new guidelines on making up feeds- what do you do in the night?

[hungryhorse]

I have read the new DoH guidelines on making up feeds fresh each time... and am I right in thinking that the most important thing is to make sure you add the formula to HOT water not previously boiled cool water?

Can anyone tell me their experiences of following these new guidelines and how practical they are in the night or when out and about?

Thanks.

bump

Am past all this with feeding now but didn't want to leave post unanswered. What are the new DoH guidelines?

When I made feeds up for DS (a good 18mths ago now) I used to boil the water, leave it to cool for about 10 mins in the kettle, stick in the bottles and store in fridge. When needed a feed for DS, would heat the sterile water up in microwave to warm and add formula. I found that adding the formula to just boiled water gave DS more gas - formula isn't meant to be added to boiling water as far as I recall

Now they are saying you boil the water, let it cool to 70 degrees (it has to be hot still and not drinkable) then add the formula. You mustn't add the formula to cool boiled water as apparently t is the act of adding the formula to hot water which kills any bacteria there may be in the formula.

With my first I used to take out with me bottles of cooled boiled water and add the formula when it was feeding time- but we are being told now this is wrong.

What you are now supposed to do if you go out is make up a flask of boiled hot water and take that out with you... then when you are out you make up fresh feeds with the hot water and then find somewhere to cool it down.

I am due in 5 weeks and don't think I am going to follow these strictly.

I wish they would make up their minds about the rules! I thought I could make up all the feeds in one go when I first started ff but the HV nearly had a rainbow coloured fit at me storing made up feeds in the fridge, but following the new guidelines, if you make then in advance with water that has been cooled to 70 degrees and it kills the bugs, then what's the problem with that to start with??!!

I think for out and about, have you considered the cartons? Yes, they are a little on the pricey side but you can just give them right out of the carton and no faffing with heating.

well 4 years ago I made up 6 feeds with boiled water straight from the kettle .. presumably killing all bacteria

and then stored them in the fridge for up to 24 hours

I know the new guidlines say you shouldnt do this any more..

but i'm well confused if its because formual isnt sterile then surely if you kill the bacteria at point of make up and keep it chilled there after.what harm does it do ???

Fraser's Mummy - join me in the confused camp! I can remember my mum - of the make 'em up in the morning for the rest of the day generation - rolling her eyes behind the health visitor when she was freaking out at my suggestion of making them up in advance...

I actually think its a plot to make new motherhood as hard as poss so we don't do it again thus saving Govt money in Child Benefit and the £250 voucher thingy...

That's why I forced myself to breastfeed with this one! Would be a nightmare to have to go heat up a bottle in the night with a screaming baby wouldn't it? And the whole wait-30-mins-after-boiling then wait-til-it's-cool-enough is surely impossible for anyone with a life? Babies don't work like that!

Can you put fresh boiled water in a thermos flask to keep it hot through the night? That seems like the only option if you're going to follow the guidlines.

Just read that you're not gonna follow the rules strictly. I didn't follow them at all. I put water in bottles, cooled them quickly in the freezer, stored them in the fridge, added powder when cold and put them in the microwave.

I used to have formula measured into an Avent measurey thing(!), a flask of boiling water, a sterilised bottle, and a bottle of cooled boiled water (need a big bedside table!)

Put 4 oz hot water from flask in empty bottle, add 7 scoops formula, shake, add 3 oz cooled boiled water, shake and should be ready to drink straight away.

i realise this makes me a slattern, but DS was bottlefed and didn't get ill on this.

boiled a kettle in the morning, poured water into his day bottles, let it cool to room temp and added formula as needed. he was happy to have it room temp. did another kettle in the evening and took everything up on a tray.

i suspect the bacteria are a theoretical risk, like the fact you can't now buy calpol for under 2s in case some moron gives a child a couple of bottles.

Yeah smitten, when I buy medised, they ask me how old the child is and they won't sell it if you say under 2 although the box says from 3 months. Got something to do with the risk of od-ing but surely no-one gives meds without checking the guide first. Mad, hey?

these aren't new rules, they've been in place for three years now at least. there is a very small chance of getting the bacteria but a very big chance of dying if you do. the parents of kids who died in belgium and france didn't knwo they were taking any risk, but they were.

I mix feed so during the night was a bf but on another thread, people have said they use cartons in the middle of the night (don't know what you do if you use Hipp Organic, like we do, as they don't make cartons).

Anyway, when we do bottles, we put the water in the bottle and leave it to cool down then add the powder. We warm the bottle in some hot water. Not what the guidelines say though.

I mix feed so during the night was a bf but on another thread, people have said they use cartons in the middle of the night (don't know what you do if you use Hipp Organic, like we do, as they don't make cartons).

