Mumsnet please can you update your bottlefeeding info section?

[tabouleh]

Hello Mumsnet Team!

Following on from this thread about the correct guidelines for preparing formula I'd like to ask you to consider updating/expanding the bottlefeeding info section.

I am unleashing my inner interfering bossy feminist/activist part!

It is clear to me that:

• many people do not know that formula is not sterile and that it needs to be made with water which is hotter than 70 degrees C

• many people do not know what the guidelines are at all or just follow what they/their mother etc did

• people who know what they are don't know the research or reason behind the guidelines and therefore dismiss them

• people don't realise that there are some pretty good alternatives to making fresh each time and that THIS DOESN'T INVOLVE ADDING FORMULA TO COLD WATER AND HEATING UP!

• the formula manufacturers need a kick up the arse to be pressurised to provide fuller explanations on their packaging and websites

• the midwives/doctors and HVs also need to know

If you'd like me to have ago at drafting something then I am happy to.

Do you think we could start a Mumsnet campaign? Could we get someone on from the FSA or something.

Hello tabouleh - and thanks for your suggestion.

We do already mention in our bottlefeeding info that formula is not sterile and that the guidelines for making up formula are not the same as the guidelines your mum probably followed.

But we're happy to take another look at it and maybe add some extra stuff in.

Oh, and fix the broken link

Adding my support.

Its every week we get a new thread "how do I make up formula" with the world and his wife telling the OP how their granny/uncle/dog made formula, usually followed by "and it never did us any harm".

There doesnt seem to be a industry standard, with even HCP's advising incorrectly.

Its a serious health risk for babies.

Just adding my support, there is a lot of misinformation and misunderstanding floating around.

absolutely worth campaigning about

what i do find shocking is how long it takes information to filter through and become the norm.

DD is almost 5, and I remember the HV telling me about teh making each bottle up fresh etc etc 3.5 years ago..

and yet, it is like this is surprising new information that can be ignored as it was done differently

having said that, if people want to make an informed decision to do things differently to teh guidelines, taht is there choice, but there needs to be easy clear accesss to to the correct guidelines

links to teh DoH leaflet would be good

Good idea to make things clearer. People get very defensive about this for some reason - not liking to think they are doing/did it 'wrong' - but the guidelines are clear, there are perfectly manageable work-rounds for when guidance can't be followed easily, but many parents (and midwives, and HVs) simply don't know about it all.

Definitely a good idea.

When I started f'feeding dd1 I was told by a variety of HVs to

a) make it up in advance and put it in the fridge

b) leave cooled boiled water on the side and add formula for each feed

Of all the mums I know who have f'fed I think I am the only one who makes it up with >70 degree water (either with the half and half method, microwaving cooled boiled water up to 70 degrees and adding formula), and think I am being a bit mad doing it the way I do it.

It would also seem that the one way that a lot of people find a little unworkable is the method they put on the tin.

Wouldn't the campaign be better if it required manufacturers to make the formula sterile rather than having to follow ridiculously impractical guidelines?

Honestly, when my son is hungry, I am not going to boil a new kettle, wait 30 minutes, mix up the formula and then cool it down. He'd be shouting the house down by then. He's 10 months old and I have never made him a bottle that way and he's never been ill because of it.

I mean, really, if there was un-sterile food for a grown up on the grocery shelves that might make a person ill, people would be livid!

In the US they some how make it sterile as the guidelines say to only use boiling water if your GP says you have to, i.e. your baby is poorly.

Of course in the US it says the same thing about sterilizing bottles.

Tee I read somewhere that although it may be unlikely that your baby will become ill as a result of 'bad' formula, but if they do, there is a 20% mortallity rate.
The main risk groups I believe are prem babies and those under 6 weeks.
Obviously the guidlines are there for a reason and it is up to each of us to decide if we are happy to risk whatever negative outcome we may experience.

cartons of formula are good for when you cannot wait for the kettle to boil and have a newborn or growth spurt and have no idea when the next feed might be

Tee - I assume the formula could be made sterile while it's sealed in the packet but that means it would only be sterile for the first feed. Unless they could create sterile 'single feed' sachets - is that what you meant? Would be a lot of packaging though

My point, silverymoon, is that why do we allow the manufacturers to sell something that can kill our children?

We had a huge outcry over a snipped finger from a buggy a few months ago. And yet we regularly feed our babies something that could kill them if not properly prepared?

Its ludicrous!

But the buggy was the same principle - could damage if not used properly.

I think the manufacturers have done their bit by supplying clear instruction on the tin though haven't they?
They tell us how to prepare their product, if we choose to ignore that, that isn't their fault is it?

Tee
If you know that there is a danger, even a very slight one, why do you not follow the current guidelines?

I understand your point, and hope that someone knows the answer to why it is not possible to make sterile formula, but at the moment the situation at the moment is such that it is dangerous to make up a bottle with cooled water.

My son had salmonella when he was 5yo and I can assure you that five minutes of screaming child while waiting for a bottle to cool is much preferable to that.

