Pre-making Formula

The Mighty Quinn

The midwife at the maternity hospital said never ever ever make up formula in advance, always boil fresh water and let cool for 30 mins then add powder, cool bottle under tap and serve.

Public health nurse says to put measured out boiled water in bottles in a fridge after it's been cooled under a tap. Add formula powder to bottle just before feeding.

HSE website has a different take, says you can make up bottles with powder added and store them in fridge after rapid cooling under tap first, heat in a big or bottle warmer before feeding.

I thought the boiling water was to kill anything in formula powder, which must not be the case as PHN says to add powder to cooled water and just warm in a jug.

I know people who've done all types of the above and babies are grand but just can't help but feel the advice is a bit conflicting and unclear.

marco_polo

For our two made up the batches for maybe 12 hours using similar to the HSE method. Boil fresh water, pour into sterilised bottles, allow cool for 20-30 mins, add formula for at least 3 minutes then cool rapidly and put in fridge. I think any similar method is fine apart from adding to already cold water as the whole point is to sterlize both water and formula, so I think public health nurse advice is poor imo.

Midwife possibly technically correct but I really don't see much danger of contamination of carefully made batches tbh.

Antares35

It seems to be one of those areas that many people disagree on!

FWIW, we used aptamil and would boil the fresh water, leave for no longer than thirty minutes (so sometimes it would just be 20 minutes for example) and make up the formula with that, then cool in a pyrex jug of cold water to desired temperature. We never pre- made but I've heard they can be pre- made and stored at the back of fridge for 24 hours. We also found the pre-made stuff very handy for the night feeds where boiling the kettle and waiting was just too much!

Edit, agree with previous poster I believe the formula isn't sterile so even if water is sterilised, it needs to be a certain temperature to also sterilise the formula.

893bet

The Mighty Quinn wrote: »

The midwife at the maternity hospital said never ever ever make up formula in advance, always boil fresh water and let cool for 30 mins then add powder, cool bottle under tap and serve.

Public health nurse says to put measured out boiled water in bottles in a fridge after it's been cooled under a tap. Add formula powder to bottle just before feeding.

HSE website has a different take, says you can make up bottles with powder added and store them in fridge after rapid cooling under tap first, heat in a big or bottle warmer before feeding.

I thought the boiling water was to kill anything in formula powder, which must not be the case as PHN says to add powder to cooled water and just warm in a jug.

I know people who've done all types of the above and babies are grand but just can't help but feel the advice is a bit conflicting and unclear.

Follow the instructions on the packet and ignore the PHN.

Using cooled boiled water will mean any bacteria in the powder will not be killed. The powder is not sterile.

The perfect way of doing it is IMO.

1) boil a kettle with 1 litre of water and then wait 20 or so mins
2) the water temp is now 70-80 degrees, a good temperature to kill bacteria in the powder but not damage it nutritionally. Make the bottle.
3) Cool the bottle in sink of cold water to temperature for feeding.
4) If putting in fridge for feeding later then cool as much as possible as quick as possible and put in fridge and use within 12 hours.

Now people may make it using cooled boiled water and never have an issue. That’s just the luck of the draw.

catrionanic

You are correct, formula is not sterile so there is a risk if you're not using hot enough water.

Right pain in the ass though. The amount of people who told me when my baby was small that life would be easier if we switched to bottles... nope.

The Mighty Quinn

marco_polo wrote: »

Boil fresh water, pour into sterilised bottles, allow cool for 20-30 mins

Even this is at odds with some instructions, saying it should be allowed cool in the kettle before pouring to sterilised bottles, to maintain it at a high temperature to kill bacteria in formula, if cooled in bottles it'll be too cold after 20-30 mins when powder is added.

Some other site also mentioned about plastics leeching to water if poured straight in from boiling.

Antares35

catrionanic wrote: »

Right pain in the ass though. The amount of people who told me when my baby was small that life would be easier if we switched to bottles... nope.

Gas, I had a fair amount of people telling me life would be easier sticking with boob, and that was a nope for me. Just proves the point that each individual mammy knows best

Antares35

The Mighty Quinn wrote: »

Some other site also mentioned about plastics leeching to water if poured straight in from boiling.

We were told that too, and switched to glass bottles, but the drawback with those is there isn't an anti-colic valve so depending on the baby, mightn't be an option. It's a minefield!

marco_polo

The Mighty Quinn wrote: »

Even this is at odds with some instructions, saying it should be allowed cool in the kettle before pouring to sterilised bottles, to maintain it at a high temperature to kill bacteria in formula, if cooled in bottles it'll be too cold after 20-30 mins when powder is added.

Some other site also mentioned about plastics leeching to water if poured straight in from boiling.

Indeed you are correct that's actually what I used to do alright just been a while so forgot the steps order

awec

For the first while just buy the big bottles of pre-made stuff. More expensive but a lot easier.

The Mighty Quinn

awec wrote: »

For the first while just buy the big bottles of pre-made stuff. More expensive but a lot easier.

