Help me understand formula feeding

[DouglasFirs]

I've been breastfeeding my baby (now 6 months) and also giving those ready made bottles when it's more convenient.

I want to start using more formula but I'm confused about how to do it when out and about. So far, the ready made bottles have been fine but they are obviously more pricey than powder (especially now she'll polish off a whole one per feed!) How do you formula feed with the powder if you are out for a day and have no access to boiling water? Is it ok to make up bottles before you go and use them as and when you need? I can't see what the problem would be with this but the instructions say not to! How did people do it before ready made bottles were available?!

[MyBreadIsEggy]

www.aptaclub.co.uk/article/aptamil-first-milk-safe-preparation

I can assure you, a doctor would disagree massively. There is the potential for so many harmful bugs to be present in powder, only water above 70 degrees will kill it. That's why formula instructions tell you to boil the kettle and either use the water straight away or leave it to cool for no longer than 30 mins - it shouldn't be below 70 degrees after 30 mins

[Banana99]

I was told to add powder to cooled water ( a few years ago) to stop people making up bottles and leaving them for hours.
It's a minefield!

[MyBreadIsEggy]

I'm not trying to scare new mum's - I'm trying to make it abundantly clear that food safety guidelines are there for a reason, and to save anyone else potential seeing their baby as poorly as my friend's DS was. He was 7 weeks old, so the only "food" he could have got EColi from was formula milk

[BendydickCuminsnatch]

I either took a bottle I'd made using the perfect prep, and use within 2 hrs; used a premade bottle (he took it cold just fine); or just went out between feeds.

[maisyanddaisy]

Make up bottles with boiled water, take formula powder out in tubs. Mix when required. I've never heard of sterilising powder, and instructions say to add it to cooled boiled water.

[sandylion]

Small flask with boiling water and another spare bottle filled with cooled boiled water. Container for formula. Make up as required when out.

[3luckystars]

Most places have boiling water but I bring a flask of boiling water with me.

Tommee tippee have little pots that hold up to 8scoops and the little container fits inside the bottle.
I pour boiling water and add the powder as the boiling water kills the un sterile powder. I let it cool and use that.

Daughter is on prescription formula and doesn't come ready made so have to make them up every time.

[JC23]

I take some boiled water in a bottle and formula powder measured into a little pot.
If your baby is over 6 months you don't need to worry so much about sterilising things.
I'm not sure about the advice to "sterilise" the powder with boiling water as a) this wouldn't technically sterilise it and b) there are probiotics in (some?) baby formulas which would be destroyed using this technique.

[BastardBernie]

Or from the preparation of your friends babies bottles? Not from the powder. Totally understand what you're saying and respect your opinion, although thousands (millions?) of women feed their babies this way and your posts would certainly unnecessarily scare me if I was a new mum.

[PlanBwastaken]

I also came from breastfeeding to prepare bottles, and as I also was confused I read up a lot.

As others have said, formula powder contains potentially nasty bugs and must be heated to above 70° to kill them. Bottles used must also be sterilized.

It's not true that you can slack off with sterilising after six months, not the gear used for formula anyway. Everything else I'd relax with all right (on number two here).

Use water that's around 70° degrees to make up formula to prevent killing vitamins etc in the formula, as advised above.

[elQuintoConyo]

I made 6 bottles of boiling water+powder in the morning, then left them all in the frige. I'd take out a bottle when we left the house.

If you're still a bit confused by all this information and conflicting advice, stick with the ready-made cartons. A 7mo doesn't drink as much milk as a 4mo and hopefully the expense will be short-term.

Our DS is now 4.8 and I can remember the stuff we spunked money on - felt terrible at the time, but that was outweighed by convenience and, sometimes, safety.

[MyBreadIsEggy]

Bernie yes, loads and loads f people are lucky enough to never encounter a contaminated batch of formula, so the cooled water method probably wouldn't cause them any issues. But the risk of getting a contaminated batch, although small, is still there, and for me, the risk is simply not worth it to save a bit of time making up feeds. I've never seen a baby so poorly in person before that, and it scared me! I wouldn't want anyone to have to see their own baby like that :/

[3luckystars]

Could the baby have gotten Ecoli elsewhere?
Sorry if I am a bit thick but could ot have gotten if from germs elsewhere like a dummy or if the bottle wasn't sterilized properly, or germs from someone else.

Again, I am sorry if that is not possible, my understanding of bacteria is limited, so I would always be over cautious with babies and milk and agree formula should be always added to boiling water. It says this on my tin here, wish I knew how to post a photo of it.

Just use the ready made stuff if you can op, you can get it in small cartons so its not as wasteful.

[MyBreadIsEggy]

I guess it was possible, but I'm just reiterating here what the doctors told her - contaminated formula was the most likely cause as that was her baby's sole source of food at the time.

