Cronobacter Support
03-04-2010, 12:46 PM
By Grainnne Ryan
Monday February 22 2010
Q: I started breastfeeding my daughter when she was born six weeks ago. However it didn't go too smoothly and I transferred to bottles. I don't really mind now, although I was disappointed initially. My query is how do you make up infant formula. I missed out on the bottle-feeding classes in the hospital as I was breastfeeding. I have been using the ready-to-feed milk. I have heard conflicting information and would be grateful if you could let me know what the most recent recommendations are.
A: Well done for breastfeeding. Breast milk is the best and most natural food for your baby, but for some parents who choose not to breastfeed, or who switch to bottle feeding, it is important that your baby's formula is prepared safely.
Cleaning, sterilizing and storing
All equipment used to feed your baby, such as bottles, teats and lids, need to be cleaned and sterilized until your baby is a year old. This is due to the fact that their immune system is only developing and cannot always protect itself against harmful bacteria.
Hands should be washed well with soap and water and dried with kitchen paper. All equipment should be washed well in hot soapy water.
A clean bottle brush should be used to scrub the inside and outside of bottles and teats. This makes sure that leftover milk is removed from hard-to-reach places. It is important to rinse equipment well under running water.
Dishwashers can be used to clean feeding equipment that is dishwasher proof, but remember they do not sterilize equipment.
Sterilizing
All equipment used for feeding your baby needs to be sterilized. By sterilizing your equipment, washing your hands and keeping the preparation area clean, you will reduce the chance of your baby getting sick.
You can use one of the following methods:
Steam: Today steam is the most popular way to sterilize feeding equipment. You can buy plug-in sterilizers or microwave ones. It is important to follow the manufacturer's instructions.
Boiling: Fill a large saucepan with tap water and totally immerse all equipment. Make sure there are no trapped air bubbles.
Cover the saucepan and bring to the boil for at least three minutes. Keep the saucepan covered until you need to use the feeding utensils.
Chemical sterilizer: Use a plastic container with a lid. Make up sterilizing solution according to manufacturer's instructions. Make sure all equipment is covered by liquid and that there are no trapped air bubbles. Leave for time specified by the manufacturer.
Use a sterilized forceps when putting the sterilized teat onto the bottle so that it does not become dirty again.
If you remove bottles from sterilizing unit before you need them, put the feeding bottles together as this prevents the inside and outside of the bottle becoming dirty again.
When bottles are put together correctly, they will remain safe to use for 24 hours if they are not opened.
Powdered infant formula is not sterile. Even though they are sealed, tins or packets of milk powder can contain bacteria, such as Enterobacter sakazakii or Salmonella.
Infections caused by these bacteria in formula milk are very rare, but when they do happen they can be fatal.
Low birth-weight and premature babies and toddlers under six weeks old are most at risk from these bacteria, so it is important that it is destroyed. This can be done by making up the milk with water at a temperature of about 70C. What this means is boiling the kettle and leaving it to cool for no longer than 30 minutes.
How to prepare a bottle feed
Before making up a feed, clean the surface you are going to use and wash your hands.
Use fresh tap water (not bottled water) to fill the kettle. When it has boiled, let it cool for 30 minutes. Do not use artificially softened water or water that has been repeatedly boiled.
Always put the cooled, boiled water in the bottle first. Place the bottle on a flat surface to ensure that the water level is correct. Fill the scoop with milk powder and level it off using the flat edge of a sterilised knife.
Follow the manufacturer's preparation instructions on the container of the milk powder. It is important to use only the scoop that is enclosed with the milk powder. Never add sugar or cereals to the feed.
Always cool your baby's milk down to the required temperature, as at 70C it is still hot enough to scald. To cool it, hold the bottle, with the cap covering the teat, under cold running water.
Drop a little of the milk on to your wrist to test its temperature. It should not be hot, but should be warm.
