Bottle-Feeding: Pre-preparing bottle feeds!

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Hello!

I'm currently 6 months pregnant and think I want to bottle feed, although I know this may change in the next couple of months and after birth! I'm researching into formula feeding and it states that you should make bottles as and when you need them, and use them immediately.

I wondered if it was safe to pour boiling water into a sterilised bottle, cool it down in the fridge, or pop it straight into an insulated bag with an ice pack that would be kept in the room for night feeds. I would then add the formula to the cooled water and then heat it in my 'Tommee Tippee' bottle warmer.
This is the same for when we're on the go, but the cooled bottles would be heated with a flask instead.

I wondered if this would be ok, as I'm not adding the powder until it is needed and by keeping the bottles cooled would mean little chance for germs multiplying quickly?

Obviously it would be fine to make up bottles the 'normal' way in the daytime, this would only be apparent for night time and feeds on the go. Also, if anyone knows, is 'Cow & Gate' really that different to 'Aptamil'?

Would love to know peoples opinions! x

"Dear Health Care Professional:

The U.S. Food and Drug Administration (FDA) is writing to inform you about a growing body of information pertaining to Enterobacter sakazakii infections in neonates fed milk-based powdered infant formulas. Clusters of E. sakazakii infections have been reported in a variety of locations over the past several years among infants fed milk-based powdered infant formula products from various manufacturers. One study tested milk-based powdered infant formula products obtained from a number of different countries and found that E. sakazakii could be recovered from 20 (14%) of 141 samples (1).

Enterobacter sakazakii is a gram-negative rod-shaped bacterium within the familyEnterobacteriaceae. The organism was called "yellow-pigmented Enterobacter cloacae" until 1980 when it was renamed Enterobacter sakazakii (2). The majority of cases of E. sakazakii infection reported in the peer-reviewed literature have described neonates with sepsis, meningitis, or necrotizing enterocolitis (3-5) as a consequence of the infection, and the case-fatality rate among infected neonates has been reported to be as high as 33%. The pathogen is also a rare cause of bacteremia and osteomyelitis in adults (2).

The literature suggests that premature infants and those with underlying medical conditions may be at highest risk for developing E. sakazakii infection. Several outbreaks have occurred in neonatal intensive care units worldwide. (See, for example, van Acker et al.(3).) However, an apparently healthy full term newborn infant in Iceland also became ill prior to hospital discharge and suffered permanent neurological sequelae (4). Although the reservoir of the organism is unknown, a growing number of outbreaks of infection among neonates has provided compelling evidence that milk-based powdered infant formulas have served as the source of infection (3-5). Significantly, the results of one investigation (the "Belgium outbreak" investigation (3)) suggest that even low levels of E. sakazakii in milk-based powdered infant formula (i.e., levels that are within what a 1994 Codex Alimentarius document (6) provides as a currently accepted limit for the presence of coliforms in milk-based powdered infant formula) can lead to development of infection."

Extract from the FDA about the persistent discovery of potentially fatal bacteria in formula which notes it was found in 14% (1 in 7) samples.

The perfect prep machine has some questions raised over whether the hot shot is large enough to sustain a temp of >70degrees for long enough to kill all the bacteria. It seems it cools to 50 -60 almost immediately upon mixing with the powder.

I made up 3 at a time until 10 weeks then 6 at a time with boiled water added the powder right in the fridge then heated in the microwave shaking well and testing the heat, never had any problems DS has always been very healthy rarely unwell and never seriously. If we went out they went in a cool bag and I heated them where ever we went to or DS had them cold if I couldn't.

I told my hv this is how I done it from day 1 she told me the common risks associated with making bottles in advance are, miss counting scoops, incorrect storage, and keeping bottles over 24 hours. As long as you are careful with making up and storage your fine.

Further to ICJump's 'helpful' post OP, some other things you might want to know:

^If you decide to breastfeed it's always at the right temperature, always available with no more wait then lifting a top and requires no additional cleaning. The 3am scenario is rather pick baby up feed fall back to sleep.
Even if breastfeeding you decide to express the milk can be served cold and pumps and bottles/cups only need washing in hot soapy water.^

Breastmilk is always available provided you don't have any supply issues. There'll be no more wait than lifting a top provided your baby never has any issues latching. The 3am scenario means you'll always be the one having to do that particular feed, and all the other ones overnight too. Unless of course you can express, which isn't actually something you can necessarily 'decide' to do, because even women with brilliant supply, no latch issues etc don't always get much out of a pump. Just the way it is. You can serve formula cold too. And the sterilising part is the easy part of cleaning bottles, it's the warm soapy water bit that takes the effort. Which will be the same regardless of what you're putting in the bottles.

Just to provide a bit more light and shade than IC's post did... after all, we're all just trying to help I'm sure. But do make sure it's the right decision for you whatever you choose OP. Good luck.

Can I ask why helpful is in quotes?

I had twins when my son had just turned two. There was no way I could make up bottles as I went.

I don't know what the perfect prep machine is, but I used to make up all 24 hours of bottles in advance (all 14 of them!), with boiling water then cool quickly and pop into the fridge until I needed them.

In terms of sterisiling, Milton and a large bucket of cold water was the quickest and easiest way.

Good luck!

You can do bottles ready in 2 mins exactly the way a perfect prep does them without shelling out £50 or so. You just have to get used to the amounts of hot and cold water needed.
Put powder in empty bottle. Add small amount of boiling water. Lid on and shake. Top up with cooled boiled water to the right level.
Doesnt take much practise till you can get the right temperature every time and no germs just like perfect prep.
Then as you just boiled the kettle anyway you refill your cooled boiled water container ready for next time.

I BF for 8 months. When on to bottles I still made them using boiled water and the powder then cool and use straight away. Now DS is crawling and eating shoes etc I make his morning bottle with cooled water from the kettle for quickness. Always washing hands and sterile bottle etc though. He's never had a tummy upset.

Perfect prep machine is not recommended, the data from Tommee Tippee isn't forthcoming if the hot shot is enough to kill the bacteria to make the formula sterile. Several health visitors and infant feeding bods I've spoken to have said similar.

I think though that you can flash cool the bottles, that might work?

If the hot shot is the same temp as water from s kettle why wouldn't it kill the bacteria? Just wondering as don't understand why it wouldn't.

As for OP, I wouldn't make bottles up without using water over 70 degrees to dissolve it.
For the people who are saying they don't know any babies who've suffered ill effects - why would you take the risk vs a couple more minutes to prepare the feed.

The research on the perfect prep is linked to up thread.
Essentially, the quantity of water used in the hot shot might not be enough to kill all of the bacteria. If 1oz of water is used in the hot shot for a 4oz feed then the water doesn't stay hot enough when it hits the powder to kill all of the bacteria in the powder. Based on that it would be safer to use a 2oz hot shot from a kettle and top up with 2oz of cooled boiled water and save yourself £70.