Should I tell my friend she's making up formula wrong?

[thenameiwantedwastaken]

Hi there. I'm exclusively bf my DD. Noticed one of my friends who formula feeds making up a bottle for her lo when we were out the other day. She added the powder to a bottle of cold water (boiled and cooled, I guess). From what I've read on here I think that's not what current guidelines say and that the safest thing to do is make up the feed with freshly boiled water, so as to kill any germs in the powder?

I didn't say anything at the time as I don't like to tell other mums what to do, have never made a ff myself and guess she is an intelligent woman who has read the instructions on the packet.

But now I keep thinking of her dc getting ill.

How can I broach it?

[AitchTwoToTangOh]

safest thing to do is kill the bacteria, which is what happens when the powder meets water at >70degs.

[AitchTwoToTangOh]

safest thing to do is kill the bacteria, which is what happens when the powder meets water at >70degs.

[Jael]

I'm still confused So back in 2006 with DD boiling the kettle, letting it cool making all the feeds up in one go and NOT reheating them again, just letting her have them stright from the fridge, was "wrong". I'm trying to understand, really, crying baby hasn't allowed me to have much sleep You're boiling the kettle and adding the formula, right. Is it all about getting the temperature of the water correct so the baby can drink it straight away, and so the bacteria in the formula is still killed? I think I leave my kettle cooling longer than 30 minutes...

TikTok I'm very sorry, I don't understand, what was wrong with boiling the kettle, leaving it, adding formula, as long as you don't reheat any of the feeds again? If that bottle is then put in the fridge, and taken out and fed to the baby several hours later, is it not ok? Will that still make the baby poorly? Gosh I wish I'd known this with DD.

[AitchTwoToTangOh]

oh yes, i think you'd have to be careful and like i say, i never had a problem with just heating it in the micro for a while. it's just that i did think that was interesting, that info was new to me about the refrigeration, adn quite comforting really.

[verylittlecarrot]

Perhaps, Aitch, but you'd have to be sure of a. the overall temp of the formula once the refridgerated water was mixed with a portion of room temperature powder - what would that bring the overall solution up to? and b. The steady rise in temp as soon as the mixed up solution left the fridge to be consumed. How long does it take a baby to drink a bottle? (no idea) and after how long does the temperature rise to room temperature and begin to allow the bacteria to proliferate quite fast?

I've no clue about the answers to these questions, but I can see why the 'failsafe' guidance has been issued.

Probably the risk is very very low, but I bet it still exists. The mortality rate is horrifying. Not just a tummy upset being risked.

[tiktok]

Yes, think you're right, Aitch....was just trying to shoehorn Jael's suggestions into UK guidelines

[AitchTwoToTangOh]

v=By tiktok on Mon 21-Sep-09 10:47:37
This is a Canadian study, quite old, but as far as I know has been replicated elsewhere. Mortality rate is 50 to 75 per cent if a baby gets this bug.

Incidence, survival, and growth of Enterobacter sakazakii in infant formula

Author(s): NazarowecWhite M, Farber JM
Source: JOURNAL OF FOOD PROTECTION Volume: 60 Issue: 3 Pages: 226-230 Published: MAR 1997

Abstract: Enterobacter sakazakii has been implicated in a severe form of neonatal meningitis, Although studies have failed to identify an environmental source for the organism, dried infant formula has been implicated in outbreaks and sporadic cases of E. sakazakii meningitis. The high mortality rate (50 to 75%), the severity of the infection in infants, and the lack of information on the incidence, survival, and growth of E. sakazakii in foods led to this study. Experiments were undertaken to determine the incidence of E. sakazakii in dried infant formula, the temperature range for growth, and the growth characteristics of E. sakazakii in reconstituted dried infant formula. Strains of E. sakazakii were isolated from dried infant formula available on the Canadian retail market. The prevalence varied from 0 to 12% in samples from five different companies. For both clinical and food isolates, minimum growth temperatures of 5.5 to 8.0 degrees C were observed by using a temperature-gradient incubator. The potential growth of E. sakazakii was followed by using a mixture of food and clinical isolates in three different formulas incubated at 4, 10, and 23 degrees C. Average generation times were 40 min at 23 degrees C and 4.98 h at 10 degrees C. E. sakazakii strains did not grow at 4 degrees C and began to die off during storage at this temperature. The results of this study stress the importance of using aseptic methods and proper temperature control in the preparation, use, and storage of dried infant formula.

that canadian study seems to indicate that you might not have to make it up with hot water, though, doesn't it? so long as it's kept in the fridge immediately and never warmed? although some powders don't like that, granted.

[tiktok]

Jael: that's a reasonable work round, yes...but water you add the formula powder to has to be no less than 70 deg C so it's not 'cool boiled water'. 70 deg C is still hot.

[Jael]

When my DD was born in 2006 I used to make all her feeds up in one go, I didn't get told by my HV to make them any differently I never used to reheat her feeds though, she used to have them straight from the fridge. Would anyone suggest which was better, if you're making feeds up with boiling water, which has cooled, and not reheating it again, rather than adding formula to completely cooled water? I know I'm a little rusty, I thought the main issue was to kill potential bacteria in the formula, if you add the formula into the cool boiled water, and don't reheat the bottle again, shouldn't that be ok?

