some kind of cheaty way of making up the powder that was still safe on here somewhere, but can't find it- any ideas?

Also, would giving her cows milk be really bad? my mum seems to think it would be ok, watered down and with a bit of bovril added but somehow I don't think that is the case.

How do you know when to feed them? The box says she should have three feeds a day by now- it is more than ten usually at the boob, but no idea how much she is taking.

Also...sigh. Didn't think I'd be making this post. I don't know ANY ff babies.

Lunar you are in good company and I am more than a match for the flames. I WILL protect you

It is right that parents should be told how to make milk the right way and the reasons why. You'll be surprised that most are in fact informed. I mean, we found out instantly when we had to bottle feed. You'll get the ones (such as myself) who will then religously follow the guidelines knowing the risk, but you'll always get LOADS (most friends and mums I know) who will not follow it, no matter what even though they know full well the risks.

I know this is a serious issue but have been really light-hearted about it is because it's only now DS is a toddler, that I realise the risk of taking him to town with my awful big bump and waddling down the street chasing after him when he yanks away from my hand away and tries to run onto a busy road, is much greater than if I'd given him formula milk made with toilet water.

Anyway, yes, completely agree with informing parents about the current guidelines, as most new parents would really appreciate that. But most will probably not follow it, and ALL the babies I know whose parent didn't follow are still alive and well, unfortunately (thinking specifically about that naughty one who kicked my son the other day in the balls). :(

I dont get the not sterilizing. I do it until I stop using bottles.

Its just not worth the risk of a stomach bug. The misery of caring for a baby with the D&V makes sticking bottles into a machine and flicking a button seem pretty easy.

I dont think there is enough good advice re FF. Lots of people find it difficult to access info unless its virtually stuck in their faces.

I am very confused about the new guidelines for mixing feeds. How do you know the temp of the water? Surely using the new method you would spend all day mixing feeds for a newborn. Boiling water, letting it cool for 30mins, making up the feed. Sounds like a nightmare.

I ff fed DC3. He came to live with us at 8 weeks and needed feeding every hour and could only take an ounce at a time. Thank God I didnt know about the dangers of making up feeds in advance then. Mind you what I did was a vast improvement on the bottle wrapped up in foil for hours that ss allowed him to be fed from.

By the time my DC4 was on ff he was only having a few a day so I could manage the ready made stuff. I plan to do the same with DC5.

BTW despite the jokey tone of my post I do think its a serious issue.

thefirstmrsDeVere - totally agree with you re the sterilizing bottles.

"I am very confused about the new guidelines for mixing feeds. How do you know the temp of the water? Surely using the new method you would spend all day mixing feeds for a newborn. Boiling water, letting it cool for 30mins, making up the feed. Sounds like a nightmare."

You raise some good points there which I will try to answer:

The FSA issued guidance to say that 1 litre of water boiled in the kettle and left for 30 mins will be just over 70 degrees. (I have tested with a thermometer and agree).

With regards to "spending all day" - 2 hours in which to use the formula is deemed reasonable so a feed doesn't have to be prepated exactly 30mins in advance - i.e. some plan ahead can be done.

More importantly is to realise that the guidelines recommend alternatives:

1 is to use a thermos flask of water at 70 degrees.

The other is to prepare in advance- - this is the most understood bit.

If feeds can't be made fresh it is safer to make in advance provided water at 70 degrees is used, then rapid cooling then stored in a fridge.

That is the bit that I find really sad - is that the message has come through as "don't make in advance" whereas the real message is "don't make with cold water". .

See these slides from WHO/FSA meeting - esp page 15.

You will see a range of scenarios of making up formula (contaning the nasty bacteria) with different temps and holding times.

The baseline scenario was making up with water which is 30 degrees and feeding immediately. In all cases using water at 70 degrees led to a reduction in risk of more than 100,000 times - this was regardless of the time between preparation and feeding.

TruthSweet - thanks for those links.

"ALL the babies I know whose parent didn't follow are still alive and well" - so that proves nothing.

These babies were not so lucky.

And here is a MNers story re salmonella infection in her 5m old.

Yes, the risk is low - but it needs to be understood - so that if parents want to mitigate against it they can.

