Same formula, different country, different rules!

[PaulineCampbellJones]

I have needed to buy 9 month old DD some Aptamil while we are away in Spain as she has turned into a milk monster. The rules on the package are completely different to the ones on UK packets. Use mineral water so you don't have to boil the water!
Both are a complete no no and have seen many thread debates on this. Are we just living in a nanny state or is there a reason?
I will continue to boil water though as don't want to subject DD to too much change.

Oh and if you are using boiled water is says cool to 40 degrees before mixing, not 70!

You'll find every country has it's own rules about making up formula and steralising.

Our doh guidelines are not too dissimilar to WHO. The only difference I could find was that WHO say you can make up a jug and keep in the fridge and doh say no.

Also not every country is required by law to amend packaging to show the latest advice.

But to answer your question: I think we can be a bit precious about steralising and making up formula in this country.

Our guidelines on everything tend to be overcautious, but I think with this I'd rather be!

I think it's just that the laws in the UK are tighter, manufacturers tend to put the minimum of information on there so as not to put people off.

Here in The Netherlands we use water straight from the tap and don't boil.

You're right about different rules for different countries though - my HV nearly had a heart attack on the spot when she saw the Moses basket!

They use bottled water here in Belgium to. Evian make a fortune out of it.

PaulineCampbellJones - here is a link to the WHO guidelines and the UK guidance.

Unfortunately in most countries the formula companies are too powerful and have resisted pressure to amend the packaging to adhere to the WHO guidelines.

Although in the UK they do include the guidelines it is a bare minimum, they do not explain why the guidelines are there (becuase formula powder is not sterile) and it also does not explain alternative methods of preparation if making fresh is not possible.

Also in this country, in many cases, HCPs do not know or follow the guidelines.

You may be interested in my Tue 13-Jul-10 17:00:51 post on this thread where I transcribe a conversation re Aptamil packaging instructions in Roumania v the UK.

There were not helpful.

Lol Skihorse - what on earth is wrong with a moses basket?

Thanks tabouleh! Very interesting indeed, i will take yime to read it. It is the same powder ingredient by ingredient. Hopefully the stuff I brought will last me anyway. Wish I was still BF!

bertie They feel here that because it's a small "enclosed" space then the air doesn't get to circulate and can contribute to cot death. Furthermore, they worry that the baby could roll and get it's mouth & nose squidged up against the side & suffocate. It did make sense to me when explained so I bought a cot - but, there are so many "rules". The HV also did an Edvard Munch face at my growbag sleeping bag thingy from the UK and said only sheets. I live less than 10 miles from the German border and here they use duvets for babies...

As for the tap water - the Dutch health authorities and scientists ran of course many tests over decades. They found that they'd raised a generation of children allergic to "everything" and so now mothers are encouraged not to sterilise everything in sight and to use tap water for bottles.

(I mean in Germany they use duvets.)

Ah yes that does make sense. Actually it's always seemed odd to me that there are such strict guidelines about cots - feet to foot, new mattress for every child, not so much as a muslin/cuddly toy in the cot, and yet moses baskets are completely ignored and taken for granted!

I'd guess most babies are in a cot by the time they can roll though anyway.

SkiHorse - have you got any links to anything from the Dutch health authorities where they encourage the use of tap water and to not sterilise bottles?

I understand the theory of the over use of anti-bac etc and certainly for older children and adults there is a lot to be said for sticking to soap and water but I just don't understand the rationale for FF babies.

An exclusively BF baby consumes no tap water and does not use (many) bottles and it receives anti bodies from the mother.

I can't see why the ideal would be to replicate this as much as possible for a FF baby - i.e. sterilise bottle, boil water etc so removing any bacteria (bacteria which a BF baby would not be getting). It seems that FF babies are getting a double whammy - no antibodies and being exposed to bacteria?

Using tap water what about the risk of Cryptosporidium infection?

There have been outbreaks of this in The Netherlands.

