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?

Aitch meant the risk of a v.serious infection like e. sarkazii is tiny, didn't read on gastro
Have to go BF DD so can't give links at the mo but I googled "contaminated infant formula in France" and it was one of the first four or five.
Ooops...or are you just being sarcastic about possibility of there being any good stuff in formula?

AitchTwoToTangOh - I totally agree with you. Formula manufacturers only care about their profit margins, not about giving good information to parents to enable them to make the right decisions regarding feeding their babies.

But why risk the contamination in the first place?

Salmonella, a common contaminant of infant formula, is not an uncommon infection in babies. It won't always have been acquired from formula, of course. But there have been a no. of outbreaks recorded where it was.

Happily, this risk can be virtually eliminated by following the guidance.

no no, i wasn't being sarcastic. i googled that but all i got was stuff about the outbreak, nothing about overheating and killing good stuff iykwim?

God it's scary stuff.
DD is 7 and she was bf for 4 months then ff, slept on her stomach, given baby rice at 6 weeks(!), not swaddled, etc, etc. (All on advice of Midwife/HV/Doc/Mum).
If I was to have another DC now, there is sooo much stuff I wouldn't know (WTF is baby led weaning?!) it's frightening.

lol, fear not, you have MN now.

oh and blw is just self-feeding. so you don't have to do any work.

Mummy369 I'm delighted that you were lucky enough to be able to bf for so long. Thanks for reminding those of us who are less lucky that 'breast is best' as if we didn't know that .

I'm sure that all of the health problems in the world are directly attributed to ff

"So really, I think we're wasting our time trying to tell anyone who is formula feeding how to make up bottles safely. Once you decide to bottle-feed, it's all downhill"

I can't quite work out if this is some kind of wind up?

Mummy369 is being extraordinarily tactless, I think

As well as wrong!

I couldn't have put it better myself, tiktok!! I'm just wondering if I should shoot my three mainly formula fed sons now, to save them suffering in the future!

Does anyone have any statistics about incidence of e salazaki (sp?) infections amongst healthy infants? Aitch said that my three boys dodged a bullet because they didn't get ill from the way I made up their bottles - and I would honestly be interested to know how big that risk actually was.

Knowing the size of the risk would help women make informed decisions. For example if I had another baby now, my first instinct would be to make up the bottles the way I always used to - but if I knew that there was a substantial risk of infection (1% or more, maybe), then I'd have to look at other options.

I have to say that making up the feed using half water at 70degrees and half cooled boiled water seems a practical option.

the risk is very small, stayingsunny. but if you do get it the fatality rate is horrifying.

My HV told me that the issue is overall about hygiene. Making up bottles as you go limits the risk but if you are meticulous about your hygiene, the risk is reduced also.
There are SO many gaps and questions in the Govt guidelines - either written by disapproving BF mothers or single men!
Everyone knows once you add water to the formula powder, the bacteria starts to develop...no matter how hot or cold the water is.
I just hate when guidelines are pure stupid and make people's life more difficult. How many bewildered new parents are out there with screaming babies, trying to cool bottles down in the middle of the night!

Enterobacter sakazakii is a Gram-negative rod-shaped pathogenic bacterium. It is a rare cause of invasive infection with historically high case fatality rates (40?80%) in infants.[2][3][4]

It can cause bacteraemia, meningitis and necrotising enterocolitis. E. sakazakii infection has been associated with the use of powdered infant formula[2][4], with some strains able to survive in a desiccated state for more than 2 years.[5]

that's from wikipedia, but it seems a well referenced article. i wonder if they said to parents that not making up the feeds properly increases the risk of meningitis if that would encourage people to boil some water?

dingdong, but your hv is wrong... the 70 deg guideline isn't about hygiene.

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.

and the guidelines could be written by anyone involved in public health, but the 'boil a kettle and leave for thirty mins' is down to the formula manufacturers, who are covering their arses.

Thank-you for those statistics, Aitch. It's that sort of accurate information that allows parents to make informed choices.

gosh, tiktok, in as many as 12 per cent of the tubs? blimey.

that does seem to indicate that if you're keeping it in a fridge until the moment the baby drinks it (and presumable not heating it either) then it should be okay, however.

Honestly, this is getting silly

The guidelines are not written by bf mothers or single men.

They are based on studies which have shown babies get ill because powder is not sterile and it contains potentially harmful bacteria (mainly, salmonella and e.sakazakii). A few babies die.

This does not need to happen. Correct preparation of powder, or use of UHT pre-packed formula, means these bacteria are dealt with and do not harm the baby.

Parents need to know this, and they also need to know the simpler work-rounds which make life easier and which are common-sense approaches for babies who are less vulnerable to infection (ie healthy, term babies beyond the newborn stage).

Why is there all this scoffing?

I am puzzled.

aye, stayingsunny, but formula manufacturers really do not want us to be making informed choices. if they did, they'd be a lot more forthcoming about what's in the tub.

What, boiling water doesn't burn the milk anymore?

i just always wanted to make my bottles up with hot water anyway, because even if the tubs were sterile when they left the factory (which they aren't), they sure as hell aren't sterile when they've been open for a week in my kitchen with me dipping a stoopid wee yellow spoon in them six times a day.

Sigh.

When my first born arrived in 2001, I was told to, never make up the formula milk with boiling water, due to the heat removing the important nutrients from the powder.

As a result his bottles were all made with cool boiled water.

This is such a minefield!