[mnbex29]

Hiya. DS was born prematurely and needed formula top ups alongside BF as he wasn't gaining enough weight from BF alone. The nurses in SCBU showed us how to make up bottles of formula and they were really firm about the powder needing to be sterilised with boiling water as the powder itself can contain harmful bacteria. Sure enough the instructions on aptimil do say mix with boiled water cooler for no longer than 30 minutes, which I think is because water cooled for any longer than 30 mins wouldn't be hot enough to kill any bugs in the powder. Likewise tommee tippee perfect prep machines also mix the formula with a small amount of boiled water to sterilise the powder first before adding the cold water to bring the bottle to the correct temperature for drinking. Because of this we use the powder when at home or at family or friends houses using boiling water to sterilise the powder and then cool the made up bottle to drinking temperature. To begin with if we were out and about we'd always take sterilised empty bottles and the ready mixed milk. But, as DS has gotten older (he's now 9 months) we've relaxed a bit and will make up a couple of bottles at a time at home and store them in the fridge, and if I pop out I will transport the chilled bottle in a cool bag and use it within a couple of hours / store it in a fridge if one's available. But if I'm out without access to a fridge for more than a couple of hours I still use the ready mix. I could be totally wrong and absolutely wouldn't judge anyone for doing things differently, but sterilising the powder seems to be very important from what I've been told and read xx

[mnbex29]

I should add that the nurses also said we should make the bottles as we needed them and not make them up and refrigerate them advance. We did follow that advice to begin with when DS was still in the newborn stage (which lasted a long time for us due to his prematurity ), but as DS got older/bigger/stronger we decided ourselves to relax on that front and store a couple of bottles at a time in the fridge as it wasn't that practical for us to be constantly making them up. But that was our decision and not based on what the nurses advised us

[honeysucklejasmine]

You absolutely should use hot water to sterilise the powder. If it scares you, good. Bacterial infection is scary.

Eggy is absolutely right. The vast majority of formula batches will be absolutely fine, but if it isn't, and you didn't sterilise it...

It's especially a pain after six months as obviously they can drink tap water, but still need to have the whole sterilising routine done for their bottles. Feels so frustrating, but it's for a good reason. I'd rather carry a small thermos flask than risk a sick baby.

[BastardBernie]

I sterilised for a year

[mnbex29]

Also, the nurses did say to let the boiled water cool for a while but not longer than 30 mins...I presumed this was so you didn't burn yourself on the steam, but seeing a post further up this page, maybe it's so you don't destroy the vitamins?! Anyhow, we've always boiled the kettle, then set a timer for 25 mins then made up the bottle. So when I say boiling water in my posts I mean boiled water that's cooled for 25 mins! Argh, it's a minefield!

[TheDisillusionedAnarchist]

Not only that but it needs to be a litre of water. If you boil say 500mls and leave it to cool for 30 mins your water will be too cold to kill bacteria.

I do think the legacy of a generation of 'we can't talk about formula' among health professionals is that knowledge of how to prepare formula safely is not being passed on, putting a lot of babies at risk. E. coli and salmonella are the low risk bacteria in formula, the real risk is cronobacter sakazakii which causes meningitis with a frighteningly high death rate. It is much more of a risk for preterm or low birth weight babies and newborns. There is a move to suggest only ready to feed for the first three months.

At the moment the safest way (after ready to feed) is to make up each bottle one at a time with water over 70 degrees (1 litre cooled for no more than 30 mins) second safest make them up this way, flash cool and take them out in a cool bag for up to four hours.

[MyBreadIsEggy]

mnbex29 it could also be so people don't end up doing what I did several times in a sleep deprived daze:
Make the bottle up with boiling water, forget that boiling water + steam takes up more space in a bottle, shake it up, have the lid explode off the top due to the pressure inside and spray half the kitchen with formula oops

[mnbex29]

MyBreadIsEggy Eak, not fun when half asleep!! DS now sleeps through the night without a feed but I always have an emergency bottle of ready mix and sterilised bottle on hand just incase he does ever decide he wants a feed in the night to avoid half asleep bottle making! Just reading the packet of Aptimil now while cooking tea and it does say 'Boil 1 litre of fresh water. Leave kettle to cool for 30 minutes and no longer', I presume this is for all the reasons discussed above xx

[mnbex29]

Anarchist, I agree there is definitely a culture of not talking about formula as all the focus is on EBF. Don't get me wrong, I think EBF is an amazing thing to do and it's great that there are BF support groups out there. But, there seems to be little understanding that there are many mums who can't EBF for various reasons and no support to help them formula feed safely or to support their mental health if they wanted to EBF but couldn't xx

[honeysucklejasmine]

Absolutely Bex. I take a medication that is incompatible with breastfeeding, so was always going to need to bottle feed eventually. (I can skip medication for a few weeks before I feel ill) But no-one showed me how to do it or talked to me about bottles etc. Its all from my own research.

I remember the excitement when we realised we could sterilise a bottle just before going to bed, take it upstairs with us, and it would still be sterile a few hours later when dd awoke. We were thrilled. Pour in ready to feed milk, and done! We had been going down to sterilise, letting bottle cool then pouring out RTF milk, all whilst she was awake

RTF made her reflux crappy though, so switched to powder.

[MatildaOfTuscany]

Eggy is absolutely right - the dangerous bugs are in the milk powder, not the water. The water should (ideally) be 70 degrees C, hot enough to kill the bugs, but not so hot that it denatures the proteins in the milk.

There is a small, but statistically significant, difference in the incidence of gut infections between formula fed and breast fed babies, and this is down to problems with infections picked up from incorrectly prepared formula. Yes, it's very rare for a baby to get e-coli, or the like, but the risk is there. This is not scaremongering, it's simply reporting accurately the scientific facts (and I'm not banging the drum for BF, either - I FF from 8 weeks).

OP - as a compromise, could you use cartons when out and about, then make up bottles at home? One trick( I only discovered way after DS was onto cow's milk) is to put, say, 60ml of boiled water into the bottle and leave in the fridge, then top up to the 200ml mark with freshly boiled water when needed - instant water at exactly 70 degrees to which you can add powder, no need to wait half an hour for the kettle to cool.