making up formula milk

[Spandangle]

i have just read on another thread that you should always make up formula milk using boiled water at a temperature of at least 70C. otherwise there is a risk of salmonella (I think) from the milk powder
Ive never done this! I often use boiled water that is completely cold, or room temperature at least.

what does everyone else do?

I started using boiled water as that was what it said on the box, then the HV said don't need to bother, it's fine to fill several bottles with measured kettle water and add formula later, then I also read the post earlier and thought ooops .

So I don't know - today I have been using just off boiling water and then chilling in a cold water bath.

D

There are lots of threads about this in the Breast and Bottle topic, good luck!

I did some googling, assessed the risk and made my own mind up. :o

i make a 210ml bottle by putting 7 scoops of powder into 150ml of 70 degree water, then shake to mix. when the powder is dissolved, i add a further 60ml cool boiled water from the fridge. this means i am making the bottles fresh each time, with 70 degree water.

this does give v.warm milk though, which dd2 prefers.

You should ALWAYS use boiled water that is 70c otherwise it does not kill the bacteria and can make them very sick.

The instructions are on the tin!!

I used to do that too, but DS had salmonella poisoning when he was 5mth old so I really wouldn't advise it.

I know that the risk is extremely low, but I would not risk it.

There was no other way that he could have caught salmonella other than from the formula - he was not yet weaned and no one else had it.

Most people I have met in RL make it up with cooled boiled water.

yeah, me too Inspirational...it never occured to me that it was so potentially harmful.

I had noted when I read instructions that the water should be 70C or more but I couldnt think of a good reason for it- i thought you needed to hold a high temperature to kill salmonella?

70° is based on research by the WHO and FAO. Sadly this advice is often not given to new parents and many midwives and health visitors still use outdated methods.

It is your decision to make. I have been in enough arguments on MN to know that many many people carry on using cooled boiled water, despite the warnings.

My DS was only 5 mths old when he had salmonella poisoning and it was really horrible. Thanks to my GP being on the ball and sending a stool sample to the lab, he was on antibiotics quickly and recovered well.

Here are the FSA/DoH guidelines.

MW also gave me wrong advice .

It's 70C not just for salmonella, although that's a common and dangerous contaminant but for any gastro-causing bug and most particularly E. Sakazakii which has caused several deaths in Europe and even when it doesn't kill can cause lifelong health problems.

Most bacteria can't stand temperatures of around 60 as their little membranes rupture which kills them very dead. Even if you don't kill 100% of them it will bring it down to acceptable levels.

Many people confuse probability and risk. The probability is relatively small but the consequences are huge which makes it a very high risk strategy.

Once you've killed off the bacteria by adding hot water you can store formula between 0 and 5C for up to 24 hours (although personally I wouldn't go more than 12), so at the back of the fridge, and warm for night feeds. Or you can use a carton.

Putting water into the baby bottle means it will cool quicker - the 'wait half an hour' guideline is because that's how long it takes a litre of water in a properly insulated container as a kettle should be to cool 30C at room temperature. If you reduce the amount of water then it will cool quicker.

The half/half method is very good as well but it means that you need to measure out your boiled and pre-cooled water in a separate bottle to make sure you have the right amount rather than just relying on topping up what you've just added formula powder to, as adding formula powder increases the volume of the water and just topping up to, say, 7oz, means you'll end up with over-concentrated milk.

Snap
That is a very good post, I did not know that E. Sakazakii could cause long-term health problems.

I don't understand how anyone could know that using cool water to make up bottles can be dangerous and still do it because it is easier.

Yep :( autoimmune problems and neurological damage in the case I know of. The full extent of the damage isn't properly known yet but her parents will never, ever forgive themselves. She wasn't a neonate either when she contracted the infection - they can be even more severely affected.

I think so many people focus on the probability and not on the potential consequences. Unless you know someone it's happened to it's easy to dismiss it as 'food poisoning' which is typically seen as unpleasant and maybe life-threatening if untreated because of the dehydration but not all that bad.

Unfortunately it's an uphill struggle against what used to be acceptable, when our knowledge asn't as complete, and HCPs relying on outdated training.

It needs to be in BIG BIG LETTERS on every tin of formula, preferably using words of one syllabe.

That is really sad, Snap.

I blogged last year about this, because in Germany they still have the outdated advice on the tins of formula. Must look and see if they have changed it.

Checked the German websites.

Nestle and Milupa are still recommending cooling to 40°C.

Ok smart-arses....I use Hipp Organic hungry formula and it does NOT make it clear on the box. The instructions say to boil the water and leave it to cool for 30 minutes. This may very well result in a temperature of 70C, but it needs to say that a specific temperature is the goal and the reasons for that. I would not have been used cooled water for convenience if I had known this. Underneath the instructions on the box is a list of 'Important Feeding Information'- there is NO reference to minimum temperatures or risk of infections.
I also have a box of Cow & Gate in the cupboard; this also instructs to boil kettle and leave to cool for 30 minutes with no reference to minmum temperatures. Important instructions are printed in red on this box, such as 'do not add powder to boiling water due to risk of scalding'. Leaving the kettle for 30 minutes is NOT printed in red.

Like I said in an earlier post - I had read it on a box previously- not sure which milk that was though

I agree with you Spandangle the info on the box is confusing and potentially misleading.

Spandangle
it is not about being a smart arse. My son is 6 yo, it has been a long time since he was a baby and we were in Germany where the advice is different still.

You asked what other people did. I told you my experience - that my son had salmonella poisoning when he was 5 months old which could have killed him. We were lucky that our GP was on the ball.

It really pisses me off to be called names for attempting to help other posters protect their children.

If you want to continue preparing your child's bottles as you have been until now, go ahead. But don't call me a smartarse for giving you the current recommendation.

A litre of boiled water should cool to approximately 70C in 30 minutes which is how they can get away with doing that. But the instructions on the box are very misleading. They are not clear. They don't say that the 30 minute rules is based on the specific heat capacity of water. They need to be clearer otherwise, as you say, people don't know the reason.

But do formula companies really want to tell their customers that the product they're buying, the baby's sole source of nutrition, could potentially cause a life-threatening infection? No. And there's no law which says they have to. So they choose not to mention it and give vague instructions which should, under most circumstances, cover them. However they're very careful to tell people not to scald themselves when handling boiling water because if they said to make up the bottles with boiling water then they could be held liable for people following their instructions and harming themselves.

My box of Hipp organic says leave for 30 minutes as well. It's not clear. It needs to be.

Someone on MN did an experiment with different quantities of water, different kettles and a thermometer - the 30 minute guideline is far from foolproof.

Mme, I believe Spandangle's "smart-arses" was aimed primarily at the poster who commented "did you never read the box? It is pretty clear".

Oh, sorry if I misunderstood, Spandangle.

Tbh, I had just read the thread that Edgar posted on arranging her son's funeral. I was angry that anyone would risk their child's life because of having to wait for milk to cool. Sorry, should not have posted when I was upset.

apologises MMeLindt - it WAS aimed at the 'havent you read the tin?' posters; sanctimonous and unhelpful, parenting is a work in progress for all of us..

SnapFrakkle- I think you've nailed it, thtas exactly why they are so clear about the temperature issue.Aaaarghhh...I knew Nestle are *** but I would've hoped Hipp had more integrity- who owns them?

is there the same risk when you make up the baby rices/porridges as they also contain milk powder?