Formula Feeding - conflicting advice from HV & MW

[wilkie50]

My friend's MW has told her that it is safe to make up bottles with colled boiled water, keep them at room temp and just add your formula as you need it. No refridgeration or heating of water required.

I asked my HV about this and she was horrified. She told me that what I was doing was correct (making 6 feeds up at a time and storing them in the fridge then heating them when I need them) and that the other way could make LO poorly.

Question is: how long does cooled boiled water stay sterile and does it need to be ep in the fridge?? I'm really confused.

Reason I ask is that if I go out for the day, it's easier to put bottles of water in my bag if they don't need keeping cold than ready made up feeds.

(Sorry if that all sounds jumbled!!!)

Excuse typos!!! Am very sleep deprived

I have always used cooled boiled water, added formula & then put the bottle in the bottle warmer to reach desired temperature as have many of my Nanny/Maternity Nurse colleagues!

My impression was that it is was the most up to date advice to do what the MW suggested. In Germany this has been the advice for years, and is considered far safer than making up all the feeds in advance.

It makes sense to me as well, I don't think water would breed as many germs as milk could, even in the fridge. And as you say, if you go out it's very difficutl to keep the milk fresh.

I'd go with the HV.

erm, according to the new guidelines, both are wrong !

supposed to make each feed as needed with freshly boiled water , cooled for 40 minutes.......

but i have to say,that i did the cool boiled water, and adding the poweder as neccesary, i kept the water for 12 hours, if not used, i got fresh water. i only heard about the new research when DD was about 10 months old, so i stuck with what i had been doing, as she was moving on to cows milk shortly.

you don;t need to keep the water in the fridge

There are new guidelines just out that go something along the lines of that you need to reheat the milk to very hot and then cool again quickly - uh! I always made up as sterile water, kept it in the fridge, warmed up the water when required (or let it warm up in my bag when I was out and about), add the powder then feed asap. Just makes me glad I b/f most of the time...................it's a nightmare I don't think they actually know what is the safest TBH!

So you are all saying put cooled boiled water into the bottles, don't need to refridgerate them then when I want to use, warm and add formula???

no no no to heating the milk very hot ! must not do that, kills whatever nutrients are in the milk.....freshly boiled and then cooled water to make each individual feed

nfant formula powder is not sterile; the risks associated with using powdered infant formula milk are reduced if:
have a look at this
Latest UK Gov advice is

• feeds are made up using boiled water that is greater than 70ºC; in practice, this means using water that has been left to cool for no more than half an hour
• feeds are made up fresh for each feed; storing made up formula milk may increase the chance of a baby becoming ill and should be avoided
• any left over milk is thrown away mothers, who require a feed for later, are advised to keep water they have just boiled in a sealed flask and make up fresh formula milk when needed or use a liquid ready-to-feed formula* the temperature of the feed should be tested and, if required, cooled by holding the bottle, with the cap covering the teat, under cold running water

ooops sorry that was a bit jumbled up

Actually no we are saying that the proper guidelines are to make them up individually as required. I personally think second safest is to make up the cooled boiled approach but yes I would keep it in the fridge whenever possible as still germs would breed slower at cold temp than room temp.

I think to be honest you need to stop worrying about which is safest and just do what you consider to be safe enough and within the bounds of reason. You cannot boil the kettle and wait 40 minutes for it to cool when your 5 day old is hysterical with hunger. It may be the safest thing, but it is absurd.

Cool boiled water is sterile for 24hours in the fridge & it also means you can take a bottle of water in your bag which you may not need to use until several hours later unlike carrying a made up bottle.

agree colditz, i think on balance, the water in the bottle, tehn adding the powder as and when is ok...

sorry I have got confused somewhere along the line!

wilkie, I boil the water and put into sterilised bottles every night, measure the powder into a dispenser, then use them the next day by shaking the powder in as and when I need it. So () the last feed at night is with water that was boiled 24 hours earlier. Did this with both DS1 and 2 and neither has been ill at all - but did bf both exclusively for the first 6 (DS1) and 4 months (DS2), so maybe it's most important when they are really tiny?

Of course, to avoid this issue altogther, you could buy ready made up formula in 7oz packs to take out and about (but this is expensive..).

I'm not quite sure how you can make each feed up as needed if you have to leave it to cool for 40 mins.... Can't really respond quickly to LO's needs then, can you?!?!

Totally agree Colditz - do these people that produce 'guidelines' actually have children???!!!

Thanks for info - I'm not so worried about when I am at home and have my fridge nearby...it is more about when I am in town or out and about, I do have one of those bottle bags to keep the milk cool but think it is much easier just to keep the sterile water in my bag to which I can just add powder.

What did they do 50 year ago eh without 'guidelines' My Grandma thinks it is all quite hilarious.

CLairemow - have got some ready made formula in (7oz cartons SMA Gold) but when my LO was poorly in hospital at 10 days old they gave me the same thing and he didn't like it as much as the powdered version.

50 years ago they would have been too busy washing clothes in a twin tub to leave the house for more than an hour with a small child!

ScottishThistle -

You don't have to wait for 40 minutes after boiling the kettle, you can used water that's just been boiled to make the milk and then cool it down in cold water to feeding-temperature. The point is that you shouldn't leave boiled water more than 30-40 minutes or it will be too cool to kill any bugs in the formula milk.

Heating formula milk too much doesn't alter the nutritional content - it may denature some of the proteins, but this will happen during digestion anyway. It's different for breast milk as the antibodies and enzymes will be destroyed if the milk is overheated.

hello wilkie (my fellow jan bud!) i was told to make each feed as required like I was going to do that so I boil water put in steile bottles and add formula when needed, its good at night as dd2 will take the bottle without having to warm it up as its already at room temp (& I don't have to trapse downstairs )

Although when I had dd1 2.5 years ago was told to make bottles with cool boiled water add formula and store in fridge (although not in the door of fridge as not cold enough).

So far neither have had any major tummy upsets just the normal ones so don't really think its made much difference

HTH

I've done all 3 (made feeds up in advance and keep in fridge, made up as required with cool boiled water and made up with freshly boiled water cooled under tap) and neither of my 2 dses had gastroenteritis. So I wouldn't worry too much as long as you are sensible. I think making the feeds up in advance is the least safe option though.