Ideally, you should make up formula milk freshly for each feed. This is because warm milk provides ideal conditions for bacteria to grow -- especially at room temperature. If you do have to make feeds up in advance to use later, make up individual bottles, cool them quickly and place in the back of the fridge.
To warm up refrigerated bottle feeds, remove the bottle from the fridge just before you need it. Place it in a bowl of warm water, ensuring the level of the water is below the neck of the bottle. You can also use a bottle warmer. Warm for no more than 15 minutes. Throw away any unused feed after two hours.
Never use microwaves to re-warm feeds. Microwaves warm unevenly and can cause 'hot spots' which could scald your baby's mouth.
Feeding while traveling
The safest option if a feed is required while traveling is ready-to-feed milk. Unopened cartons of these do not need to be kept in the fridge. All you need to bring with you is a sterile bottle and an unopened carton.
If this is not an option and your journey is short (less than two hours), you can make your bottle as normal, cool quickly and place in the fridge. Just before you leave, remove the cold feed from the fridge and place in an insulated cool bag with ice.
When you arrive, place the feed in a fridge as soon as you can. Re-warm the feed when you require it.
If you are going on a longer journey and will not be able to boil fresh water, bring powder and sterile bottles of water with you. Make up sterile bottles of water at home by pouring the correct volume of boiled water into the sterile bottles immediately. Do not cool for 30 minutes.
Bottled water
Tap water is usually safe to use, but sometimes it may be necessary to use bottled water. This can happen when there is a boil notice on your water, when you are on foreign holidays or if you have a water softener.
When using bottled water to make up feeds:
Use still water only.
Use bottled water that has a sodium content of less than 20mg/l. This information is on the label.
Always boil bottled water before making up feeds.
How much feed should a baby take
For the first six months your baby should be taking between 150ml-200ml of formula per kilo in 24 hours. For example, a baby weighing 6kg should take 900ml-1200ml (150ml-200ml x 6) in 24 hours.
All babies are different and may take more or less. If your baby is taking her bottles, sleeping and gaining weight, there is no need to worry.
- Grainnne Ryan
Irish Independent
Posted from independent.ie
Monday February 22 2010
Q: I started breastfeeding my daughter when she was born six weeks ago. However it didn't go too smoothly and I transferred to bottles. I don't really mind now, although I was disappointed initially. My query is how do you make up infant formula. I missed out on the bottle-feeding classes in the hospital as I was breastfeeding. I have been using the ready-to-feed milk. I have heard conflicting information and would be grateful if you could let me know what the most recent recommendations are.
A: Well done for breastfeeding. Breast milk is the best and most natural food for your baby, but for some parents who choose not to breastfeed, or who switch to bottle feeding, it is important that your baby's formula is prepared safely.
Cleaning, sterilizing and storing
All equipment used to feed your baby, such as bottles, teats and lids, need to be cleaned and sterilized until your baby is a year old. This is due to the fact that their immune system is only developing and cannot always protect itself against harmful bacteria.
Hands should be washed well with soap and water and dried with kitchen paper. All equipment should be washed well in hot soapy water.
A clean bottle brush should be used to scrub the inside and outside of bottles and teats. This makes sure that leftover milk is removed from hard-to-reach places. It is important to rinse equipment well under running water.
Dishwashers can be used to clean feeding equipment that is dishwasher proof, but remember they do not sterilize equipment.
Sterilizing
All equipment used for feeding your baby needs to be sterilized. By sterilizing your equipment, washing your hands and keeping the preparation area clean, you will reduce the chance of your baby getting sick.
You can use one of the following methods:
Steam: Today steam is the most popular way to sterilize feeding equipment. You can buy plug-in sterilizers or microwave ones. It is important to follow the manufacturer's instructions.
Boiling: Fill a large saucepan with tap water and totally immerse all equipment. Make sure there are no trapped air bubbles.
Cover the saucepan and bring to the boil for at least three minutes. Keep the saucepan covered until you need to use the feeding utensils.
