Prepare each feed individually or refrigerate 24 hours worth?

[peaches27]

I have read a lot of information recently about new Government Guidelines on preparation of feeds. At first I ignored the notion that I should prepare each feed individually, thinking no one has enough time for that. I also toyed with the idea of filling the bottles with water and adding milk from those little dispensers at feed time.

I read this yesterday:www.babymilkaction.org/press/press4jan06.html
I dont usually bother with babymilkaction because I thought it was geared towards those who promote breastfeeding, but I found the information very instructive as to how to prepare feeds.

".....the powdered infant formula is not sterile and may be contaminated and should be mixed with water which is at least 70 degrees Centrigrade ? a decontamination step which experts say is needed to kill off bacteria that may be present and which if used consistently could result in 10,000-fold risk reduction. If this treatment is applied only 80% of the time the estimated risk reduction would be only 5 fold."

So if I dont prepare feeds in one 24 hour batch and go for the putting water in bottles to cool and then mixing powder in when ready, I wont be killing these bacteria as the water wont be hot enough.

What I do is prepare the feeds with water recently boiled (30 minutes since) which will hopefully be at 70 degrees. Cool them rapidly and then refrigerate.

What would you do?

Does anyone have any information on which method is the safest, given that preparing each feed individually at 70 degrees and then waiting with screaming baby for it to cool down to temp isnt really practical in the real world.

Sorry so long, but I would like others opinions.

scarey stuff! I guess if u have to/choose to then using the made up cartons would be the best choice? i honeslty never knew this info and was never informed of it (although always followed instructions. 20 minutes cool down for water b4 adding formula)

have never used a bottle after its been out for more than an hour, and always make up feeds 24 hrs in advance... but have seen many mothers who have previously made up bottles on their prams for HOURS and srill give them to the baby!

Its a scarey world out there...

I am a breastfeeder, so do not speak from experience. However, I have sat in on talks with the DoH recently on exactly this issue. The point was raised about how would a mother know if the water was 70 degrees and also the point you raised about cooling it. However, they were adamant (and quite right) that the risk is high if you do not follow these guidlines. I did think about it a lot after the meeting, about what I would do if it was me. I would try to anticipate when the baby would need a feed and prepare the bottle a little in advance, using the boiling water to ensure bacteria was killed, and then allow to cool. This is just my personal opinion though.

With my dd now 3 I made the bottles up in advance and stored tham in the fridge and she was fine. With my ds these new guidlines came out so I just filled the bottles up with boiling water and left them at room temp adding powder as needed, he's fine too. I guess it's up to you to judge they also advise not leaving the water in a kettle for any longer than 30 minutes once it's boiled.

good lord! I always went for 'filling the bottles with water and adding milk from those little dispensers at feed time'. I did bf exclusively for 6 months though and then swapped to formula, so maybe DS's immune system was ok by then. He was never ill or anything on it.

This is an issue that I've been aware of since my DD was born 8 months ago. Initially I made up 3 bottles at a time, but when I looked into this a little more I started to prepare the bottles all at once with recently boiled water (20 - 30 mins after boiling), cool them down quickly in a sink of cold water and put them in the fridge. Then when DD is due a feed I heat the bottle of water then add the formula. This way the water is warm enough to hopefully kill some bacteria and also the formula mixes better when the water is warm. I used a bottle warmer until she was about 4 months but now use the microwave. Always ensuring I've shaken the bottle vigourously and never give it straight to her incase of hot spots. Not sure if this helps?

i boil the kettle and fill the bottles. then leave to cool.
when i need a bottle i heat up the water in the microwave (about twenty secs does the trick in ours) then add the powder, either from the tub or the dispenser.
not sure if this is the best way but it strikes me that the water is less bacteria-tastic than cooled milk.

I am curious - what is different now that wasn't there before with formulas? Why have the guidelines changed?

I have three healthy boys who were all formula fed and I made their bottles up exactly the same way - 24 hours in advance and kept in the fridge, reheated by a quick turn in the microwave unless out and about.

My children are healthy - the oldest two only suffering the odd ear infection here and there as infants, the youngest has never even had that, just a week of viral gastroenteritis, (which was going around earlier this year).

It was after 2 babies died in Belgium, they looked into it and found powdered milk to be at fault. They checked the factory and found nothing, but tests on different milks found it was likely to contain bacteria. I think it was the Hipp factory but couldnt be sure.