He was lucky, I did not wait for days thinking it was "just a bug", I went straight to the doctor who tested and prescribed antibiotics.

You can do half boiling and cooled water, it is very easy once you get the hang of it and your DS will not have to wait any longer than at present.

When I was buying powdered formula about a year ago, it was mentioned on some brands of formula but not others, so I only knew about it because I happened to buy a certain brand. I never intended to use formula so knew nothing about it, and because I was so upset about having to use it, I couldn't have looked at the breast and bottle feeding section on here

And, I would be very pleased if MN could help highlight this problem.

a great big tub of formula will only be sterile until the seal's broken. So it would need to be in individual sachets

Yes, but that's true of bottles, as well SPB. Your bottles are only sterile until you open the sterilizer. You're kidding yourself if you think they are still sterile after that. Or really, are sterile at all with a home or microwave sterilizer. Ask a scientist at what temp and how long it actually takes to sterilize something.

mmeLindt because I did the research and the probability of a child becoming sick from wrongly prepared formula is very very small. And its a guideline. It was not handed down by Moses on The Mount. And it goes totally against the other guideline, which is 'feed on demand.' If you are boiling a kettle, waiting 30 minutes for it to cool and then making up a bottle and letting it cool even further? Its not 5 minutes of a screaming baby. Closer to an hour.

And really, MmLindt, I am assuming your 5 year old was not drinking formula, so not really sure what your story has to do with the discussion, as he did not get the salmonella from formula. Although, of course, I am glad he is fine!

Anyway, I have to head to the supermarket so I may get behind. I'll be back though!

I agree. But the manufacturers are at fault for not explaning it properly and saying why it has to be done correctly.

By the time we were on bottles the dc's were in a strict routine so never really had any crying before the bottle was prepared as I had already done it. But heaven knows how it would work for a newborn, you'd need ready made really wouldn't you?

Tee There are ways around it though. I'm sure a PP has stated that you could have a jug of cooled boiled water in the fridge, then when feeding time comes along, you could boil kettle, pour in lets say 4/5oz of water, add in your powder, then add cooled water to make it right mix and cool the bottle.

[food science hat on]

1. Formula cannot be made sterile-ly using the spray-drying method. Some bacteria, including E.sakazakii, can survive the heat and dessication, but most other bacteria cannot.

1. Most food we buy is not sterile (exceptions include eg cartons of UHT milk and tinned food). However the bacteria present do not pose a risk to healthy people with competent immune systems. Tiny babies do not have competent immune systems.

1. Bacteria that enter the tin of formula powder after it's opened from air, fingers etc are significantly less harmful than the E.sakazakii that may have been in the tin to start with.

Sorry, he was 5 MONTHS not years. So used to writing 5yo as that is the age he is now.

It is not so small, the risk.

He definitely got it from the formula as he was not at that point weaned and was getting nothing else.

None of us had it so it had to have come from the formula.

Tee, there have been 3 ways of making up feed mentioned on this thread -

topping up with cooled boiled water

microwaving cooled boiled water to 70 degrees, then running under cold tap to drinking temp

using ready to use cartons

I used a mix of all 3 methods to feed dd2, and she was never left for 'close(r) to an hour', once you are all set up, it doesn't take very long at all.

Whether bottles are sterile isn't the issue, the fact that there is a small chance of a baby ingesting a very dangerous bacteria in the formula is the issue. I can't remember her name, but there is someone who posts here who contracted salmonella when she was 3 months old from formula - it is rare, but it can happen.

Yes, and my point, hazeyjane is still why do we allow our kids to eat this if it is so dangerous? Forget what method I or anyone else uses to make up their formula. The fact that the formula can kill is the real issue.

And that's the campaign MN should start, IMHO. Not to promote guidelines for making the formula in a safe way, but making the formula safe no matter how it goes from powder to liquid.

As I said, the US apparently has done it, so why can't the UK?

mmelindt, that does make more sense. And I'm glad your baby is okay.

Tee - no one is saying you have to wait 30 minutes. If you read the posts carefully you will see that it says water than has been boiled less than 30 minutes ago. So boil the kettle, allow to coil for a couple of minutes, add to bottle with powder, cool under cold water or in iced water jug - would take 15 minutes or add boling water to formula then top up to required level with cooled previously boiled water - this would take less than 5minutes - no idea where you got your hour from.

Also - as mrs B has pointed out, it is a completely different bacteria in powdered milk to that found in every day life. Yes, children are exposed to bacteria all day every day, and there is a general rule of thumb that this helps to boost their immune system but the bacteria E.sakazakii that is found in powdered milk needs to be killed in water hotter than 70deg - if it isnt then it can cause severe problems in babies - esp prem or those with weak immune systems.

At the end of the day you choose to feed your kids the way you want, just like you choose whether to put your baby to sleep on its front or back, wean at 16 or 24 weeks etc etc, but there for the grace of god, you live with the consequences of your actions.