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 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.

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?

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.

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.

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

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.

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.

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.

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

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