Friend making formula with cold water

[marzipananimal]

I'm looking for a bit of advice on how to deal with this tactfully, if at all.

My friend has started introducing ff to her 9 month old and I noticed she mixed the powder with cold water. I know about the risks and preparation guidelines etc and feel a bit uneasy.
Should I say something? If so, what?
I don't want to offend, especially as I don't use formula (though I did when DS was newborn for a bit so I know how to use it).
She may know the risks and have decided to do it anyway, which is her decision, but given that she has bf up til now she may not know.

Any advice?

[Bella8]

I realise this is an old thread but just incase anybody googles this a lot of answers on here are misleading and incorrect.
Formula has to be made up at 70C as this is the correct temperature to kill bacteria/bugs within the dry powder. Any hotter kills the nutrients in the powder. The reason the water has to be boiled first then cooled to 70c (cooled boiled) is because babies under 6 months aren't allowed tap water and boiling it first kills anything in the water. Best to always follow guidelines unless you're happy to risk your babies health. The guidelines are there because babies have been made ill by the process not being followed. Just because some people's babies have been fine doesn't mean they all will be so is it really worth he risk?

[estya]

Agrumino 70 degrees comes in because 'things' live and reproduce nicely up to about that temperature - called the danger zone.
Hotter temps kill bugs off - the hotter the water is, the better it'll do so, but you then have to balance the risks of scalding (knackered parents juggling boiling water in one hand and crying baby in other hand etc)

[estya]

I think the most important thing it not using the formula after it has been made up for 2 hours.

Since the powder is dry, bugs won't survive in it (presuming its kept dry etc). But their spores could be dormant in the powder which, when the powder is added to water, could multiply to a significant (dangerous?) level - obviously this happens over a period of time and will be fastest at a lovely warm drinkable temperature.
2 hours is a standard time for this kind of thing - hot food counters etc all have to stick to this 2 hour limit for keeping food warm.

When it comes to whether the water is boiled or not, I would expect its more to eliminate nasties that come in with the water (dirty taps etc - i have a pet hate for people who wash raw chicken in the sink and then drink water out of the tap that chicken-y water has just sprinkled all over).

I would thought that if you are giving you 9 month old water from the tap to drink, its the same water once you put formula into it. The key is not leave the milk hanging about too long.

[TheWolfpack]

We used to add 4oz of boiling water to the powder to sterilise and then 2oz cold tap water to take it to right temp (or more if necessary).

This was over the age of 6 months though.

[MumblingRagDoll]

My elder DD is 7 and she had nothing but room temp from day one....

[RitaMorgan]

At least 70c - ideal is between 70-80C. I believe water hotter than that can destroy some of the nutrients, particularly vitamin C, which is mostly an issue for very young babies.

[AgruminoMum]

What I don't understand is the 70 degrees benchmark. Does it mean that milk should be made with water which is at least 70 degrees hot, or does it mean that water should not be above 70 degrees (i.e. maybe water hoter than 70 degrees destroys the protein in the milk?)? Why does the guidance say that water should be cooled down to 70 degrees, can't I just use boiling water full stop?

[DrinkFeckArseGirls]

The thing people believe what they want to believe and hear what they want to hear, regardless of what the advice is. I once made a similar comment to a FFing friend, "oh, I thought I read somewhere it needs to be done with hot boiled water to sterilize the powder" and she said, "nooo, I'm sure that's fine" (her making it with cooled boiled water). I would at least bother to check if someone made a comment like this to me. You can say it for your own piece of mind but don't count it will actually be taken on board as it's not convenient to implement and people don't like being pointed out they're wrong.

[RitaMorgan]

Out of the fridge it only lasts 2 hours.

Refridgerated it will last 24 hours, but personally I wouldn't make 24 hours up in one go, I think that's pushing it a bit. Making a couple at a time so you're always one ahead of yourself seems a good compromise.

[Fontsnob]

But I thought it had to be thrown away after 2 hours?

[SparkleandShine]

The way to do it to avoid minimal hassle is to make up 6 (or as many as required for 24 hours) bottles in the morning with boiling water and powder.

Then put lids on bottles so they remain sterile. Refrigerate and use as required.

Then the powder is properly sterilised, as is the water and they are ready for immediate use. Bottles can then be given cold or warmed.

You use the last one the following morning (while making up the next batch) and throw any remaining away after 24 hrs.

It is also worth noting that ready made formula is not that much more expensive (circa 25% dearer) and is already sterile.

[marzipananimal]

tricky isn't it yes. It would be very interesting to know how the risk compares to, say, eating brie when pregnant, or eating undercooked chicken generally.

