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?

I don't think it's that many people don't follow the guideline, it is just that they change all the dam time. 7 years ago when ds was a baby, it was all cooled, boiled water to make up feeds (and then shove a days worth in the fridge), even when he was in SCBU, that's what the nurses did. Weaning at 16 weeks was the norm etc. This thread is the first I time I have heard that you 'should' make up feeds with boiling water!

If I had another baby, tbh, I would probably do everything the same way as I did with ds and stuff the 'guidelines'. Lord knows that by the time I get around to having another one they will have changed again anyway.

On my HIPP ORGANIQUE formula can it says:
Pour boiled tap water or mineral water at the 40 degres maximum.
Add powder.
Shake.
Check it's not too hot.
So, 40 degrees is obviously not enough to kill any germs. We're in France, but I don't think HIPP is trying to poison French babies and get sued? So what's the answer to that?

I'm definitely surprised at that, winnybella, since on the mineral water bottles, it usually says not to be used for babies. I think this is all supposed to confuse parents and cover companies' backsides.

I'm working on the premise that babies are designed to stay alive (as are we all) and so the common sense approach is best. I plan to use boiling water + formula + cooled boiled water for DS when he turns up. I expect him to survive having me for a mum.

Here's some info.

Guidelines do not change all the time.
The guidelines on making up formula have changed once, after decades.
The guidlines on weaning have changed once, in decades, from 4-6 months to 6 mths (they never were 16 weeks, though individual HVs may have got this wrong), in 2003.

The formula making up guidelines came from the European Science and Nutrition Council (may have got that name slightly wrong - haven't checked) after studies done on powder and a number of outbreaks, plus a handful of fatalities. Manufacturers massively resisted changing their own instructions until very recently. It has nothing to do with wanting to avoid being sued.
Packaged baby foods do not have the same bacteria as powdered formula, and thus they have a different risk. The risks with powdered formula are salmonella and enterobacter sakersakii. The risks and incidence of both are in studies, and can be accessed if you have access to journals.

Oh...some mineral waters are ok, some are not. Depends on the minerals....high sodium would not be good, for example.

Tiktok Yes, not all mineral waters are suitable for babies and here in France it says on the bottle whether they are or not.
I still don't understand why a renowned brand such as Hipp not specify a need for using hot water for the preparation of formula. I mean, if I do as they say and use cold water and my baby gets seriously sick, they would be held accountable and liable to huge lawsuits?
I will check on the health ministry site whether there are any specific guidelines and will post here later, but I don't remember midwives mentioning anything about a need for hot water during birth preparation classes. But, here they tell you NOT to sterilize, so maybe it's just a different attitude.
And I get the difference between, say, pureed banana and milk in terms of potential bacteria etc., but that was not what I was asking. If those guidelines are pan-European, then surely manufactures would have to conform here in France?

I think if you use the feed immediately it is highly unlikely to be a problem. Equally if you use hot enough water and then reheat from the fridge it won't be a problem.

The issue is where people don't use hot enough water and then put the feed in the fridge for 18 hours. If there are bacteria in there then they multiply.

If you use a feed made with cold water immediately then there may be two bacteria, which will not make a baby ill. If you stick it in the fridge and reheat then they will multiply exponentially and I have no idea how many there will be. Perhaps there would be enough to make the baby ill.

FWIW I used the diluting with water from fridge when dd was tiny and used cartons to go out.

'if you use a feed made with cold water immediately then there may be two bacteria' I think you probably mean 'fewer'. It is impossible to quantify, or even say that it isn't enough to make a baby sick, but yes it probably isn't as dangerous as having heated it and storing it.

No idea why the formula labels are different in France, but I used to work for a pharmaceutical trade association and I can tell you that the law is very complicated and there are loopholes that are specific to a country. I can tell you with certainty if there is on, the formula companies will have found it.

WRT sueing. You can't sue unless you can 'prove' that your baby became ill from their formula and not say, licking the floor.

I think the guidelines on weaning changed before 2003 - my first was born in Oct 1998 when the health visitor said "16 weeks", and my second in Nov 2002 when she said "well the guidelines say 6 months but 16 weeks is fine".

