really cross about lack of info on Bottle feeding

[carbooty]

I had my DS 2 nearly 3 weeks ago, and not being able to breast feed was sure I would get the help and advice I would need to safely bottle feed. But have been really saddened at how little info there is about how to bottle feed.

I have found it very frustrating trying to work out the best way of doing it. And haven't really found any support with information on what is right/safe or not.

We are sterilising, then filling four bottles of freshly boiled water to aquired amount. Then leaving them out on the side until required, by which time the water has cooled. We then just add the powder and give to baby at room temp, which he doesn't mind.

Is this okay??

Hi,

I think it says that you ideally should make the feed up as you need it, but if you have to, the latest guidelines also suggest that the next best thing is to make the feeds up with water above 70 degrees C and then cool them and store in the fridge, but for only 24 hours maximum. Then, the extremely hot water will have killed off the bugs and as long as you use a sterile bottle it should be ok.

And yes, I do agree that if someone is actually FFing as they leave the hospital then there's no reason why they can't explain how to prepare a feed safely.

NHS has a booklet doesnt it? And it says on the tin? I know everyone in nursery got a booklet recently.

The reasons guidelines change is that newer and clearer research comes out which recommends change. If recommendations didnt change mums would still be taking thalidomide.

Yes, you can buy 'Ready Made Milk' for 1st milk, only not at the moment (in London) because there is a supply problem from the factory meaning that there is no Cow & Gate or Aptamil (made by the same people) in my local shops.

I'm not sure you can get Nutramigen ready made though.

The reason why the guidelines changed was because a small number of babies developed infections from the non sterile powder. It is a tiny risk though.

The water is supposed to be at 70 degrees or more so as to kill any infection. But it doesn't kill everything which is why they also say make each feed fresh - milk is a good culture medium for bacteria.

It is a complete PITA though and takes ages to cool.

The easiest way to do it is to pre sterilize your bottles and put them together - they are fine for 24 hrs. Fill another bottle with boiled water and keep that in the fridge.

When you need a feed, boil the kettle and pour one or two ounces into an empty bottle. Add the scoops of powder to this - therefore adding it to hot water. Then add the rest of the required water from the bottle in the fridge. Then it is cooled and ready at the right temperature. Just one important thing - add the right amount of water from the bottle. eg if you need a seven ounce bottle, and used two of boiling water you need to make sure you add a full five of cold. This is NOT the same as just making it up to seven on the bottle as the powder takes up a bit of room and if you measure it only up the mark you will be putting a bit too little water.

So finally..is it okay to make up some bottles and put them in the fridge?? Then reheat in Microwave for a few seconds?

My little lad is very impatient and wants a bottle as soon as he wakes, he screams until he is fed. So with this in mind what is the safest quickest way of doing feeds?

Not the microwave as this heats with hot spots.

I use a thermos glass (the starbucks thermos is excellent) with immediately boiled water (5 mins tops - even faster if you're in Starbucks and they give you the really hot hot water - don't know why their water is hotter than my kettle and don't care, it just works)

So...
bottle + 2 ounces boiled water + formula powder
Add extra ounces of water from your fridge stash
shake/ mix
pop into thermos flask with hot boiled water to heat
then serve

then wash, sterlise and begin again
I can't believe people think this is the easy option!

The ready made milk isn't available for every brand and doesn't come in the right size cartons (always a bit left over or not enough for the dose you want to serve)

Jimbobs' way is probably the best way to combine safety and speed. Just be very careful with the measurements of the cold water.

Your DS is unlikely to come to any harm from making bottles and leaving them in the fridge - the risk is very small, but it is a real risk and one that parents should be made aware of. Otherwise its not possible to make an informed decision.

If you do decide to make bottles to keep in the fridge, use freshly boiled water to mix the formula, cool them as fast as you can, and make sure they are in the coolest part of the fridge.

Thanks for the help ladies,

My DP has just read the Nutramigen tin and it states let the water cool to room temp before using. Now I am really fed up - Think I will call them on Monday and challenge it!!

There may be an issue with some specialist feeds such a Nutramigen if adding boiling water might damage the components. You might be best checking that with the manufacturer.

But if they say cool it, then at least you'll be fine to make all the bottles up with water in advance!

By the way there is no need to warm up feeds - they are fine to give cold, room temp or warm. Get your baby used to havinga variety then you won't have a problem if you ever can;t warm it. Plus you don't have to bother warming it in the night, just give it as it is!

But if you do warm it I can't see any reason at all not to do it in the microwave - theoretically there might be uneven heating but all you have to do to get round that is give it a good shake, surely?

I googled for Nutramigen instructions and could only find US sites/information. I don't know if the instructions to let water cool is because US official guidance is different, or because US legislation allows manufacturers to put what they like on the packs regardless of best practice/official guidance, or because Nutramigen actually needs cooled water for some reason as jimbobsmummy said.

Probably best to phone them and explain exactly what you need to know.

imo the best thing to do is boil water and fill bottles once a day, then nuke the water in the micro (you'll have to use a thermometer once to see how long it takes to get to 70degs) then add the powder which will bring down the temp to about drinkable (esp if you keep the powder in the fridge) or run under tap for a few secs if it needs more cooling.

if you do it that way you get the best of all worlds, it's pre-boiled, quick, cool enough (more or less) and there's no time for bacteria to develop while it sits round cooling somewhere. plus, you will never forget to shake the bottle well as you've just added powder to it. whereas you might if you're nuking made up milk.

oh, and yabu, tbh, the instructions are on the box. the manufacturer can't tell you another way, they'd get their arses sued if your baby got sick. that's what happens when you buy a commercial product, and milk is just another product. it might be the making of your baby, but the manufacturers don't care much either way.

this thread has some information that the OP got direct from the manufacturers of Nutramigen about making it up. HTH

Hi All,

And thanks for all th info. I called and spoke to a lady from the Nutramigen helpline today to clarify the advice on temps when making up formula. And she said they are in the process of changing their packaging to reflect the 70deg guideline from the DOH. So there you have it, you should be making up all formula including specialist formula with water at 70degs.

So now I am sterilising my bottles, making them up empty ready for when I need them. Boiling the kettle, making up the feed and putting in cold water for about 5 minutes to cool down. Not as convienient or quick but rather this than the chance I could make my baby poorly.

I too had set my heart on breastfeeding and was distraught when it turned out not to be possible with my first baby. I felt terribly guilty and upset about it. It didn't help that everywhere you look there are posters and leaflets advertising "breast is best". I found it hard to get information and support on bottle feeding. People think that if you bottle feed then you have chosen not to breastfeed. But many mums don't have a choice as they are unable to breastfeed for various reasons. I wish bottle feeding was more acceptable and people were more understanding and supportive.