Can I use cold tap water to make formula bottle for DS (9 months)?

[33goingon64]

I am still using First infant SMA formula powder, as I gather there are no nutritional benefits to moving to Follow On formula. The tin says I need to use cooled, boiled water... But is that just for babies under 6 months or do I always have to use boiled water? It's such a faff having to boil the kettle in advance and am getting tempted to move on to the much more expensive ready to pour stuff. Not sure if there is something about the First Infant formula that requires the water to be warm?

Oh OK thanks for clearing that up lilham, I see what you mean now.

As a one off in an emergencyfor a 9 month old, you'd probably get away with it, but for every day use it's not great.

Depending on your finances you might decide that the cartons are worth the money for that particular feed (depends on whether your DS will happily drink at room temperature).

Just a quickie to highlight that there is a difference between first stage and second stage formula, in that stores are allowed to promote/discount/award points on follow on.

With regular boots points promotions I saved a a small fortune on red SMA :)

Every penny counts this time of year!

We used to make feeds up one at a time but we'd have a days worth of bottles half filled with boiled water, then as and when we needed them we'd top up with hot to make the right temperature (takes a bit of practice figuring out the ratio of hot to cold to make the temp right) then add as many scoops as needed and the bottle was ready to go. The HV advised us to do it this way when DD was 2 days old and we found it very easy!

We used to make feeds up one at a time but we'd have a days worth of bottles half filled with boiled water, then as and when we needed them we'd top up with hot to make the right temperature (takes a bit of practice figuring out the ratio of hot to cold to make the temp right) then add as many scoops as needed and the bottle was ready to go. The HV advised us to do it this way when DD was 2 days old and we found it very easy!

toddlerwrangler follow on formula was invented to avoid the regulations which is why it can be discounted. Its amended formula can cause health problems, especially the extra iron which is unnecessary despite the adverts. I highly recommend using infant formula to a year, then ditching formula completely and moving to cow's milk.

newmum001 the problem with this is that again the water won't be hot enough to kill the bugs on the powder. Babies have died not long ago from this not being done properly so it's really important to understand that the powder needs the water to be around 70 degrees, and it's because of these babies that the guidelines were changed. HVs are often behind the times unfortunately.

Organic - I am aware of the higher iron content - however it was actually the argument that second stage is actually so close to first stage in its make up (as it is is just a way to get round marketing regulations) that convinced me to use it.

I do think its good that you pointed it out though :)

Does anyone have information on how many uk babies actually fall ill because of formula being made up incorrectly? I was wondering how much of a risk it really was?

BabyDubs - not many, not many at all. Unfortunately the problem is, is that it can be fatal - not just a bit of a poorly tummy. So the chances are minimal, but the risk is immense.

BabyDubs - I don't think the numbers are high, but when they get ill, they get really ill (die) :(

I was never made aware of the 70 degree rule when I had Alf. Now I know what could have happened I am furious about that fact.

I'm not sure if any UK babies have died from formula - I think they were mainly in Belgium and France. Rates of gastro-enteritis are much higher in formula fed babies compared to breastfed though.

I think of it a little like avoiding foods that can give you listeria in pregnancy - the chance of actually getting listeria from soft cheese or whatever is pretty small, but the potential consequences are severe. Same with salmonella or enterobacter in formula.

Obviously the chance of getting less serious tummy bugs from incorrectly prepared formula is higher than the chance of getting the fatal ones.

I agree with everything on here so pls don't flame me for this but can anyone paste a link to any news source about where babies have become seriously ill because of bacteria in the formula (e.g. the sma case mentioned above)? This 'fact' gets banded around very liberally on here but I've googled it a few times and never found reference to it.

To be clear though, I totally agree with the way to make up bottles to be on the safe side!

The cases that prompted the guidelines to change in 2005 were in Belgium and France (I guess in 2004ish?). One of them was in a maternity or neonatal ward iirc. The WHO organisation website might be a good place to look for the details.

Ds was in hospital at 16 days old and had to be taken off breast and put on special formula (long story). They made his feeds using small bottles of distilled water (cow and gate) and added the powder to it. Milk was served at room temperature. That's in HoSPITal!!!!

I don't think we can say that 'not many' babies fall ill in this way. The figure is likely to be high. There are many thousands of babies admitted every year to hospital with gastro-enteritis, which will certainly include episodes caused by pathogens in the powder. In addition, many more babies experience an episode of gastro which doesn't actually need hospital treatment.

However, we can only rarely say for certain in individual cases that a particular baby's particular illness is caused by formula powder pathogens, because of course babies can become ill as a result of contact with other bug-carrying objects. It's just that milk and warmed milk at that is a powerful medium for them.

