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?

cross posted!

so would the powder not be safe to eat dry then (should you want to??)

no it wouldn't would it
urgh
I really have just realised the implications of this - I have always assumed that this was to kill off miniscule amounts of these bugs that an adult could handle but a vulnerable tiny baby (who lived solely on the stuff) couldn't. However what you're saying is the powdered milk would be unsafe for anyone to drink!
Does that also apply to normal powdered skimmed milk? Is that make up with boiling water? If they can make that safe, why can't they for formula milk?

Becuase now I think about it I used to chuck powdered skimmed milk in the breadmaker, add liquids and then leave it all night to turn itself on in the morning.

op i think it is right to say something. You night help her lo avoid illness, even the non life threatening kind is no fun.

stealth bread is baked very hot, which would kill anything :)

Babies really are more susceptible to bugs than adults. Their immune system is pretty much non-existant at birth and only develops over the next few months (and doesn't mature until around age 6 years). Without the protection of breastmilk a baby is more susceptible to infection anyway, so parents need to be doubly careful with formula powder.

So, as Moon says, avoiding even the non-major stuff is important.

So could I drink formula made up with cold water? And I suppoe what I'm wondering is at what point does it become OK? Or is it never safe to drink, and if not, that's really shocking!

jellyjenko I think you are probably in the majority! I know loads of people using cool boiled water to make up formula, or tap water. Bacteria in the powder? Unlikely in the extreme, this is for those rare cases where its possible-like that baby in Belgium. Nestle wouldn't fight it unless they thought there was a good chance they were completey correct as it they won and it happened again...?!? More e-coli in animal petting farm places!! In our area the health visitors are telling you not to sterilise bottles full stop after 6 months. I am sure there will be more bugs in the bottles (the teats obviously) than in the powder!!!!!

At 9 months, when they're sucking everything they can get hold of from the floor, I wouldn't worry about milk powder. There is more and more evidence that lack of exposure is increasing allergies. In Asia where very young babies have peanut sauces, their nut allergy numbers are far, far lower than ours. Plus there is a new study on now that you can enroll little babies on to look at early weaning (3 months) giving babies milk, wheat etc from much earlier to reduce allergy risk. To get that through an ethics committee it must be possible that this will provide health benfits and incredibly unlikely to give any poor side effects. My friends baby is in this study!

My point was partly the fact that these guidelines are new and they weren't around a few years ago, yet babies survived perfectly well. I don't ever recall the papers being full of babies dying from formula.

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!!!

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!

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.

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.

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.

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.

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.

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.

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

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

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.

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

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...

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)

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.

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