Preparing baby formula - Belgium and other European countries

[Prometheus]

OK - so I have posted a question on the breastfeeding part of mumsnet and also on xpats.com asking about formula preparation.

I have to stop breastfeeding DS as I am returning to work and the paediatrician recommended Nestle NAN HA. I have read the instructions on the box and it says to use water that is cooled to 40 degrees before mixing the formula.

In the UK you are told to use water no cooler than 70 degrees: www.nhs.uk/Planners/birthtofive/Pages/making-up-formula.aspx

"Even when tins and packets of powdered infant formula are sealed, they can sometimes contain bacteria such as Cronobacter sakazakii (formerly known as Enterobacter sakazakii) and, more rarely, Salmonella. Although these bacteria are very rare, the infections they cause can be life-threatening. To reduce the risk of bacteria, prepare each feed freshly and correctly, using boiled water at a temperature of at least 70ºC. Water at this temperature will kill the bacteria."

WHO guidelines say the same: www.who.int/foodsafety/publications/micro/pif_guidelines.pdf

What do people who live in Belgium, France etc. do? Do you use 40 C water or even cold bottled Evian or Spa as the Nestle helpline recommended? Or do you use 70C water and if so is your baby still getting nutrients? The Nestle helpline said that vitamins are killed by water above 40C so all formula fed babies in the UK are vitamin-less I assume!

interesting that the paediatrician recommends nestle!

With DD in the UK I used cooled boiled water. Don't think I checked the temperature beyond putting a drop on my wrist to make sure it wasn't too hot to hurt her. With DS in France I used bottled water, whichever supermarket own brand said it was OK for mixing formula. They are now 6 and 3 and in very good health!

I know one person who bottle feeds and she was told to use bottled water.

In my opinion the health professionals are all taken in by the reps from nestle various companies.

Hello, I was in exactly the same position as you when I went back to work and stressed endlessly about this (and needlessly).

When I tried explaining to French people, MIL, CM etc that DD's bottles should be made up with freshly boiled water not cooled to less than 70 degrees they looked at me as though I had been touched by some kind of new mother mania. I got frustrated trying to explain - and they got frustrated trying to explain to me that it had to be bottled water as tap water wasn't safe and insisted I bought a bottle warmer.

It was one of those things that I had to let go of, there are so many things that we stress about as new mothers and I felt like this was one thing that was causing me unnecessary stress! I just carried on doing it my way and decided not to get stressed and let them do it their way.

How old is your baby btw? I think after a certain age there is almost zero risk from bacteria in formula and it is only really tiny babies that are at risk

Your baby will get nutrition whichever way you chose to go.

I am still amazed that the guidelines are so out of sync though.

Just wait til you start weaning (onto solids) - if you are not there already you will find even more differences cropping up!

I say the risk is tiny but so serious that you can't not use 70C water. Sadly I know a tiny baby who got an Enterobacter Sakazakii infection, was very, very ill and is potentially disabled for life - too young to tell what the extent of the probable brain damage is.

Vitamins cannot be 'killed'. They can be broken down or oxidised by extended exposure to heat, in the same way that proteins can be which is why you shouldn't use boiling boiling water, instead wait until it's cooled to 70C, and why you should cool rapidly to minimise the exposure to high temperatures. If done quick enough it's the equivalent of pastuerising milk. The bacteria don't survive the initial heat shock but there isn't time for the heat to catalyse the chemical reaction which affects the vitamins sufficiently and in any case vitamin C, one of the most fragile vitamins, is thought to break down above 70C anyway, so if you're really worried then get a thermometer and do it at 65C. Storing formula in the fridge for an extended period (low temp, long time in water) is likely to result in more vitamin loss than a brief heating.

Also large amounts of water increase the likelihood of the reaction so my preferred method (powder into bottle, add half amount boiled water at 70C, mix, add half amount of boiled-and-cooled water) also preserves the nutritional content by reducing the amount of hot water used. It has the additional advantage of being speedy at cooling down the bottle to drinkable temperature.

The list of ingredients for French formula and British formula are essentially the same and babies resident in both countries that I've cared for have thrived with me making up their bottles at 70 so the argument they don't get any nutrients is, IMO, complete crap.

When DC gets here I shall say 'sod the European instructions' and do it the safe way if/when we switch to formula.

Hi there - DS is almost 3 months old. When he goes to creche they will prepare the formula in the Belgian way (i.e. with 40C water or bottled water) which worries me. I agree that weaning is a whole other story.....at the creche they introduce fruit at 4 months, veg at 5 months and meat/fish at 6 months!!!! I can only change this for my DS if I have a doctors note!!

Can you not get packs of pre-prepped (sterile) formula and send it in with him?

I can't find the pre-packed stuff here. Don't think they make it (Belgium is like the UK in the 1960s so things that you can buy in the UK are not even heard of here)

Frakkin - you are right that the risk is there and you are much more qualifed than me to answer this (and your answer was so much better than mine). I am so sad to hear about the sick baby, and reading that does make me think that perhaps the stress I went through over this matter wasn't misplaced and if only there was a way to convince French people to change their guidelines.

Also, I wonder if I am being completely stupid, but before switching to formula I looked for one which came in a sterilised ready made format and have failed to find it anywhere (in France).

would this article be of any use to explain to the skeptics?

I found ready-made formula in French supermarkets this summer, it was follow on milk (he was about 9 months). I can't remember the brand, it took me a while to find as it wasn't kept next to the boxes of powder, and came in white plastic bottles rather than cartons so I didn't spot it straight away.

and this?

Prometheus, I just want say I feel for you trying to do things your way in Belgium.

My DH is from there and even though we are living overseas, his family think BLW is utter madness. If my MIL tells me one more time that DH was eating purees at 12 weeks I swear I will scream.

Where we are living, the other wives are all Belgians and again think I am doing my 6 month old DD serious harm by doing BLW. Only this morning when I was showing one of them a small rash she has on her tummy, I was told it's because I've introduced gluten too early - she's almost 7 months old and has a piece of toast a couple of times a week for her breakfast!

And breathe....

Anyway, stick to what you want to do. You are paying the nursery fees so I think you are within your right to say when you wish your child to be given food.

Prometheus - that's ridiculous regarding the doctor's note - if you don't want to introduce solids until 6 months, then they should listen to you. I know other children in creches who didn't have soldis until six months and I've never heard of anyone needing a note from the doctor

[[http://www.dwrcymru.co.uk/English/library/publications/milk%20guidance/english.pdf would this document from the FSA be useful to show to child care and health care providers in Belgium. that is cites EU food safety guidelines may make them pipe down.

have those of you struggling to introduce the concept of BLW in Belgium already know about this site?

oops was meaning to hit preview there.
it was supposed to look more like below:

would this document from the FSA be useful to show to child care and health care providers in Belgium. that is cites EU food safety guidelines may make them pipe down. have those of you struggling to introduce the concept of BLW in Belgium already know about this site?

I do agree though that there is a very strict set way of child rearing in Belgium that everyone follows, and I totally ignored because I've never been one to follow the crowd.

It just strikes me as so incredibly boring to do something because everyone else is doing it, having all the babies acting exactly the same way, sleeping and eating to a strict schedule, and any baby who does anything different is described as difficult.