We do know that ff babies are at more risk of gastro than bf babies for two reasons i) ff babies are exposed to pathogens more, because of being ff and ii) they don't have the protection that comes with breastmilk

The good news is that the pathogens inherent in formula can be seriously reduced if they're zapped by water at 70 degrees, and if the other obvious and sensible rules about formula preparation are followed - and that's firmly backed up by research.

Without getting into an argument over this.....

The risks are fairly remote for the most serious bacterial contamination (chronobacter/entrobacter sakazakii) but if the baby does fall ill they can be utterly catastrophic.

The first recorded cases of neonatal Enterobacter sakazakii meningitis was in the UK in 1961. As well as meningitis, e. Sakazakii can cause meningitis, septicemia, necrotizing enterocolitis, brain abscesses, cerebral infarctions and dermoid cysts of the posterior fossa (part of the brain). Mortality rates can be as high as 80% though 20-50% has also been recorded.

Salmonella is also a contamination risk and is responsible for stomach bugs (d&v) but in a very young baby Salmonella get into the bloodstream which can be life threatening.

There is also the risk of contamination from humans (not washing hands before preparing formula/bottles not being cleaned thoroughly) which if the milk is made up with cold water or stored incorrectly can multiply to levels that can cause infections.

Rita - the first two cases of neonatal Enterobacter sakazakii meningitis in the UK were both fatal and this is going back 50 years (1961 as mentioned above). The guidance on how to prepare formula wasn't changed until 2005.

I remember reading the report on the Enterobacter sakazakii fatalities that occurred in France or Belgium. The report was posted by someone on a similar thread. The babies who died were premature (therefore had a weaker immune system) and the cause identified was the fact that the bottles were not stored at the right temperature in the hospital fridge.
I really do think that there is a great deal of scaremongering about the preparation of bottles.
I am not saying that instructions should be ignored but I think things should be put in perspective a bit.

THe risks of the most serious illness (ie fatal illness) is small. The risk of less serious (ie non-fatal) illness is much higher.

tealeaves www.infactcanada.ca/news_releases_May_2002.htm comes from a quick Google. Term baby.

dialM no, I'm afraid that's not true. It is a simple scientific fact that there is a great deal of illness caused by formula feeding - just, thank goodness - not very often catastrophic illness. The risks of FF should always be seen in the context of not FF where BFing isn't working for whatever reason. However, this doesn't take away from the fact that FF is a risk, no matter how prepared, but preparing it safely is the best way to minimise risk.

Organic what is not true?
The risks of FF should always be seen in the context of not FF where BFing isn't working for whatever reason and sorry I did not get what you meant by that either

did not mean to underline this quote either.... oh dear my head cold is worse than I thought!

Oh sorry you're not well :( And sorry I wasn't clear.

What I meant wasn't true was, "I really do think that there is a great deal of scaremongering about the preparation of bottles."

It's really, really important that it's done right. Maybe not because of the tiny risk of a terrible infection (because it's so rare) but because of the risk of a less serious but still nasty infection which is pretty common.

"The risks of FF should always be seen in the context of not FF where BFing isn't working for whatever reason"

Yeah, badly worded, sorry. I feel it's really, really important to not shy away from discussing the risks of FF. I am aware that this is a difficult thing to discuss because it causes a great deal of upset for mums who for whatever reason have no option but to FF and means that breastfeeding supporters are accused of making people feel guilty, or being anti-formula. However, this does not mean that the risks should be downplayed because to do so means that there are a very large number of parents who are not able to make an informed choice.

HOWEVER, I am immensely grateful for the fact that we have an alternative to BM for when it's needed as it is clearly a life saver when required. What I was trying to say was that while I feel it's the right thing to do to discuss, where appropriate, the risks of FF, those risks need to be understood within the context of the fact that formula may be being used feed a baby for whom BM is not available. In that case, the risks of FF are irrelevent because the risks of NOT FF are starvation. Minimising the risks, though, are still important.

Hope that makes more sense :)

ok got it.
Well I'll agree to disagree on the scaremongering. I am not saying FF is risk-free (nothing in life is) but I do think that some people say very nilly willy "babies DIE of badly made bottles" as if it was a daily occurrence.
I chose to FFeed and although I sort can see where you are coming from, I resent the assumption that by doing so I am deliberately putting my baby at risk.
But hey, it does not sound like we are going to agree on this one. Maybe next time?

I think it's important parents are made aware of how to make up formula properly. There is a risk, even though it's small, but if it happens it's fatal. We can choose to use cartons when out and about to reduce the risk, for example. Rita gave a good example with listeria. Another good example is honey and botulism.

To see we aren't making this up, the NHS page on formula does mention Cronobacter sakazakii (Enterobacter sakazakii) and Salmonella specifically. You can google it with infant. You will see lots of hits from organisations like WHO, FDA, ASM, FAO etc. Not just pages from mum forums.