making bottle feeds who follows guidelines

[IdreamofFairies]

i have never bottle fed so am new to this. i am working with pregnant young woman who is planning to bottle feed, part of my 'job' will be to advice her on the correct procedure.

according to all the information i have read it says to make each feed up as needed. in order to do this you need to boil the kettle and leave cool for 30 min in order to have the perfect temp, warm enough for the powder to mix, cool enough not to kill of all the nutritional bits.

but really at 4 in the morning or at any time i suppose, does anyone do this if the baby is crying who can wait 35-40 mins to make each feed.

whats everyone doing. i have to tell her the guidelines but cant see her following them whats the next best thing.

thanks in advance to anyone that can help.

The next best thing is to follow the WHO guidelines which allow for up to six feeds to be made up in one go (in the way you've outlined above) and quickly chilled in cold water/iced water. These can then be stored in the fridge for up to 24 hours.

That's the way I did it and had no issues at all. That statement does come with the proviso, however, that said small child was in rude good health.

All my friends who bottle feed do as moonlight explains - the new guidelines are completely unrealistic in my opinion, especially at night. I suppose the exceptions would be if the baby was ill or perhaps in the first couple of weeks where they are still so new.

I suppose the woman your working with needs to know the official guidance and then make her own mind up about the risks. I think most health visitors understand women aren't following the guidance.

The other alternative would be to use the ready made stuff, but that would be really expensive.

I always make up as listed. It's a bit annoying but doesn't take too long, as I run bottle under cold water to cool down once made. So prob 5 mins. Most times you work out how often then feed, whether that's every 2/3/4 hours and can have the kettle boiled, cooled down for 10 mins, then make bottle at 70degrees.

So feed every 3 hrs. 2.40hr ish after last feed boil kettle

Cartons can be easier if out and about

So how long does it take to warm up? I have never thought about this!

How long do you have to stumble about in the middle of the night with a crying baby til you can shove a bottle in its gob?

My feeling is to give the information on making up a bottle to guidelines and explain the rationale behind each step. That way the parents can understand better what the risks of missing steps or changing methods are. Babies in "rude health" can still be made very seriously ill, and a few will die, by contaminated formula or bottles. Many will contract unpleasant but not life threatening tummy upsets. Being healthy doesn't stop this, but being ill to start with certainly makes D&V far more dangerous. They will also (as all parents do) get a lot of "I did XYZ with my bottles and my baby was always fine) which will undermine their understanding of the risk.

But at the same time it's clear that the guidelines of making up a fresh bottle from 70 degree water etc etc is unrealistic for everyone, at all times of day and night. So having the information on why each step is important can help parents to decide the best course of action for them.

Obviously cartons for those who can afford it is a useful thing. I have heard of people boiling water, then storing it for a few hours in very clean, sterile, sealed containers (eg bottle with a lid) to cool down, then making the formula up with freshly boiled/cooled to 70 water for half the water amount, mixing the formula, leaving for a few minutes to kill any bugs on the powder and then adding the cool water to the right water amount. Less time to cool down. The risk would be adding the cool water before the hot water had sterilised the powder and I don't know of any research into how long that would take. Probably the better way is to make up several bottles and store them on balance.

I'd also focus on really, really cleaning bottles and teats really well as studies on premature babies taking donor or mother's milk have shown that even sterilising bottles can't always get rid of bugs which are growing on milk residues. It's as important as making the formula up carefully.

thanks for the reply's. i will print of the who guidelines.

i did ask about making feeds in advance for the night but the guidelines are only to make in advance if you 'have to' so they thought a night feed didn't count.

this will of course be a new born so i understand she will have to be more careful.

i am sure there is some issue surrounding warming the cold boiled kettle back up to temp something to do with perfect temp for germs to breed will need to have a look see if i can find it. when we heard the guidelines that's what we all had said to the midwife who came in to talk to us and she gave it the big thumbs down.

i suppose the hardest part will be as the guidelines are so hard to follow will be getting her to listen. when i know the majority of the people she knows wont be/or have bothered with their babies. you get the old well i did this and my baby is fine.

she has more to lose than them though

I think the key thing is that you can't have a hard and fast rule like leave kettle to cool for 30 mins - every kettle will be different in terms of how the temperature drops (how well insulated it is, how much water in the kettle etc) - the water needs to be AT LEAST 70c to kill any bacteria that may be present in the milk, rather than the concern being about the water.

In the early days ( I FF from 4 weeks) I used cartons overnight. Then I got a little more relaxed and made 3 feeds up at a time - cooled rapidly and stored at back of the fridge.

I know a couple of mums who didn't realise that if a feed wasn't finished that you couldn't just leave it lying around and re-use later on. My 18 yr old cousin would leave unfinised bottle next to the bed overnight and use the remainder of it when the baby next woke until we explained the dangers.

After badly scalding myself at 3am when DS was a month old the midwife pointed me in the direction of the WHO guidelines.

Yes that's a really important point, about not leaving bottles around. To clarify the 70 degrees - it's not so much at least 70, but as close to 70 as possible. 70 degrees will kill any bugs on the powder, and much higher than that and it will destroy vitamins in the powder. You're absolutely right, notaqueef, that leaving the kettle for 20 minutes is a tricky one as each kettle is different, but I guess it's ok as a rule of thumb.

Bacteria won't grow in boiled water put into sterile containers, then quickly chilled and stored chilled. Should be used within a few hours though. But I still have reservations about that method.

In the end, her baby is her responsibility and perhaps the best way of approaching things is to encourage her to make her own informed choices by giving her the information she needs to evaluate her situation.

I have always put a jug of boiled water in the fridge every morning and boil the kettle for a feed and have 1/2 just boiled water and 1/2 out of the fridge so he can drink it straight away

for those of you that are cooling down under the tap or mixing cold water in how are you checking the water temp. i mentioned this today but think she will need a thermometer to be able to get it the correct temp.

Well if it's going in hot then you know it's 70, then you cool it down until you sprinkle some on your wrist and it feels warmish but not hot. Body temp really.

or is that old fashioned?