Bottle Preparations - Make there & then or make in advance. HELP!!

[mumsrthebest]

Hi Ladies, I know that the recommendation nowadays is to make the bottle up 'as and when'. My 6 week old daughter has been suffering badly with colic and therefore we purchased some Dr. Brown anti-colic bottles and started using Colief. To make the bottles in advance the instructions on the Colief packet says that you can make the bottles up, add the Colief (2 drops) and place it in the fridge. The milk can be used within 4 hours and must be used within 12 hours as long as it is kept refridgerated. So why can't milk without Colief be made up in this way? I know several people that make up the bottles for the day and leave them in the fridge. Does anyone else do this? if so have you had any problems with your child? I know that up until several years ago child care professionals said that making up the bottles in advance was fine. So what's changed? It does make life so much easier. Would appreciate your advice as once she stops Colief making the bottles in advance would be far more practical.

The WHO advice does say that it's possible to make bottles 24h in advance if freshly made isn't practical.

You boil your water, allow it to cool to 70deg, then make up as fresh with the correct powder ratio to water. Mix, put straight into fridge and keep there until needed.

On phone so linking to the guidance page is hard. I think the issue with making them in advance is people not cooling the bottle in the fridge or storing them incorrectly, so it's safer to advise they're done freshly when needed.

Making up fresh is best, but making up small batches the was Fliss described is ok too.

What isn't safe is what people used to do - rows of bottles of boiled water stored in the fridge, powder added to cold water and then heated to drinking temperature.

Great minds lady

I believe that the advice (WHO?) for a while was to make it up fresh because thinking on a world-wide basis there may not be reliable refrigeration. It's fine to store made-up formula in the fridge for up to 24 hours.

The complex way to do it - keep a flask of boiled cooked water. Boil fresh water, add it to the bottle, add a bit of the cooled water so it is about 70degrees, add formula, shake well till its dissolved completely, add cooled boiled water to get it to the right temp. Serve to baby.
I did this and it was such a pain initially but once I got the hang of it, it was ok. Baby had no problems and it lasted only 6 months and then it was normal fresh cows milk (ebf 6 months before)
The WHO guidelines are quite simple actually - have a look so you feel better about how you decide to make formula.

www.who.int/foodsafety/publications/micro/PIF_Bottle_en.pdf

I make up 6 at a time to last 24 hours and DS has had no problems. I told the health visitor this and expected to be told not to but she told me the main reasons they advise to make up one at a time are you are more likely to miscount scoops if you make more, people don't store them correctly and people using left over ones after 24 hours so I always make sure i chuck any left overs away after 24 hours, chuck any away i think i might have mis counted and store in the middle of the fridge simple.

This maybe a lot of rubbish of course just the opinion of one HV.

I am right royally confused now after reading all this! I boil water and decant into sterilised bottles and let it cool. I then use this water though the day adding a dash of fresh boiled water to raise the temp. At night I do the same and take three bottles to bed but do not add fresh bioiled water so she has it a room temp. She is six months and has been on F since 3 months - never been ill or had diorriah. Just looked at the instructions on the box again - it doesn't say you can't do this.

This is the guidance:www.who.int/foodsafety/publications/micro/pif_guidelines.pdf here

Nearlycooked If the water you add the unsterile milk powder to is 70c or less then you run the risk of your DD being made ill by the Enterobacter sakazakii and/or Salmonella bacteria.

Unless your formula packaging states otherwise then you should either make up the bottles one at a time, fresh, with water of 70c when you put the milk powder in, OR make up a batch with the water at 70c when you add the milk powder, and then put them ALL in the fridge and take them out when you need them. Just because it says don't do it the way you do it, doesn't mean that you should then do it that way!

It's great that she hasn't been ill - yet - but these bacteria are nasty and can be fatal.

We used to take DD's night time bottles in a cool bag with a couple of ice packs in them if we didn't want to come down to the fridge at night.

Flisspaps thanks for your advice. I don't know how I missed this? It was all a bit frantic when I had to start bottle feeding as I was admitted as an emergency to hospital and couldnt carry on breast feeding full time. I really appreciate your post.