Those of you who are not finding what I post useful or interesting but annoying - ^and yet are still posting on this thread" :

I have fun categorising you as one of the following:

avoiders who actively avoid issues in order not to have to change habits

pragmatists who only change habits if they believe opinion is widespread

headline reactives who tend to display concern which is often short-lived, resulting in a fairly superficial impact

purists who are more cautious and knowledgeable than the other types so are more able to decide on what action to take as a result

As per FSA research.

Seriously though LunarRose and FunnysInTheGarden - genuine question - why did you decide not to make bottles in advance if you thought that making fresh was impractical?

Remember - if you weren't actually on this thread I wouldn't be asking you.

Also (to everyone) - don't feel guilty if you didn't know the guidelines or didn't understand them or decided not to follow them.

Australia have obviously decided not to adopt the WHO guidelines.

The USA has not adopted them plus other European countries do not seem to have.

I think in Canada they recommend using ready to feed or water at 70 degrees for infants under 3 months or so.

I am amazed that people can be 'laissez-faire' about formula. I am not a bf purist and yes, had a go, didn't work out but come from a very ff background as does dh so not too guilty.
Formula is AMAZING stuff but like other amazing stuff (the ocean, the car) needs to be treated with respect to get the best out of it.
Why you would ignore this for the sake of 20 minutes of guarding a kettle I have no idea. Why you would use this to make a point about styles of parenting I have no idea.

Thank you for that tabouleh it is very helpful.

I used to work with parents who were vunerable to having their children removed by SS. Much of their vunerablity arose from lack of accessible information regarding parenting.

When I was working in the field (about 6 years ago) there was virtually NO information suitable for parents with limited literacy i.e. with learning difficulties or British Sign Language using Deaf parents.

I had to leave my job due to DD's dx and at the time I was working (with others) on improving the situation for these groups. I believe this has moved forward but its all very much dependent on funding and interest.

For e.g. when the welfare foods initiative was introduced a few years back, despite repeated requests, nothing was produced in BSL!

We cannot assume that its easy for everyone to understand guidelines. Try reading the instructions on the side of a milk tin if you are visually impaired (or over 40!)

thefirstmrsDeVere - access to info for parents with limited literacy/different languages/deafness etc etc is not something I had given much thought to.

There should be some youtube videos about this.

Unicef Babyfriendly UK have some leaflets on their website in different languages but I could see that they were not uptodate! The English language one was though . I emailed to tell them and they are now going to update them.

To be fair, technology has moved on hugely since I was working. It was really hard to put videos online then. Now anyone can do it!I may have a look about later and see what it available for those groups of parents.

My DS had salmonella poisoning when he was 5 months old. Almost certainly from the formula not being made up properly.

He was lucky. He had a week or so of incredible diahorrea, sore tummy for a couple of days but was soon put right with a dose of antibiotics. Some babies are not so lucky.

Salmonella can kill.

If you want to risk your babies life, for the sake of a few moment's, for the sake of convienience, go ahead.

Sterilising at 9.5 months is no longer necessary, IMO as they aree putting dirt and all sorts into their mouths at that age.

But for the love of god, please follow the WHO guidelines for making up the bottles.

Thanks MmeLindt.

I only skimmed this thread earlier, I was on my way out. Thanks to Tabluleh for all her posts and for the link to my blog post.

This is a subject close to my own heart, for obvious reasons and it makes me quite cross to see posts suggesting that I should relax, chill out or whatever it was.

You would not leave you baby in the same room as a pit bull, even though the likelihood of the dog attacking the baby are slim. Why not take the extra couple of minutes to ensure that you are not giving a bottle that is contaminated with salmonella?

The charge that we are all failed BFers is ridiculous. Aside from the fact that every FFer (or the overwhelming majority) are failed BFers, as most women attempt to BF for a while.

I did not bf for long but I was not consumed by angst about it, I would have been glad if it had worked out but it didn't so I moved on to FF.

My reason for posting not this thread, and others like it is simple. I would like to spare another child the illness that my son went through. An illness that is absolutely avoidable by the adherence to the WHO guidelines.

Do you know how guilty I felt, the knowledge that I had caused my son to be ill. Why would anyone put themselves through that?