Surely this would be very dangerous to babies? Or is it just because it is a low risk that it is deemed unecessary to worry about?

I have no wish to discuss this with you. Please google a Dutch hospital and ask to be put through to gynaecologie or google midwife.

Gosh SkiHorse this is an internet forum you know where things are discussed!

Other people might be interested in why the Netherlands take a different approach.

If we can have a look at the reasons why the Netherlands decided to use tap water and whether this is due to a difference in water quality between the countried or a different risk profile/perception then I think that's of interest.

If you don't want people to ask you Qs about FF preparation then I suggest you don't post things such as "Here in The Netherlands we use water straight from the tap and don't boil." - then you won't have people initiating discussion with you!

Just out of curiosity tabouleh why would formula companies care what advise is given to parents on how to make up the formula?

You said they were too powerful and had resisted advising parents of the WHO guidelines. I don't understand what possible benefit there could be for them in doing that other than perhaps the costs of redoing the printing.

I guess i just don't get why there is such an assumption of wrong doing against formula manufacturers.

by your first question spf.
imo they would rather not make it clear that formula is not sterile as many people are unaware of this and if they knew it would scare the bejesus out of them. Then they might kick off and formula manufacturers might be forced to invest in r and d for expensive new sterile manufacturing plants.

Formula companies have to print instructions for use on the packs. They choose not to give the WHO guidance unless forced by legislation.

TheSugarPlumFairy - it is not in their interests to state on their product that formula powder is not sterile and to explain that their manufacturing process does not eliminate bacteria and may well introduce it.

Most of the UK packets do now say something re the powder not being sterile - howver most don't explain the 70 degrees just say boil, wait 30 mins - s not making much attempt to make sure people understand.

Anything which makes FF seem less easy/more difficult is likely to decrease sales.

For more info on FF companies and their wrong doing see Baby Milk Action - on that link scroll down to see the on pack info Nestle uses in large letters in another country "Strengthening the immune defenses and reducing the incidence of diarrhea in the crucial first year of life" - It is totally misleading - because FF leads to more diarrhea than BF.

Info about on pack instructions.

Actually tabouleh, the OP spoke about how different countries do things differently. I chose to respond briefly knowing that your aggressive whining would turn up within minutes.

It strikes me as somewhat ironic that you demand urls in a language you don't understand, yet have failed to read the dates on the WHO guidelines, or perhaps even the guidelines themselves - or even links I have previously supplied - in English!

Analysis and assessment of risk are wonderful tools to posess.

I would say that it's good that countries have their own guidelines because WHO have to generalise based on everyone in the world, despite massive differences in availability of clean water, sterilising equipment, adequete nutrition etc.

As a result, their advice tends to play to the lowest common denominator and represent overkill for people living in developed countries.

bagged, the powder is not sterile.No amount of putting it in a sterile bottle, or making with clean water (let alone those doing it /baby being well nurished ) will kill the bacteria in the powder. If there might be bacteria in the milk why would it be ok to suggest making it with unclean equipment as your post seems to suggest? Surely this would just make the risk greater. Plus i think they have pretty good sterilisation/clean water/ good nutrition in the netherlands. Where were you thinking of? I can't think of anywhere where mothers don't deserve to be told how to make baby food safely.

Skihorse perhaps you could research analysis and risk assessment and post some links so people can use these wonderful tools, rather than making personal attacks?

i find this mystifying really

ff users get angry and defensive and insulting when told about how to use ff safely

do you also go ballistic when the which report on carseats comes out, or advice on sids? do you take that as a personal dig too?

whenever i've gotten information on safety my reaction is 'great, i will think about this and use it to help make decisions' not 'bastards! how dare they!'

i would love to know how this mindset works

What chilbi said.

SkiHorse can you explain what you mean by:

"yet have failed to read the dates on the WHO guidelines, or perhaps even the guidelines themselves - or even links I have previously supplied - in English!

What links did you suggest I read? I will have to go back and look at old threads now.