You say you took a cool bag to bed with pre prepared bottles- did your DC have cold milk? How did they fare with that or did you warm it somehow? DD wakes in the night and I deploy the bottle very quickly - worried about having to wait to warm a bottle up - she routinely has been having it at room temp or slightly warmer. In the day I could take the bottle from the fridge and use my bottle warmer as I know roughly when it will be needed but not so at night.

If you take it from the fridge do you let it cool to room temp or is this no good?

Feel awful - had no idea I was doing it so wrong.

Don't feel awful - if you don't know then you don't know You won't be the only one doing it that way, and your DD has been fine so you've done her no harm!

At night DD would have it cold, wouldn't touch it cold in the day though so we'd either microwave it briefly (which isn't recommended as it can cause hot spots) and then shake well to dissipate the hot spots, or stand it in a bowl or jug of hot water until it reached the desired temperature (which I believe is the recommended way to heat up pre-prepared bottles)

As someone who started out BF before switching to FF with DD, it's a shame this information isn't given out more widely antenatally alongside the info about BF so that parents who do choose to FF can do so safely!

I was so on board with breast feeding and was gutted to have had issues stopping this. I had done no real reading about ff as I was NOT going to be doing it!! Should have been more savy and read up more. I think she will take it cold at night so will get the cool box out and follow your advice. This is exactly why I did not want to be ff as it is all such a hassle - with bf you just whip out the boob!!

I know so many people that add the powder to cold, boiled water. I think that it should definitely be made more well known that this is not the best way to do it now.
I always reheat mine in the microwave too, as long as you give it a damn good shake afterwards then it's fine!

Does anyone know why the boiled water has to be cooled to 70 degrees before formula is added? Can you not just use freshly boiled water straight away? I understand that it has to be above 70 to kill bacteria in the powder but am confused by the WHO guidance to ' allow to cool a little '.

I find it very conflicting. I have had two different hv tell me its best to make up the sterile bottles of water first and store reheat then add milk. Do not make up formula in advance. Also don't restore the scoop back in the milk pack as I am sure many do then keep retouching with dirty hands. The chances of babies being ill is minimal from pre making bottles. It's more people's hygiene and unsatisfactory sterilizing.

Anchorwoman I believe that if the water is too hot it destroys the nutrients in the milk, 70c is the hottest it can be to destroy the bulk of the bacteria yet leave sufficient nutritional content present.

cazm that would be fine as long as you reheat the water to 70c, in which case you may as well boil the water when needed and then cool quickly to 70c.

Unfortunately not all HVs give advice that is safe or currently recommended so don't take their word as gospel. Read your formula pack and follow those (some special formula needs making with cold water) or the WHO guidelines.

nearlycooked I don't advise the cool bag method as that may not keep the milk cool enough overnight (we would do so if necessary, eg at the ILs where going downstairs would set off the bloody burglar alarm and I had no key to turn it off ) the advice is to keep it on the fridge until needed

Ok flisspaps thanks.

Agree that advice could be clearer it's a blimmin minefield. Instructions on can says let water cool for 'up to 30 mins' but this leaves a fair margin for temp change during that time.

Trawled eBay last nit and found a counter top fridge for the bedroom for a snip. Been to pick it up this morning!! All bottles made up for the day and in the kitchen fridge ready for deploy. Night bottles will be taken up to their new residence tonight!!!

I made up six bottles in in advance as per the instruction set out by Flisspaps

SMA instruction states: WATER MUST BE CHILLED PRIOR TO ADDING POWDER TO MAKE FEED. Use water within 24 hours. Once opened, milk powder is not sterile so I never did this.

Eggrules- just to be clear though, that is staydown, so one of the special formulas that need making up with cold water. Sorry if you were having to deal with reflux - it's miserable isn't it. Neither of mine had it, but a close friend's baby did.

YoullLaughAboutItOneDay - is right.

Still the powder is not sterile; so glad I am past the bottle stage.