We did this with our first, almost exclusively for a year but lots of shortages in shops at the moment, none in tesco, dunnes or lidl, so needed to make do with powder.

shesty

Honestly, if you find advice conflicting on formula making, try getting consistent advice about breast feeding.Messages are very confusing on all fronts.

There's quite a detailed thread on the topic of formula making here :-)
https://touch.boards.ie/thread/2058182986/1

markpb

OSI wrote: »

https://www.tommeetippee.com/en-gb/product/perfect-prep-machine

We have one of those and used it on babies two and three. I can't imagine going back to all that messing around with boiling and cooling water.

I’m aware of concerns that the machines are untested and may come with some risk but I’m not sure how true that is or how quantifiable the risk is.

Vaccinated30

Definitely something nobody agrees on.
So for what it's worth, I've done bottles every way imagineanble.
Pre made in the back of the fridge
Adding powder into cold water
Adding powder into a 30 min kettle
Adding powder into a kettle that's just boiled.
I have given bottles that were more than 1 hour made.
I have 4 kids, eldest 8. Everyone is alive and well. Nobody ever had an upset stomach from any method (normal temperment and nappies)
All slept through the night. Breastfeeding was so much easier than all the faff with bottles

Cazale

markpb wrote:

We have one of those and used it on babies two and three. I can’t imagine going back to all that messing around with boiling and cooling water.

We used it for our daughter. Worth its weight in gold.

Bogwoppit

Have a look online about those prep machines before you get one, people have opened them up and the absolute mank inside the tubes would horrify you!

After doing a fair bit of research ourselves into the rights and wrongs we settled on boiled water into the bottles, seal them up and put in the fridge. Keep the formula in one of the tubs with separate compartments, a full bottles worth in each compartment. When you need a bottle you just pop in the pre measured amount of formula, give it a shake, warm it up and away you go. We would have the kettle on while making up the bottle, put the bottle in a bowl and pour the boiling water in the bowl to warm it up, by the time you had baby ready to feed the bottle was usually the right temperature.

Always make sure you have more than one bottle with water ready in the fridge as mistakes and disasters can happen and you don’t need want to be trying to go through the whole process with baby screaming at you.

Cazale

Bogwoppit wrote:

Have a look online about those prep machines before you get one, people have opened them up and the absolute mank inside the tubes would horrify you!

You need to run a cleaning cycle using white vinegar regularly on them to keep it clean internally. I'd say those who opened it up didn't bother.

Shelli2

Cazale wrote: »

You need to run a cleaning cycle using white vinegar regularly on them to keep it clean internally. I'd say those who opened it up didn't bother.

Yes, and change the filter regularly too.

Best invention ever, I wouldn't be without it.
That and a few of the 200ml ready made bottles for out and about.

Milly33

It is such a disgrace how the information is not the same between nurses and HSE all of them. A friend of mine was told by the nurse that there was no need to add the formula in the boiled water to just use cooled boiled which is all wrong.. Lead to a lot of wasted bottles etc feeding more formula. Even after I approached the subject it was said well the nurse told me..

Asked, our own PHN as she said that it was actually not confirmed within the HSE and nurses, and a lot of older nurses tend to tell you not to use hot water..

Never got the prep machines, but we used to make as per the back of the tin (bar the odd time when you ran out of the last scoop of formula or trying to wean off the bottles).. Boil the kettle enough for six bottles (we live in a hard water area and never used bottles water unless there was something very wrong with it). Fill bottles, add formula let cool and put in the fridge use within 24 hours..

andreac

Bogwoppit wrote: »

Have a look online about those prep machines before you get one, people have opened them up and the absolute mank inside the tubes would horrify you!

After doing a fair bit of research ourselves into the rights and wrongs we settled on boiled water into the bottles, seal them up and put in the fridge. Keep the formula in one of the tubs with separate compartments, a full bottles worth in each compartment. When you need a bottle you just pop in the pre measured amount of formula, give it a shake, warm it up and away you go. We would have the kettle on while making up the bottle, put the bottle in a bowl and pour the boiling water in the bowl to warm it up, by the time you had baby ready to feed the bottle was usually the right temperature.

Always make sure you have more than one bottle with water ready in the fridge as mistakes and disasters can happen and you don’t need want to be trying to go through the whole process with baby screaming at you.

But this is wrong. Formula must be added to the hot water to kill off any bacteria in the formula, as formula is not sterile and cold water will not do that. Hence why they say boil the water and let it cool for 30 mins so its hot enough to kill off any bacteria in the formula.

anndub

The Mighty Quinn wrote: »

The midwife at the maternity hospital said never ever ever make up formula in advance, always boil fresh water and let cool for 30 mins then add powder, cool bottle under tap and serve.

Public health nurse says to put measured out boiled water in bottles in a fridge after it's been cooled under a tap. Add formula powder to bottle just before feeding.

HSE website has a different take, says you can make up bottles with powder added and store them in fridge after rapid cooling under tap first, heat in a big or bottle warmer before feeding.

I thought the boiling water was to kill anything in formula powder, which must not be the case as PHN says to add powder to cooled water and just warm in a jug.

