When DS was less than 3 weeks old, we were in A&E for something unrelated, gave a urine sample, but otherwise DS was found to be ok (though needed more milk).
A few days later we were called and told we had to go back to A&E immediately. They had found something in the urine. They had found Enterobacter. At the time they couldn't tell if it was enterobacter sakazakii which is found in formula powder or another type of enterobacter. (We never were told)
Luckily, DS was looking fine, was happy, and quick-dip tests in his urine came clean, and blood tests showed no infection. So the possibility was entertained that it might have been a contaminated urine sample. We had to give two further separate urine samples in order to double-check.
Even so, even though everyone thought it was likely to be a contamination, because DS just did not seem ill in any way - even so, they were going to insert a cannula into him and start giving him broad spectrum antibiotics IV. They were going to keep us in until they were absolutely certain that he did not have any enterobacter. We were told that this was absolutely dead serious. They were not going to take any chances.
So when we did go home (they failed to insert a cannula - not for lack of trying - and were therefore not going to be able to give him IV antibiotics anyway), I googled around a bit - wanted to know what this scary thing is that DS might have!
I found out that just one month earlier, 9 babies had been infected with enterobacter in a German hospital, 6 of them died.
I found out that there is hardly any treatment for it. Enterobacter is resistant against all but two or so known antibiotics. Treating enterobacter with the wrong antibiotics initially will make it all but impossible to deal with it later. Regarding its resistance to antibiotics, it is worse than the 'superbug' MRSA.
I found out that the death rate of enterobacter in babies is between 40% and 80%.
I also found out that one strain of enterobacter (the e. sakazakii) is found in formula powder. I think I remember reading somewhere that scientists believe the cases of infant death caused by e. sakazakii in formula powder were massively underreported in the Western world. In effect, the science of it is, babies die of it, probably more than we know of. In places where formula is often made up with water that isn't hot enough, the cases are more common.
The link below btw says that it is on the rise, too.
Basically I didn't sleep until we got the all-clear.
Sorry, I know this sounds like scare-mongering. But the fact that a random A&E team picked up on this and was immediately so very concerned tells me that it is not so rarely seen in English hospitals at all. I think there is good reason for the 'new' advice on making up formula.
I also think that the thing about 'letting it cool down for 30 minutes' is meant to be helpful. On my formula box (SMA) I believe it did say it should be 'about 70 degrees celsius' which could be achieved by letting it cool down for about 30 minutes. Saves you the thermometer, makes it more practical to do, no?
In the end, it's got to be your decision. The e. sakazakii risk is not enormous, and salmonella are hardly ever found in formula anymore. Using boiled and cooled water is clearly better than using totally unboiled water. But my way of doing it would have been to keep near-boiling hot water in a thermos, cooled boiled water in another flask. When feed needed, mix formula powder with hot water, then add cooled water. Works day (away and about) as well as night!
healthcare.mylovemyworld.co.cc/2011/02/enterobacter-sakazakii-history-symptoms.html
Although this bacterium can infect at any age, the greatest risk of exposure is the age of the baby. Large increase in cases reported in the U.S. Neonatal Intensive Care Units (NICU), several hospitals in England, Holland, U.S., and Canada.
In the United States the incidence of E. sakazakii infection that have ever been reported is 1 per 100,000 infants. An increasing incidence rate to 9.4 per 100,000 in infants with very low birth weight (less than 1.5 kg of body weight).