I used to think oh Ive always done it like this and my kids are OK, but when I read into it more I saw how important the hotter water was to kill off any bacteria that might be present, and thought, well I can do that.

It would be sensible if a trial was coducted by a microbiologist to see which was more effective, milk made at 70 degrees, cooled and refrigerated and kept for several hours in a fridge or milk added to cooled water which wont kill the bugs, but the short time means bacteria wont multiply.

can i just make a quick point. i says on your carton of formula that you are to make the feed up NO LONGER than 30 mins after boiling, also we are not to re boil water, it has to be freshly boiled. therefore unless your baby is a regular feeder (and mine isnt) it is impossible to make the feeds up when required as it takes about 40mins to make each feed.
like you said the formula is not sterile, so you need the hot water to kill the germs. you also cannot boil the water and add powder to the water once it is cold.
the only way is to make up 24hours and cool them in the fridge.

i think they will do more reseach into it and next year it will be back to the old system!

so how long does a bottle made with 70 degrees water take to cool down to drinkable temperatures?

Would just like to add that I used enfamil formula which is specially designed for babies with reflux. With this type of formula it is impossible to make the milk with anything warmer than room temperature as it's heat that causes the milk to become more solid - ie when baby drinks it it warms up inside, becomes more solid and they can't sick it up as easily. What would be the DOH's advice regarding this type of formula?

There is also a school of thought that we shouldn't sterilize because it's helpful to be exposed to bacteria from and early age - who do we listen to there?

Millions of people over the world have been making up formula in the morning and putting it in the fridge for the rest of the day - if it was really dangerous there'd probably have been more cases to cause concern - the companies that make it aren't THAT good at cover-up.

It'd be silly for me to advise anyone else to go against the DOH advice but personally with my new one, I'll be doing exactly as I did with DS.

I always sterilized up until DS was putting everything in his mouth, (damn hard to sterilize a remote control, for instance)!

Followed this with each child.

I'm sure they were all exposed to plenty of germs of different varieties to build up their immune systems with all the cuddles that they got, (youngest took to gumming the shopping trolleys too - very hygienic, I don't think)!

I prepared enough bottles for the day by mixing formula with hot water, cooled down fast afterwards and keep enough bottles for a day in the fridge, just microwaved (and carefully checked temp was OK) when I needed. DS never had a tummy bug.

Now, I have a friend who is a biologist and has very strong feelings about not sterilising a bottle or using formula that has been prepared more than an hour agao and had not been refrigerated. She says that if you observed the remains of a bottle for a moment under the microscope you can actually see the bacteria grow

I still don't understand. this is what I did - last thing at night, boil the water and pour it immediately into bottles I'd just got out of the steriliser, put the teats and lids on, then put them on the side without adding formula. Then measure out the scoops of formula into the sterilised dispenser, ready to add to the water when required the next day. No microwaving required, can be done out and about, and DS always drank it room temp. He never got a bug. But this is now wrong?

Is this guidance saying that this could cause my child harm? So what should I do if I'm going out, take one of my pre made up bottles out of the fridge, put into a cool bag (which won't be as cool as the fridge so surely bacteria will multiply), take it out with me and then try to find somewhere to heat it when required?

All theoretical at the moment as DS drinks ordinary milk, and my new baby will drink breast milk for 6 months, but wondering what to do when the time comes to swap across.

I recently attended ante natal class & this is what we were told if bottle feeding (I'm b/f & now completely put off the odd bottle of formula!)

The 'rules' around storing EBM have changed too...something like can be stored for5 days.

Ref the heating the milk in the microwave, I understand you weren't supposed to do this with formula & EBM because it changed the molecular content AND it carries on cooking/heating after it is out ?

Mojomummy - yes the advice is don't heat milk in microwave but mainly because microwaving can make hot spots which could potentially burn baby's mouth. However now DS is 21 months I always heat it in microwave, stir thouroughly and then shake when I've put the cup lid on - it's only ever luke warm anyway. If you can get your baby to drink milk from the fridge or room temp like tortskymow life is much easier.

Despite the school of thought about not sterilising I would always sterilise DS's bottles. My problem with the new rules is that they're SO impractical. Surely it wouldn't allow bacteria time to grow if you make up the bottles with thte right amount of water, refrigerate as soon as it;s in the bottle, then mix the feed and warm when you need it - that would be much easier (though not quite as easy as what I used to do making all the feeds at once.