German baby formula different than UK

[Kartoffelsalat]

Hi all,

I am in Germany where I gave birth to a baby recently, he is 2 months old. I’ve been formula feeding since a month old. Per NHS guidelines, I had been boiling water and leaving to cool for 30 mins then making up a feed. I had been disregarding the instructions on the Aptamil Pronutra package which says boil water and leave to cool to 40 degrees C and then add 2/3 of the water and mix the powder in. Then add the rest of the water. Just wondering if any of you live on the continent and have some advice to offer me? Baby has been thriving and gained 3 lbs in 4 weeks when I had been doing it the UK way (70 degree C or above water). I’m really worried I’ve killed off the nutrients by doing this and deprived my baby of proper nourishment.

Babies in the UK aren't suffering from that method. It's about bacteria in the water and the formula, not the nutrients. If your doctors are happy with baby, then they're okay

The German Aptamil site says nutrients and vitamins will be destroyed if I use boiled water above 70 degrees and to use 40 degree water 😕

I make it with water over 70 degrees, I don't think the NHS would recommend it if it was going to cause problems with the nutrients. I also reason that the premade formula in bottles is heat treated at much higher temperatures to make it shelf safe and is still ok nutritionally.

Are you in the UK or Germany?

Are you in the UK? Just wondering if the German version of Aptamil is a bit different as all of the formulas here say to make it with water cooled to 40

Can you follow the guidelines on the aptamil? I’d forget the NHS stuff as it’s to do with killing bacteria in UK tap water, so if you just follow the instructions on the aptamil you’ll be fine. I’m in France and here we use bottled water for formula - mainly Evian. I’ve never boiled any water! Xx

I’ll try. Thanks for your reply. Bought a kettle with temp control. My prep machine is now useless with German formula I guess. How old is your LO? Ever been sick with the bottled water?

I'm in the UK.

The NHS guidelines are to do with killing bacteria that could possibly be in the formula powder, not in the tap water.

I agree I understand that but I’m confused as to why the instructions on the formula tin are different here in Germany (use water cooled to 40 C) versus 70 in UK and Ireland?

Presumably because the German authorities have decided that the risk of infants becoming unwell from bacteria in formula is small enough to disregard. Whereas the UK have decided it isn't. Two different health authorities coming to different conclusions over the same data/research.

As others have said, the ready made formula is ultra heat treated so it is sterile, and that doesn't destroy the nutrients in it. Same as cooking food to > 70 degrees doesn't destroy the nutrients.

I'd follow the instructions on the formula that you have and the follow the guidance in the country that you're in.

I think it's really confusing. I started to make bottles with boiled, cooled water as per the instructions, but the health visitor said no, I needed to add a splash of boiling water first, shake it up and then add the rest of the boiled, cooled water.

The reason I was given is that in the UK, formula powder doesn't have to be sold sterile (the made up milk is different), so the idea is that the splash of boiling water is what 'sterilises' the powder...I'm sceptical it does anything though, as all the instructions for sterilising bottles etc are that you boil and keep on the boil for a period of time, so I can't see that a 3 second splash of boiled water actually sterilises anything.

And given that we're expected to do this with a screaming hungry baby...come on, formula manufacturers, just sell the damn stuff sterilised so boiling water isn't needed!

Formula powder from any source is not sterile. It cannot be, given how it's manufactured, and how it's used and stored once opened.

Only the liquid ready-made formula milk which is ultra heat treated is sterile which is why it can be kept at ambient room temperature until opened.

The UK advice for making up formula is to boil the kettle with fresh water, wait no longer than 30 minutes (to ensure water is still over 70 degrees) and make up the bottle with that hot water. Then cool before using.

The advice you were given @Speedweed to use a splash of hot water is pretty pointless as the resulting mixture is not likely to be above 70 degrees. That's also the issue with the perfect prep machines that are very popular.

I believe the first infant formula sold in different countries is pretty similar. The UK’s advice is just more precautionary than other countries. The risk of a baby getting ill from bacteria in formula is tiny but very serious in extremely rare cases when it does happen. I would go with following the instructions on the tin you are using.

Thank you for this reply! I wanted reassurance that I’m not doing something wrong. I had been doing 70 degrees for the past month. Ready made is too expensive, I spent about €200 on ready made in one month then moved to powder. Its €2.45 per bottle for 200ml of Aptamil.

Thank you for your reply! So I’ll do 40 degrees then 😕 bought a tommee tippee prep machine and all but that gives a 70 degree c hotshot. Do you happen to know if the formula packages in UK say use water that is not under 70 degrees C?

I see what you mean as the German Aptamil package tells us to cool water to 40 C then add 2/3 of the water, powder, shake then add the rest but the problem is theres so much foam + added volume that I can’t even see the mark to know how much water has been added and where the foam starts and stops . I guess I’ll ask a German nurse who visits us soon.

You need to measure out the right amount of water in a separate bottle first, then use that to work out the 2/3 to add first. The only reason for adding 2/3 first is to be able to properly shake the water with the powder, as there is enough room in the bottle.

In Germany the thought is that bacteria is more likely to come from unclean bottles and spoons, prep stuff etc, than from the powder. And they also see 70 degree water scalding a baby as more of a risk than bacteria.

@Kartoffelsalat Yes! Some brands are foamier than others, but Aptamil UK was terrible. Absolutely impossible to get the right amount of water without measuring out the water before you put it in, rather than using the bottle markers to gauge the water.

In the end I gave up and got a perfect prep machine, but I'm so glad reading your query and the responses that it wasn't just me being to exhausted to work it out

Don't stress about it OP.
Your baby sounds like he is thriving so there is no reason to assume he hasn't been getting proper nourishment.

Guidelines about how to prepare formula change are always changing and plenty keep doing what they always did with previous babies etc. and they all end up fine.

Aptamil Germany seem to have a whatsapp number you can text if you want more clarity but as I said your baby is clearly doing well so need to worry, You're doing great ❤

Thank you so much for reassuring me. I messaged them on WhatsApp and they said this:

“tatsächlich gibt es in verschiedenen Ländern unterschiedliche Zubereitungshinweise für unsere Speisen. Dies hängt zum Teil mit der Zusammensetzung zusammen.
Wenn Sie das deutsche Aptamil mit zu heißem Wasser zubereiten – deutlich über 40°C – dann werden einige Inhaltsstoffe zerstört. Da die Verbrennungsgefahr bei den Kleinen sehr hoch ist, wenn die Temperatur vor dem Füttern nicht kontrolliert wird, ist einer der Gründe, warum wir 70°C heißes Wasser für die Zubereitung unserer Aptamil-Nahrung nicht empfehlen können.
Liebe Grüße vom Aptacare-Team💙”

translation:
“in fact, there are different preparation instructions for our dishes in different countries. This is partly related to the composition.
If you prepare the German Aptamil with water that is too hot - well over 40°C - then some ingredients will be destroyed. One of the reasons why we cannot recommend 70°C hot water for the preparation of our Aptamil formula is that the risk of burns in the little ones is very high if the temperature is not controlled before feeding.
Greetings from the Aptacare team💙”

I went out to get a kettle with temperature control and it took me 4 hours to get it down to 45 degrees 🤦🏻‍♀️ seems like they want us to buy the super expensive ready made although aptamil powder is €20 here