help with making up powdered formula

[goblinmum]

Hi - I'm new to all this and want some advice. Older books and my mum's generation were happy to wash bottles scrupulously, sterilise then make up 24 hours worth of formula and store in the fridge. Current advice however is to make up each feed as and when. This is crazily time consuming! Also, the health visitors say "feed on demand", so you have to know (psychic, anyone) 30 minutes before hand that your baby will want feed to get everything ready. Is the NHS going over the top with its advice in case one baby gets gastroenteritis and they get sued, or will I poison DS if I make bottles in advance? (Or is it like the advice on alcohol, they think mums are too stupid to know the difference between a small glass of wine and a 10 pint bender, and similarly, if told they could make up formula in advance would make up a week's supply at one go!)

Incidentally, I BF for 8 weeks before impending starvation and doctor's advice had me switch - and I can't tell you how much of a relief it was for both of us (also a big relief to have a health care professional admit honestly that some women just don't produce enough milk, and no amount of relaxation tapes, baby moons etc. etc. are going to change your underlying physiology).

Thanks,
Goblinmum

Lots of threads on this, Goblin, which are still live (ie in the list in the folder) and they include discussion on why the guidance is as it is (it's not gastro-enteritis that is the issue, but more serious, though rare, conditions) and also discussion on the practicalities of what you can do to prepare in advance - it should help.

I childmind a baby and his mum sends bottles of cooled boiled water and i add the milk powder when he's hungry. She has a little pot with compartments in and adds the correct amount of powder to each compartment. All i have to do is tip it in and give the bottle a shake.

Some babies have died from infections that they got from milk powder. As no one wants a baby to die from a preventable cause, the 'new' (issued in 2005) guidance was issued as it removed the risk from using non sterile milk powder.

It is, of course, your choice as to whether you follow this, or take the small, but known, risk.

You don't need to make a feed up 30 min in advance either - by adding the powder to a smaller amount of freshly boiled water than the feed amount, mixing it, and then adding cold, previously boiled water up to the feed amount (you'll need to experiment a little to get the proportions right depending on the temp of your fridge), you can make a feed up very quickly, and it'll be excatly the right temp with no need to warm it.

Dusty, the guidelines are to use hot water (70 degrees) to kill any bacteria in the milk powder. Powdered milk is not sterile.

Goblinmum, there are a lot of recent threads on this, one of which suggests using a small amount of v. hot water to mix with the formula, then making up to the required volume with pre-boiled cooled water.

x-post.

what Dibbler said.

Tiktok - can I ask your opinion on something? A breastfeeding counsellor that I know says that she is concerned that by making up formula feeds with very hot water this can destroy some of the vitamins and make them deficient in nutrients. What's your take on this?

I don't know about that, Daisy - I can recall the people who make HIPP writing to NCT and saying something about their ingredients not being 'at their best' if the water is above 60 deg C, but I don't know if that is still their position on the topic.

However, the govt advice is based on extensive European testing and research. I couldn't tell you if they compared the nutrient content of each and every formulation in different temps. The thinking behind the 'no cooler than 70 deg C' was to ensure enterobacter sakerzakii was destroyed.

Would be worth a call to the manufacturers, I think. I don't know how frank they would be.

This is one of the areas where there is just a dearth of information - and people need to know!

There are risks attached to all events in life. A woman who is BF could accidentally touch her breasts while her hands were not sterile but the risk is so small that it is not worth worrying about and cannot realistically be prevented. Obviously it's your choice but if you do keep prepared feeds in the fridge, make sure you have a thermometer to check the temp is cold enough. The danger is that when safety guidelines become more and more stringent, this leads not to more safety, but to the guidelines being ignored altogether. At the risk of going round in circles, the Dept of Health advice in 2007 to women in flood affected areas was to use cooled boiled water for formula milk - but our govt. probably think women would use the flood water if they weren't told otherwise.

cyberseraphim, of course there are risks everywhere. But you need to know about them. I didn't know until I saw it on this board, and had to use formula during a nursing strike, that the bugs we are talking about are not just your common everyday ones, but global deadly ones thaty arise partly because of the global market in baby milk production, with traffic in non-sterile powder including a meningitis bug that has actually killed some European babies.

So, yup, a small risk, but not one I'm prepared to mess about with.

I'm sure there will be more of a move towards UHT cartons with pre made formula for those reasons - and that kind of sterilisation will be safer all round.

Thanks for all the replies - and interesting to see my suspicions about the HV's advice (store cold water in the fridge) were right - the milk powder isn't sterile so the resulting milk won't be either. I also had a feeling using water that was too hot might destroy some of the ingredients (the instructions say leave the kettle to cool for 30 minutes, but this seems a bit hit or miss to me - the eventual temp will depend on how much water you put in the kettle in the first place). Maybe I should take the financial hit and just use the UHT cartons instead. Anyway, must go, DS is making snuffling noises and I'm in the reference library!