Anyway, when we do bottles, we put the water in the bottle and leave it to cool down then add the powder. We warm the bottle in some hot water. Not what the guidelines say though.

Do you know if I can prepare a bottle of water in the evening and keep it on a side table for night drinking please? I won't be heating it up when my DS wakes up. She is happy with room temperature.

My DD is at nursery so I have to taken in prepared formula at the beginning of the day so I can't follow the guidelines. I boil the kettle, leave it for 30 mins, add the formula to the water and make up the day's bottles. I then make up a fresh one last thing at night for DD to have for breakfast (as of last night as have just stopped mix feeding).

We boil the water & leave it in the kettle for 30 mins before poring it in to a flask. We then make the feeds up from the flask as and when needed. The bottles just need to be put under cold water for a moment to cool it a little.
We take the flask out and about and have never had any problems. It's a bit cumbersome but better that than use the dodgy bottle warmers that I've seen in some baby feeding rooms.
Interestingly (for me anyway) my DS doesn't seem to like the ready made cartons.

Ds is 14 weeks & i boil the kettle, left it 2 cool, poor the water in the bottles & leave them on the side!!! when i need them i then just add the formula! he'll take it any temp but if i want it warm i just poor a little away & top up with freshly boiled!! my cousin, sil & most of my friends have done this! i know its against the guidelines but if u're demand feeding & your baby is screaming 2 fed u don't have half an hour 2 make it up fresh & as the guidelines also state that any unused made up milk should b discarded after 1hr u can't make it up in advance!!!

Yes thank you everyone...
as I said with my first I added the formula to cooled (room temperature) boiled water...

but now it seems that its VERY important to add the formula to HOT water, as it is the act of adding to HOT water which kills any bacteria.

So will either use a flask or make up bottles completely (as in water and formula) in advance and store in fridge. Not 6 at a time like I did with DD, but maybe 1 at a time in advance, and 2 for the night?

Surely this is ok, as long as the formula was added to the hot water?

All this is confusing... I may just have to tell a few fibs to the hv to get her off of my back.

Why fib.

Just say you know what the guidelines are.

You understand that there is a risk of gastroenteritis if you don't follow the guidelines.

But you have made your own risk assessment - and decided to take the risk!

gagarin, there is a risk of more than gastro, though.

I know - but hungryhorse feels she has to fib rather than have a frank exchange of views on the risks involved. And that is a problem IMO.

HCPs need to be absolutely honest about what is being discussed - death of vulnerable babies from severe gastroenteritis - but they also need to make sure that all the information is available so parents can make their own choices.

The Food Standards Agency says...

"While infections due to powdered infant formula milk are rare ? there have been 50-60 known cases in the past 40 years ? they can be severe and the risk is considered to be greatest for pre-term, immuno-compromised and low birth weight infants under the age of two months."

but the DoH offical bottle feeding stuff says (and removes the figures from it's advice)...

"Very young babies are at most risk, and it is better to use commercially sterile,liquid ready-to-feed products for premature or low
birth weight babies."

So I sort of think that it's not easy to have the "how much of a risk is it for my baby?" discussion.

Btw is this what most mums of prem babies do (use liquid formula)? And when do you swap to powdered (made up the correct way of course!)?

The guidelines say that if you cannot make up bottles fresh each time, say for example you have to take baby to nursery with prepared feeds, then it is ok to make up bottle- hot water and formula, cool it down, put in fridge and keep it that way.... then when travelling keep it in a coolbag with icepack until you can put it in fridge again.

So that is what makes me think it is better to store in fridge than to go out with cooled boiled water and then add the formula (as that is what other expecting parents have told me they are planning to do). I completely understand the research and the importance of following the guidelines, I am not dismissing them or saying- "ooh we never knew that before it won't do my baby any harm this time"...

its just that I know that at 3 o clock in the morning when baby wakes up, there is no way 'm going to start making up a fresh bottle, or that baby should have to wait for his feed.

Or say baby wants a feed when I'm on a bus... its no good having a flask of hot water, because I wouldn't be able to cool it down?!? Ok the likelihood of this happening is rare but still... I'd rather have a bottle made up stored in a cool bag with ice to be able to give to baby on demand?

By the way I am planning on breastfeeding, but incase it doesn't work out, I wanted to see what everybody else does.

of course it depends how far you're goiing and how long you'll be out, but i used to labour the point a little with dd1 and fill a bottle with boiling water and stick one of the tommee tippee powder dispensers into the neck of the bottle (and hope most unscientifically that this might have some effect on the bugs, given that they were at least submerged in boiling water).

then i'd mix it up later on. if on a bus i'd be forced to risk it, i suppose, but actually if you're in a cafe you just ask them for a cup of boiling water and then pour some into your now-cool water until it feels like the right temp, then pour off the excess and add the powder. chances of you feeding on a bus v slim ime.