[AitchTwoToTangOh]

i really don't think it works like that, actually, they did advise for the first couple of days that only children and old people needed it boiled, now that i think of it. surely the swimming pool water is full of piss and chlorine? nowt wrong with that.

[brettgirl2]

Well quite, I would imagine if there was actually a problem it would be safe for no-one.

I guess in the very unlikely event that there was an undetected problem then a tiny baby would be at more risk of being dangerously ill though.

I think what got me thinking is that dd (5 months) tries to drink the water when I take her swimming. I then get home and lovingly boil tap water

[AitchTwoToTangOh]

there have been a couple of episodes of campylobacter rising to unsafe levels in our local reservoir, to the degree that we were ALL told to drink boiled or bottled water, so again it's not a risk i would take with a wee baby. i did stop boiling at 6 months, though, with fingers crossed.

[tiktok]

Sorry, brettgirl, I don't know.

My common sense guess is that in the UK this would be a small risk, as our water is good, but if you have mucky taps you'd need to let the water run out a bit first....but don't quote me on that, as it is something out of my head only!

[brettgirl2]

OK Tiktok/other in know another question - what is the risk of giving babies under 6 months unboiled tap water (either to dilute formula made at more than 70 or to drink)

Not that I have done it but it is something that I have frequently wondered whether or not it is necessary.

[tiktok]

One of the big misunderstandings seems to be the idea you always have to wait 30 mins.

YOU DON'T HAVE TO !

This is the max. time to leave the water before mixing with the powder.

Anything up to 30 mins is within the guidance.

It is still too hot to drink, then, of course.

Some parents add cold water after it has been mixed with half quantities of > 70 deg water....you just need to know how much to add and to be accurate about it.

[AitchTwoToTangOh]

grab a thermometer and test it yourself, you'll only have to do it once and then you'll know the measurements, i suppose it could be different for different fridges.

70degs isn't drinkable, so you need a splash of cold in there, then some boiling water, add powder, then top up with the cold for the desired temp. both of mine liked their milk surprisingly hot.

i used to keep boiled water in the fridge and then just heat in the micro (again, you'll have to test it) and add the powder and shake, shake, shake for hot spots.

for out and about, what bottles are you using? if tommee tippee closer to nature, get the little powder dispensers, they are GREAT.

[unyummy]

Oh blimey, so i've just started mixed feeding my new baby after excl breastfeeding last time, i had no idea about this and have been using boiled water kept in fridge til feed needed and then slightly warmed.. can someone very patiently and slowly explain to a bottle feeding novice what the get rounds are - i have just been trying to wade through this thread but its too much!

Can i boil the kettle, add formula and make up with cold boiled water and feed straightaway? How much of each water for a temp that is safe and wont scald the baby?! I'm sorry if this is dense but i cannot see how you can wait for 30 mins for night feeds, my baby screams after 30 seconds.

For out and about, if i sterlise a bottle, put the cap on and take it out empty, and use read made cartons, that's ok, right?

[AitchTwoToTangOh]

there's no need for that, dingdong. but again, i'm utterly baffled as to why making up a feed at >70degs is unreal or unrealistic. it's a doddle.

[dingdong3]

This is the trouble with forums....sometimes difficult to get humour across...or perhaps I am a crap poster!
Not a sneer at all Aitch..sorry you took it that way. Just throughout the whole thread I have been exasperated at unreal govt guidelines. As mentioned earlier, because of these unrealistic guidelines, I fed readymade formula to mine for the early months. In fact, had no idea of the dangers of powdered milk to be quite honest and now glad that they are finished completely with formula and that I am having no more babies.
Am giving up MN posting...it's stressing me out...will just read from now on!

[AitchTwoToTangOh]

no no, i wasn't referring to you, stayingsunny. it's the 'my kids survived' that creeps me out, like i said before.

my grandmother's kids survived car journeys without so much as a seat belt, but in light of changing circumstances and better understanding of what happens in a crash i'd be loathe to employ her advice on the matter now.

i swear to god i hope that if and when i'm someone's grandmother i will be able to respond to the latest research that my dd tells me without snorting with derision about how she survived.

[Stayingsunnygirl]

I wasn't trying to belittle, Aitch - just a humourous aside to tiktok, alluding to the fondant fancies and battenburgs she was dodging.

[AitchTwoToTangOh]

well of course it's luck, dingdong. it certainly wasn't because you made the safest choices, as you yourself have observed.

i just Do Not Get the resistance here, i find it completely baffling. as it happens, i don't make up feeds 100% correctly all the time, because sometimes i can't be arsed. i accept that about myself, and i accept that there is a risk involved. what i don't do, however, is come on and sneer at people who are only giving the correct information, and belittle that correct information with stupid comments.

[Stayingsunnygirl]

Ahh well, tiktok - Mr Kipling does make exceedingly good formula!!

[tiktok]

The 'leave water to cool for no more than 30 mins' is a work round; obv the length of time water takes to cool to a certain temp (no less than 70 deg C) from boiling depends on ambient atmosphere, volume of water (exhausting school science knowledge now) but it seems to be a sensible sort of time

[dingdong3]

Must be pure luck then that my three survived...off to have a real bun now!