Making up formula feeds.

[srh96]

Why do people not understand that formula powder has to me mixed with boiling water (above 70 degrees celsius) in order to sterilise the formula powder?

Or do people know but choose not to do it because it's inconvenient?

Is it the NHS's fault for not discussing formula feeding enough?

I'm a midwife, any woman who I discharge from hospital who is formula feeding her baby leaves with this information (and other info around making up formula feeds and sterilising etc).

I'm just trying to understand. So many people don't seem to get it, I see it on mumsnet and in real life all the time. I say something like 'when preparing the formula you need to sterilise the formula powder by mixing it with boiling water, then allow the formula to cool to a drinkable temperature for baby' and am met my shock or surprise. They have usually done other research on formula feeding so aren't completely clueless, but it's the vital part of adding it to boiling water that comes as a shock.

It might just be me, but it's an almost daily occurrence. I don't mind educating, that's literally my job, I enjoy it, I just don't understand why it's not known about more.

I was hell bent on bf, knew nothing about ff at all, didn't even own a bottle. I had a major haemorrhage and it stopped my supply of milk to the extent that none EVER came in. I was clueless about ff and all I did was read the back of the box of formula. Problem solved.

It seems much more common practice in America. It's possible that people are reading info that is US specific, and not realising that we have different guidelines here. For example, making up a large jug of formula each day to keep in the fridge seems quite a common practice in the US.

I have a perfect prep machine that dispenses a hot water shot for each bottle. It doesn't appear that perfect preps are all that popular in America. The Baby Brezza machine is more widely used, and that doesn't dispense a shot of hot water to sterilise, yet it's really popular

I agree. I used to work in breastfeeding support. It boggles my mind that it was frowned upon for us to support families to prepare formula, if they chose not to breastfeed or if breastfeeding wasn't working out in case "Baby Friendly" thought we were promoting formula over breast milk.

I did my job because I wanted to help those who wanted to breastfeed succeed. I didn't do the job to try to steamroll those who didn't want to breastfeed to do it anyway.

Dissuading those who genuinely care for the well-being of mothers and babies from sharing impartial, safe, factual information is anything but "baby friendly". I have massive issues with unicef who are fast turning into the ofsted of the postnatal ward. Creating paperwork and fear rather than supporting and informing professionals to do better.

The instructions are really clear on the back of the tin, I think its people either having baby brain, being stupid and not reading it, or relying on outdated advice from much older relatives. Or all 3.

I'm not meaning to grandparent bash with that either, but its true that things were different back in their day, as I get told on a weekly basis from my DMum!

Well I used to do mine by putting boiling water in all the bottles and leaving at room temperature on the side and adding formula when I needed them. Wouldn't be kept over 24 hours obviously but that's what I was advised by my midwife and health visitor....

That was only 2 years ago I was given that advise too.

@BlueberrySugar that's pretty shocking that your midwife and health visitor were sharing such outdated practice.

I'm glad your baby was fine and well, and for the vast majority of babies, no harm would be done, but from time to time contamination occurs in formula production lines, so preparing with hot water is a safety measure that can kill off bacteria that may be lurking.

The chance of getting a contaminated batch is low, but the risk of harm is great.

This is absolutely not a criticism of you - you took advice from professionals. But this is an example of professional training coming up short in all aspects of infant feeding.

People are just idiots 🤷‍♀️🤷‍♀️ it's the only conclusion I can come to. I plan to ff my baby and have looked up bottle prep, there is clear info on the NHS website and indeed on the back of the bloody tub. Yet people keep telling me what they did , which definitely isn't inline with best and safe practice. The mind just boggles

When I had mine we were told to make up multiple bottles with boiling water at a time and store in the fridge reheating as required. Crucially it was with boiling water though. I did breastfeed do information wasn't used

I think it’s two things.

Firstly, people just don’t realise that milk powder could be contaminated/ not sterile. “But it’s a fresh packet” etc. We aren’t used to sterilising food. People probably think it’s just made “non sterile” by adding contaminated water, rather than the powder could be non sterile in the first place.

And secondly, it’s just so massively inconvenient and feels impractical. Having to spend 15 mins actively cooling a freshly prepared bottle in the middle of the night. Carting flasks of 70 degree water around and having to cool bottles on the go. So you look at the “here’s how to do it properly” advice and think “well, that’s clearly unmanageable, what are the short cuts” and then everyone says “oh just do it like this it’s fine” and you start compromising.

(I did do it “properly” btw, when I started using bottles, but these were the things that surprised me, and I def didn’t realise that the powder could be non sterile.)

Honestly, you want to know why people don't make formula as advised? Because it's an absolute ballache.

I know that sounds awful because it literally is putting baby's health at risk but to make up a feed fresh with boiling water and waiting half hour to cool down and then cooling to drinkable temperature while your baby is screaming in hunger is just not practical for any mum that wants to preserve any semblance of sanity.

That's why the perfect prep and brezza machines were invented.

And the guidelines have changed so many times over so many years and it does make you question things because people think it was OK x amount of years ago so why isn't it OK now.

I had a baby 13 years ago and 4 weeks ago. It's VASTLY different now to then. Being honest, and I'll take a flaming here, if I didn't have a perfect prep now I'd probably just make a batch of bottles and store in fridge knowing full well it's against guidelines but some risks outweigh the benefits and there's no way on a practical level that I'd have time or patience to make bottles "properly". 13 years ago i made batches and stored in fridge. When DS was born 10 years ago, I kept boiled water in sterilised bottles on the kitchen counter at room temp, warmed to drinking temp and added formula as and when required. 4 years ago for my next DD, and for my newest DS who is 4 weeks old, I had/have the perfect prep.

So to answer your question, we leave the hospital armed with the guidelines. We read the instructions on the cartons of formula and we come to our own conclusions and do things the way that's easiest for us.