Lots of other stuff changed as well. e.g. I had a 1998 Dorling Kindersley pregnancy book which recommended peanut butter as a good source of protein and energy, and liver as a source of vitamin A, both of which were Not Recommended in Pregnancy by 2002!

I wouldn't say anything either. There are probably some things you do that she finds surprising - 11 years on, my NCT friends and I can all have a good laugh about how shocked we were at things the others did. All the babies are strapping healthy nearly-11 year olds. Obviously not statistically significant but i and many others I know wish we'd worried and fussed less in the early days and just enjoyed our babies more...

Guidelines and what HV say aren't always correlated unfortunately.

Yes, guidelines for other things change, but the guidelines for weaning have not changed regularly.

That's right moonlight, but certainty is rare in this life...

Particularly when you have a baby that licks the floor!!!

seona, your bolding of the second piece of advice is a bit disingenuous as it is reliant on the first, ie if you don't own a kettle. hardly a situation that we find ourselves in here.

i think that the chances of a baby getting the e salazakii (it's something like that, can't remember exactly) are small if the feed's not made up at 70degs because it relies on your tub being contaminated, but if the baby does get the bug the death rate is actually hideous. something like 90% (someone google to check but i'm sure it's a devastating figure).

all this 'my kids survived' stuff creeps me out, tbh. imagine how those poor parents in belgium and france felt, not having been told how to make the feeds up safely and yet their babies died.

I think at the end of the day they are 'guidelines' ans each person will decide hw they feed and make feeds for their children, my first 3 dd's were ff and i would make up a days worth of bottles in one go and take one ready made out with me, i wouldn't change my methods now if dd4 were ff rather than bf.

But what is stronger than 'guidelines'?

Could the government really pass a law on this?

I think what would be stronger is to actually properly explain to women why they are sterilising, using hot water etc.

I am very to be honest about the 30 minute kettle cooling. Once it has been poured into the bottle can you be confident it's more than 70 degrees?

it's ssooooo easy to put half the water in boiling and top it up, or to check how long it takes a micro to heat up to 70degs. (fear not about hot spots, they're dispersed when you shake the powder through). i don't get the resistance, tbh.

I think that's a good point brettfirl2. I feel that the reasons for chosing not to follow the guidelines come from assumptions and misinterpretations of WHY they are in place.

but yes, the 30mins cooling advice is so outlandish that it demands to be ignored. (which is why they do it, tbh. the manufacturers just want to cover their arses legally and emphatically Do Not Want to be writing 'caution, this tub may be contaminated with a bug that if not eliminated at 70degs will probably kill your baby').

No aitch, but the point is that you are understanding the reasons and finding ways round it rather than blindly following the instructions on the carton.

Ultimately the guidelines are there because they have been proven to have the least risk. That's not to say other methods have major risk but the risks are increased, however slightly.

It's up to the individual; however, I imagine if you routinely flouted the guidelines and your baby got terribly sick or worse, then you might always wonder if there was a connection. At least if you follow the current guidelines for safest bottlefeeding then you could cross that one off your conscience.

I use cartons or make up as per guidelines. However, if in a hurry then powder with small amount with boiling water first then make up to correct amount with cooled boiled water. If you were out and about with powder you should have a flask of boiled and a flask of cooled boiled.

Alos, people seem to wonder why to wait 30 mins before using boiled water. Its so you don't scald yourself (says so on the packet ). If you use newly boiled the bottle can fizz boiling formula everywhere.

Aitch The resistance is probably to do with not being somewhere with hot water perhaps. What if you are in the park with a toddler and your baby needs feeding for example?

completely agree brettgirl.

Then you use a carton?

I haven't scalded myself yet and I'm sure I'll survive it if I do.

ah, well what you do there is you use a powder dispenser. personally i fill the bottle with boiling water then plonk the dispenser into the neck of the bottle. it may even make it hot enough to kill the bugs, but that's not the point... if you're in the park you move onto seona's govt advice 'what to do if you don't have a kettle' and go with cold water but no storage of the milk.