New and expectant parents take note: powdered infant formula is safe. However, it is not sterile and, therefore, has a very small chance of bacteria growth in the powder.
So what, as parents, can we do to protect our infant children? Some mothers are not able to breastfeed and have no choice but to feed their children powdered infant formula. How do we minimize the risks to infants?
Unfortunately, parents cannot rely on the directions offered by manufacturers: add “X” amount of formula to “Y” amount of water (no temperature specified). So, what do we do?
The U.S. government has not yet developed safe procedures for mixing and preparing powdered formula for consumption by an infant child. So, you have to look to the World Health Organization (WHO). Here’s what it recommends:
- Clean and disinfect a surface on which to prepare the feed.
- Wash hands with soap and water, and dry using a clean cloth or a single-use napkin.
- Boil a sufficient volume of safe water. If using an automatic kettle, wait until the kettle switches off; otherwise, make sure that the water comes to a rolling boil. Note: bottled water is not sterile and must be boiled before use. Microwave ovens should never be used in the preparation of powdered infant formula as uneven heating may result in ‘hot spots’ that can scald the infant’s mouth.
- Pour the appropriate amount of boiled water, which has been allowed to cool slightly, but not below 158 degrees Fahrenheit, into a cleaned and sterilized feeding cup or bottle. The temperature of the water should be checked using a sterile thermometer. If making a batch in a larger container, the container should be cleaned and sterilized. It should be no larger than 1 liter, be made from food-grade material, and be suitable for pouring hot liquids.
- To the water, add the exact amount of formula as instructed on the label. Adding more or less powder than instructed could make infants ill.
- Cool feeds quickly to feeding temperature by holding under a running tap or placing in a container of cold water or iced water. Ensure that the level of the cooling water is below the top of the feeding cup or the lid of the bottle.
- Dry the outside of the feeding cup or bottle with a clean or disposable cloth and label with appropriate information, such as type of formula, infant’s name or ID, time and date prepared, and preparer’s name.
- Because very hot water has been used to prepare the feed, it is essential that the feeding temperature is checked before feeding in order to avoid scalding the infant’s mouth. If necessary, continue cooling as outlined in step 6.
- Discard any feed that has not been consumed within two hours.
According to the WHO, the risk dramatically decreases when powdered infant formula is mixed with water that is no less than 158 degrees Fahrenheit, as this temperature will kill any bacteria in the powder.
Consequently, mixing powdered infant formula with water no less than 158 degrees Fahrenheit dramatically reduces the risk to all infants, even slow-feeding infants and infants in warm climates in which refrigeration of the prepared formula may not be readily available. When powdered infant formula is prepared with water that is less than 158 degrees Fahrenheit, it does not reach a high enough temperature to completely inactivate the bacteria present in the powder.
Follow these tips to ensure that your formula is safe for your baby to consume.
___ Michael Brandner is an attorney with Brandner Law Firm LLC in Metairie, Louisiana