People aren't "idiots" or "stupid", although the judgement on this thread is strong. There is another active thread that shows exactly what the issue is: www.mumsnet.com/Talk/breast_and_bottle_feeding/4348735-Struggling-to-keep-up-with-night-feeds How many mums with a baby screaming for 30mins at 3am wouldn't look for advice on how to make up bottles more quickly and although well-meaning, that advice might not come from the best sources.

I am combi feeding after my baby was very poorly in NICU / SCBU - it took a long time for my supply to start and still isnt sufficient for baby to EBF. We were lucky in that our NCT class had covered both breast and formula feeding in detail (although that didnt stop me having a tremendous amount of guilt about not being able to EBF). But without those antenatal classes, we would have had no advice about ff, because at every appt we diligently said "oh yes, we are planning to EBF". I think pp are right that there needs to be more open conversations about ff safely without undermining the messaging around breastfeeding so that people are informed before baby comes along.

In France, you are advised to fill the bottle with the required amount of tap water or bottled water, then add the formula and shake! No need to heat the bottle if you are using room temperature water. They don't sterilise their bottles either. French babies seem to survive...

Just to be clear I don't think that parents are stupid, or idiots. Not at all! This thread is NOT parent bashing.

@dannydyerismydad I couldn't agree more. 'Ofsted of the postnatal ward' couldn't be more accurate!

@HopelesslyHopeful87 I agree with you also. It is a ball ache.

I'd say I'm a pretty common sense practitioner. I believe and agree with the guidelines, however with certain things for example the perfect prep machines, I'll say something like 'we don't recommend them for xyz reason, I can't recommend you use it because of this. However we hear of lots of parents using them with no issues, there are also some parents who use them and do have problems, it's my job to provide you with the information and your job to make an informed decision on what works best for you and your baby'

Yesterday I had this conversation with a para 5 woman, her kids were all under 8. Theres 0 chance she's going home and not using the perfect prep, it will make her life infinitely easier. I know this, but that's her choice to make, I provided her with the info to make her own choice.

I also think not giving BF mums info on AF prep is a mistake. All because of BFI. Darent even utter the word 'bottle' !!!

Because when I finally broke down at 3am and my DH went to the all night Tesco to buy bottles and formula, all I had to go on was the information on the back of the tin and what my mum said in reply to my text message "just make up half a dozen in the morning, pop them in the fridge and warm them when she's hungry".
I got zero support with breast feeding, in hospital or at home and when that failed I got zero help to formula feed 'properly'. And since then all I've had had been judgement and shaming for not persevering with BF.

@Reachersloveinterest sorry you've had a rough time and got so little support

all I had to go on was the information on the back of the tin

The information on the tin says boiling water.. though?

@FTEngineerM

all I had to go on was the information on the back of the tin

The information on the tin says boiling water.. though?

I'm not sure what it said if I'm completely honest. It was 12 years ago now. I was also distressed and exhausted in the early hours of the morning with a screaming baby.

I have said on here before, it must be a country guideline thing though, not the milk manufacture.

If you go on to aptimal.de for example and look at the German guidelines for now to make a bottle it’s very different and it’s exactly the same product.
It basically says 40 degrees max. And that’s what they do in hospital

@HopelesslyHopeful87 if you look on nhs website it does say if you have too you can store in the fridge, I do this and my baby is 6 weeks old and just fine!! It says best to make them up in advance but just so you know you can do it as nhs says fine to do so

@Reachersloveinterest

Because when I finally broke down at 3am and my DH went to the all night Tesco to buy bottles and formula, all I had to go on was the information on the back of the tin and what my mum said in reply to my text message "just make up half a dozen in the morning, pop them in the fridge and warm them when she's hungry". I got zero support with breast feeding, in hospital or at home and when that failed I got zero help to formula feed 'properly'. And since then all I've had had been judgement and shaming for not persevering with BF.

Make them up girl, you're allowed!!! Nhs website says you can do this however it's best to make up fresh (I don't though I store and my baby is fine!!)

Because HV or midwives seem completely unwilling or unable to give decent FF advice. If they’ll engage on the subject at all it’s usually just to suggest expensive ready made formula or making every feed from scratch which is ridiculous because who is going to wait with a screaming baby for 45 minutes whilst the bottle cools to drinking temperature. They can’t recommend the perfect prep, can’t suggest any practical alternative, it’s really frustrating and you inevitably look for ways to cut corners. That usually means cracking on with the PP even though the MW can’t recommend it or asking your mum what she did with you and your siblings. It’s also really easy to dismiss the NHS recommendation for hot water as OTT when most other western counties including France, Australia and the US don’t feel it’s necessary.

Knowing this put me off formula feeding tbh - it seemed like such a pain in the arse to go through all that when a baby was crying for a feed.

When breastfeeding wasn’t working out and I was sobbing in a corner as someone else fed my tiny DS a bottle of ready-made formula, it still seemed like a pain in the arse. We spent a crazy amount of money on ready-made cartons until my anxiety relieved enough that I was confident I could anticipate and prep a feed shortly before DS wanted one (about five months iirc) and had the time and brain space to make up bottles with 70deg water, cool them and fridge them. There is absolutely no way I could have done that competently with a newborn and I’m in awe of anyone that could and never slipped up.

@LakeShoreD not unwilling, but somewhat unable. If you're wanting to breast feed, we won't discuss formula as we aren't allowed due to the unicef baby friendly initiative.

If you're wanting to artificially feed then you should be advised and supported of course! We can only advise what we're allowed to advise. So maybe you don't think the advice we can give is decent, I'm sure plenty of people would agree with you.

I don't really know what the answer is. We want feeding to be doable and manageable for parents but we also want what's best and safest for babies.