Long haul flight with Nutramigen fed 4-month old

[Wincheki]

I have to travel to New Zealand from the UK with my 4-month old who has a severe milk protein allergy. She is on prescribed nutramigen lipil formula and cannot take normal formula.

Any suggestions as to how I manage to prepare her feeds during the 30 hours we will be travelling and in transit?? I am at a loss! Please note:

• Nutramigen does not come in ready to feed liquid form. Only powder.
• Nutramigen has to be made up with boiled water no less than 70 degrees celcius. WHO guidelines state this is essential to kill potentially life threatening bacteria in the formula.
• I can't add boiling water to the formula directly as it apparently kills some of the nutrients in the milk.

I am really desperate! I have no idea how I will manage her feeds safely... Any suggestions massively appreciated.

please no suggestions to breastfeed or questions as to why I don't just breastfeed. It is a long and painful story, and no, I do not have the option to do this now.

I would get some disposable bottles and teats for the journey, and also some of those small pots to pre-measure the quantities of dry powder for each feed. Try googling disposable feeding bottles and see what is available. It will be easier than worrying about how to clean and sterilise stuff.

At airports and on the plane there will always be boiled water available for hot beverages, so you could ask for some to make up a feed, tip in the powder, and cool the bottle more quickly by placing in a jug of cold water. You could ask for a few cubes of ice in it as well, hopefully this will help to retain more of the nutrients in the formula, while cooling it for feeding. You could take a cheap plastic jug of your own if you wanted for this. I don't think that there will be much lost from the formula, and doubt it would have serious consequences for a well fed baby for the time scale you describe.

I'm sure the cabin crew will do their best to help your baby, as they would any passenger with special dietary requirements. I don't know if you are required to inform the airline in advance of these, usually this would be if someone had a nut allergy or similar where not nuts could be eaten on board for example. But by alerting the airline they may be able to tell you what they are able to do to help, and warn the cabin crew on your flights so that they can be prepared.

Hi girlywhirly thanks so much for your ideas. Really helpful. I guess you are right about the consequences of using boiling water probably being insignificant if it is over a day or two only. I read a couple of other posts re: formula fed infants on planes and a few people suggested that boiled water provided by the airlines wasn't suitable for making up bottles. I have no idea why and to be honest there is no other choice when you are talking 30hours travel so will have to politely ignore that advice! I think I will phone ahead to the airline and the airport as you suggest just to make sure that there are no issues...

I don't know about how high a temperature the water is heated on planes, I used to burn my mouth on their coffee. I don't think you'll have a problem with the water at the UK airports.

I think the problem might be with the type of water. Some bottled waters contain high levels of sodium which is considered unsuitable for infants. If you could buy some bottles of low sodium water airside and have it boiled as and when you need a feed made up that could be a way round it. Or if there will be a few under 2's on the flight the airline might be able to stock up the plane if they have enough warning. You could buy more during a break in flights for the next leg of the journey. A 1.5l bottle would make 6 x 250ml feeds for example, I don't know how many feeds your baby would need in each leg of the journey.

I think consulting the airline would be a wise move, they can tell you what facilities they have onboard (I haven't a clue about long haul planes) if they had a sink and washing up liquid, you could scrub your usual bottles and teats, and if there was a microwave, sterilise them in one of those microwaveable bags.

Thanks again for your help and ideas. I will call the airline and airports this week for a chat. Starting to feel like i will be able to manage it if I prepare carefully enough.

How about this or this

I use to have a 3 compartment dispenser when my DC were little and just used to add it to cooled boiled water that i had in sterilised bottles. Of course that was never for a long journey like yours and both my DCs were weird unusual in the fact that they liked cool milk.

How about making them up and freezing them ahead of time. Take in a cooler with a jug. Ask for hot water to defrost them in as you need them

...?

Not sure if it will be useful, but you could try asking a specialist organisation.

We are members of an organisation called PINNT which is a support organisation for people who are tube fed or intravenously fed. Most of the members will use specialist feeds, so may have travelled with them. They would be able to advise you on getting things through airport security I.e. with a letter from the doctor etc. So you may then be able to take sterile water etc.

Since we were discharged from hospital our dd's feeds were supplied by a home care provider who's job it is to assist us with travel.

Our dd (3.8) is intravenously fed, so we have not actually flown with her yet. People do fly with this feed though and PINNT help to advise them how.

Really hope your travel goes well.

I would bring ready sterilized bottles. Whilst there are microwaves on some airlines these are commercial ones and will melt your bottles to gunk in a few seconds, they are NOT suitable for sterilizing.

There is no washing up liquid either, its generally not used onboard.

So bring your pre sterilized bottles (the ones with plastic bag inserts are a good idea for travel as they take up less space). Bring two at a time into the galley and ask cabin crew to fill them with boiling water. Take back to your seat and let them cool to desired temperature. If in doubt bring a cheap thermometer, either a medical one or a meat one (no sharp spears please as they will be taken off you at security). when at desired temperature mix your formula. Feed one and keep one incase you need more. Then when they are gone go up to the galley and get more water for your next feed.

Alternativly bring and EMPTY thermos flask. Ask crew to fill with boiling water. Leave to cool with lid off for a few minutes. Water will gradually cool and you will have a good temperature water to use. Or 3/4 fill with boiling water and top up with Evian ( the only bottled water I was recommended to use, bring your own as you cant guarantee the airline will have evian) to desired temperature. Now you have the right temperature water on tap. Keep topping up with boiling water if it goes too cool.

Cabin crew will be happy to help but to be sure go up yourself and mix.

Remember planes are not the most hygenic places, although clean enough they are not sterile or disenfected in any way so some dettol wipes and handsanatizer goes a long way.

Have done a lot of L/H flying with my little ones both b/f and bottle feeding.
From experience Breastfeed as long as you can if you are able too! Makes life so much easier!! Good luck!!!