I do, and always will, makes formula exactly as it says on the tin. One at a time, with water over 70. To not do so and have my baby get ill would be too much for me to bear, what with my extreme guilt about BF not working out as well. Seriously, why would you want to risk looking after a baby with D and V??!! No thanks!

The only time I prepared in advance was when I had access to a fridge.

I used a variety of FF methods when out and about, usually sterilised bottles with boiling water which had cooled by the time I came to use them and a tub of pre measured milk powder (actually usually 2 of these the amount each of my 2 could get though), If I was lazy or on holiday premade and sterilised bottles or steribottles.

Regarding the WHO we must remember this advice is given on a whole world basis where water supplies may well be of seriously poor quality and limited access to sterilisation equipment. Something that is often forgotten when BF and prolonged BF is advocated based on this WHO information.

On the cows milk question from memory there is a weight rule of thumb that was used when my daughter was little on whetheer it should, as with all of these things weight and health should take precident

LunarRose: the quality of the water/access to sterilisation equipment is not the issue. It is the formula powder which is not sterile and may contain pathogens.

Lunarrose - the WHO is very clear that bf advice is for all babies in the world not just those in developing countries . Hate misconceptions too.

LunarRose - they're called the World Health Organisation and not the Third World Health Organisation for a reason. Likewise, their advice on breastfeeding is no less relevant here in the UK; totally irrelevant to the sterility of formula though.

Really sad to hear about mmeLindt's story, which kinda makes me relieved that I did follow the guidelines.

I was extremely curious reading it as it's said on this post that "it's almost certainly" from the milk powder, yet I cannot see in the blog that a lab has tested it and confirmed it's the milk powder. Can you please confirm that it was?

At one point, my son had S+D every now and again, we thought it co-incided with the HiPP milk we were giving him then. We of course immediately blamed Hipp organic. We got it sent to the labs where they tested it. Test results came back confirming that it wasn't the milk powder at all.

It's just that at 5 months, I remember DS was extremely dirty, putting everything in his mouth whenever we went for baby groups, outings, meeting friends/relatives. Not to mention all the older toddlers and children who kept offering him dirty toys and food to put in his mouth(to which I had to scream to them NO.... please don't feed him that!)

I'm just trying to ascertain the validity of this sad/serious case before I start spreading it to all my mum-friends that this is the case. Thanks.

Having just read you're link, If anyone has serious concerns it may be worth referring to the original research and checking out the original sample basis. It's been a long time since I've looked into this, so my memory may have got it wrong...

Also it may be worth finding out the figures for the hospitalisation of babies in the UK as a result of malnutrition and the connection with BF failing :(

I say again we shouldn't feel guilty however we decide to feed our children, life is full of risks we balance and in the end it's simply too short.Feed your child and enjoy your life.

must apologise for not having read the entire thread so hope it's not already been covered but, once water has cooled for thirty minutes and it's time to add the powder... the steam from the hot water makes the powder stick to the bloody scoop, so then you have to tap it, get it in the (i forget the name) screwy bits to screw the lid on and then not only do you have a scoop which you need to clean, you also have a bottle that leaks. grrrrr! now there's a problem someone needs to get thinking about!

i'd always assumed it wasn't great to mix up all the milk for your steriliser's worth of six bottles in advance. i kept milk and water seperate for both dc.

LunarRose as others have said it is the formula powder which is not sterile and may contain bacteria - this is a worldwide problem.

anonMum2 - just in case MmeLindt doesn't come back - where would you think that a 5m old baby, whose only source of food/drink was powdered infant formula, caught salmonella from - especially when the rest of the family did not catch it?

tapan - I always sterilised the scoops from the powder tins - I used to save them so I had a few at a time to wash/sterilse/dry. I then used to sterilse little plastic pots and add the powder to those and then tip into the bottle. It is important to make sure that a scoop with moisture on it does not go back into the tub.

"i'd always assumed it wasn't great to mix up all the milk for your steriliser's worth of six bottles in advance. i kept milk and water seperate for both dc." - this is the point I am trying to get across.

The safest method is make fresh each time - but nearly as safe is to follow the proper guidelines for making in advance.

See here.

E. Sakazaki blog has more info for those interested.