Thanks for that seona, I wasn't aware of that. Things I've read say that if you can't make it up fresh each time then to make it hot then keep it in the fridge/with ice packs so I would interpret the section you quoted as applying to situations where boiling water is unobtainable at all, not just at that moment (and anyway, you could take a thermos of hot water out if you weren't going for too long)

[Yesmynameis]

I read this thread with interest, as everyone i know who ff has always made up their bottles with cooled boiled water.

Although I was aware of the guidelines, I've never actually considered saying anything to them, because I wouldn't have thought it would go down well, especially from a bf mum. Prob nothing worse that a bf mum lecturing on how to make up bottles...

Although this has got me thinking that I should have spoken up...

[marzipananimal]

don't worry Fontsnob, if it had caused her any problems, you'd know by know. If you want to make it with hot water you could then cool it quickly in cold water or the fridge

[Fontsnob]

I have been giving dd formula made from filtered water for the last 2 months. Now I feel rubbish! Problem is that she won't drink it even slightly warm.

[bestfootforwards]

Ah no. Didn't read it properlly, looks like the bottom paragrapph is referring to formula generally

[bestfootforwards]

Ah no. Didn't read it properlly, looks like the bottom paragrapph is referring to formula generally

[bestfootforwards]

seona I think the who leaflet refers to special formulas e.g. My son has a hypoallergenic formula which specifically states on the tub that it should be made up with cooled boiled water.

[Seona1973]

this is from a WHO leaflet:

What about formula that can not be prepared
with hot water?

For compositional reasons some formulas, used for special medical
purposes, can not be reconstituted with water at 70ºC. If this formula is
not available in a sterile liquid form, feeds should be made fresh as needed
using boiled water that has been allowed to cool below 70ºC. Feeds
prepared with water cooler than 70ºC should be consumed immediately -
they should not be stored for use later. Throw away any left-over feed
after two hours.

What if boiling water is not available?

The safest way to prepare a feed is using water that has been boiled and
cooled to no less than 70ºC. If you do not have access to boiling water
you may wish to use sterile liquid infant formula. Alternatively, you can
prepare feeds using fresh, safe water at room temperature and consume
immediately. Feeds prepared with water cooler than 70ºC should be
consumed immediately - they should not be stored for use later. Throw
away any left-over feed after two hours.

[Seona1973]

I used room temperature boiled water for formula for ds although I was aware of the proper guidelines. There is a formula preparation leaflet that says that in the absence of boiled water you can use 'safe' water to make up a feed as long as you use it straight away. The issue is leaving it at room temperature for any length of time as that is when the bacteria can multiply.

[RitaMorgan]

Eglu - the guidelines were changed in 2005 in response to outbreaks of illness from contaminated formula in which several babies did die. Think it was in Belgium and France.

[organiccarrotcake]

salad FWIW slugs and sand/mud can be great for toddlers as they're full of micronutrients that they need around that age . Not something one would recommend (esp as slugs can have various worms, and also can have eaten slug pellets) but even so...

However, slugs and mud are NOT formula powder so saying a child has eaten one and is fine does not make the other safe.

[organiccarrotcake]

It's not about dying, it's about becoming ill, and because gastro illnesses are relatively common in FF babies, they're not news. Babies have always suffered from these gastro illnesses, but thanks to modern medicine they don't usually die from them in the West. Doesn't make them a barrel of laughs.

Nestle did believe that they didn't need to change the packets, but they have been forced to (as have all manufacturers) because others disagreed. Nestle's decisions on whether or not something is good for babies isn't really to be taken at face value.

There is more potential for the growth of bacteria in formula powder than on washed teats or bottles because the powder is a food for them, whereas bacteria don't grow so well on washed plastic.

The evidence that allergies are on the rise is due to the whole area that a baby lives in being too sterile. Certainly using anti-bacterial sprays all over the house can lead to the environment not pushing the child's immune system which is not healthy. But, there's a difference between sterilising the normal environment and sterilising a potential source of very harmful bacteria.

[saladfingers]

That's really interesting z123. I think it makes so much sense.

I'm also in the cooled boiled water camp. 4DC mixed feeding from approx 3-6 months. None of them every had any problems. DS1 ate a slug at 7months and DS2's favourite food would appear to be sand/mud whenever he gets the chance. No ecoli here yet!

[z123]

I hadn't read the posts right above this on the thread- just the ones at the beginning. I still think it's not an enormous issue, as many people if making bottles out on the go have to used cooled boiled water in a bottle and tip in the right amount of powder? I was given a formula-portioner tub thingy by a friend. Have to say,never managed to persuade my LO to touch the stuff.... given up and moved onto cows milk smoothies at HV advice... not really winning there either!! Poor child has barely drunk any milk since 8 1/2 months. Yoghurt-ing it up!!!