Chemical sterilizer: Use a plastic container with a lid. Make up sterilizing solution according to manufacturer's instructions. Make sure all equipment is covered by liquid and that there are no trapped air bubbles. Leave for time specified by the manufacturer.
Use a sterilized forceps when putting the sterilized teat onto the bottle so that it does not become dirty again.
If you remove bottles from sterilizing unit before you need them, put the feeding bottles together as this prevents the inside and outside of the bottle becoming dirty again.
When bottles are put together correctly, they will remain safe to use for 24 hours if they are not opened.
Powdered infant formula is not sterile. Even though they are sealed, tins or packets of milk powder can contain bacteria, such as Enterobacter sakazakii or Salmonella.
Infections caused by these bacteria in formula milk are very rare, but when they do happen they can be fatal.
Low birth-weight and premature babies and toddlers under six weeks old are most at risk from these bacteria, so it is important that it is destroyed. This can be done by making up the milk with water at a temperature of about 70C. What this means is boiling the kettle and leaving it to cool for no longer than 30 minutes.
How to prepare a bottle feed
Before making up a feed, clean the surface you are going to use and wash your hands.
Use fresh tap water (not bottled water) to fill the kettle. When it has boiled, let it cool for 30 minutes. Do not use artificially softened water or water that has been repeatedly boiled.
Always put the cooled, boiled water in the bottle first. Place the bottle on a flat surface to ensure that the water level is correct. Fill the scoop with milk powder and level it off using the flat edge of a sterilised knife.
Follow the manufacturer's preparation instructions on the container of the milk powder. It is important to use only the scoop that is enclosed with the milk powder. Never add sugar or cereals to the feed.
Always cool your baby's milk down to the required temperature, as at 70C it is still hot enough to scald. To cool it, hold the bottle, with the cap covering the teat, under cold running water.
Drop a little of the milk on to your wrist to test its temperature. It should not be hot, but should be warm.
Ideally, you should make up formula milk freshly for each feed. This is because warm milk provides ideal conditions for bacteria to grow -- especially at room temperature. If you do have to make feeds up in advance to use later, make up individual bottles, cool them quickly and place in the back of the fridge.
To warm up refrigerated bottle feeds, remove the bottle from the fridge just before you need it. Place it in a bowl of warm water, ensuring the level of the water is below the neck of the bottle. You can also use a bottle warmer. Warm for no more than 15 minutes. Throw away any unused feed after two hours.
Never use microwaves to re-warm feeds. Microwaves warm unevenly and can cause 'hot spots' which could scald your baby's mouth.
Feeding while traveling
The safest option if a feed is required while traveling is ready-to-feed milk. Unopened cartons of these do not need to be kept in the fridge. All you need to bring with you is a sterile bottle and an unopened carton.
If this is not an option and your journey is short (less than two hours), you can make your bottle as normal, cool quickly and place in the fridge. Just before you leave, remove the cold feed from the fridge and place in an insulated cool bag with ice.
When you arrive, place the feed in a fridge as soon as you can. Re-warm the feed when you require it.
If you are going on a longer journey and will not be able to boil fresh water, bring powder and sterile bottles of water with you. Make up sterile bottles of water at home by pouring the correct volume of boiled water into the sterile bottles immediately. Do not cool for 30 minutes.
Bottled water
Tap water is usually safe to use, but sometimes it may be necessary to use bottled water. This can happen when there is a boil notice on your water, when you are on foreign holidays or if you have a water softener.
When using bottled water to make up feeds:
Use still water only.
Use bottled water that has a sodium content of less than 20mg/l. This information is on the label.
Always boil bottled water before making up feeds.
How much feed should a baby take
For the first six months your baby should be taking between 150ml-200ml of formula per kilo in 24 hours. For example, a baby weighing 6kg should take 900ml-1200ml (150ml-200ml x 6) in 24 hours.
All babies are different and may take more or less. If your baby is taking her bottles, sleeping and gaining weight, there is no need to worry.
- Grainnne Ryan
Irish Independent
Posted from independent.ie