I know people who've done all types of the above and babies are grand but just can't help but feel the advice is a bit conflicting and unclear.

The public health nurse is wrong and obviously hasn't bothered to keep up with current advice. The HSE website is correct. In an ideal world bottles would be made up fresh but babies don't tend to want to wait thirty minutes and tired parents can't always remember to be thirty minutes ahead! Making a few bottles up correctly, then cooling and storing at the back of the fridge is perfectly safe. I used to do a batch in the morning to cover up to dinner time and a batch in the evening to cover the nights.

You are completely right in your thinking that making up with cold water won't sterilise the formula. It's completely illogical to go to the palaver of sterilising bottles, sterilising tap water and then lob in non sterile powder o cold water which will do nothing to kill bugs!
Please avoid the perfect prep machines. The above method is the safest and least hassle. I'm a microbiologist who has worked in this area

Wesser

Do whatever suits you. There is no evidence of any increased illness in the baby no matter what method you use.

anndub

Wesser wrote: »

Do whatever suits you. There is no evidence of any increased illness in the baby no matter what method you use.

Simply untrue. While incidences of fatal illnesses are extremely low, why would any parent want to increase their risk of being the 1 in a million when it's so easily avoided by following correct practices rather than doing what suits them?

https://www.cdc.gov/cronobacter/infection-and-infants.html#:~:text=Cronobacter%20sakazakii%2C%20formerly%20known%20as,%2C%20herbal%20teas%2C%20and%20starches.

Anyway, it looks like the OP doesn't plan on doing it any which way so I'll say no more

screamer

I’ve 4 kids with twins in the mix. All bottle fed, and I’ve always made up the bottles in batch, and none of them ever sick etc.
The advise has changed from the HSE on every child, so I follow what I’ve always done, and with hangry babies, I need something fast. No one has time to wait for boiling water to cool and a screaming infant.

I have my own method of making and mixing bottles as when my twins were small I’d have 12 bottles to make with 2 different formulas.

Anyways most important is use kettle water boiled and cooled for half an hour, there can be bacteria in powdered milk that can make a baby sick, the 80 degree temperature is essential to kill that bacteria.
I cringe when I see idiots mixing with cold water only.

fits

Wesser wrote: »

Do whatever suits you. There is no evidence of any increased illness in the baby no matter what method you use.

If you knew of the care taken with premature babies and the damage that can be done you wouldn’t say that. It’s why they try to give preemies breast milk or donor milk if possible. I’d definitely be trying to ensure I’d be following the latest guidelines on hse website. PHNs a d other health professionals can be out of touch.

Wesser

No what i mean is that no one has never done a head to head study of the various methods as listed above in the original post to detect which method has the lowest incudence of infection.

Im not advocating that the OP does not attend to basic hygiene.

Im just saying nobody has ever done a trial with the 3 different methods as listed above , with thousands of babies enroled.... to see which was the best.

anndub

Wesser wrote: »

No what i mean is that no one has never done a head to head study of the various methods as listed above in the original post to detect which method has the lowest incudence of infection.

Im not advocating that the OP does not attend to basic hygiene.

Im just saying nobody has ever done a trial with the 3 different methods as listed above , with thousands of babies enroled.... to see which was the best.

You advocated for formula to be made up whatever way suited the parents. What suits the parents is largely irrelevant and your claim about fatality rates being unaffected is quite frankly, dangerous.

A controlled trial does not need to be carried out. The growth temp range for the microorganisms in question is known, as it's the temperature of death. The microorganisms will die and risk is removed if water cooled for no more than 30 minutes is used. If the formula is added to water cooled for longer than that the date rate will slow or completely stop depending on how cold the water is. Therefore bacteria remain.

https://pubmed.ncbi.nlm.nih.gov/15059207/

Wesser

Sorry if i havent explained my point well.

When i say make it up whatever way suits you..... i mean make it up in whatever way suits you hygienically.... ie one if the 3 mothods ... midwife...phn... or hse.... obviously the water has to be boiled!!!!! Im mot for a minute advocating that hygiene is not attended to!

anndub

Wesser wrote: »

Sorry if i havent explained my point well.

When i say make it up whatever way suits you..... i mean make it up in whatever way suits you hygienically.... ie one if the 3 mothods ... midwife...phn... or hse.... obviously the water has to be boiled!!!!! Im mot for a minute advocating that hygiene is not attended to!

I think you're missing the point. If the water is cold the process is not hygienic. The water must be 70C or more in order to sterilise the powedered formula. Powdered formula has been found to be contaminated with bacteria that can prove fatal to newborns. If the water has been boiled and then cooled it renders all other hygiene steps (boiling the water in the first place and sterilising bottles) pointless as you are introducing bacteria back into the process at the final step. If that bacteria is not killed by heat it is ingested by the baby.

I can't really explain it in many more ways than I already have. Making up bottles with cold water, whether it has previously been boiled or not, leaves babies at risk of serious illness

Wesser

Yes i totally agree.

All 3 methods as listed in the op advocate using boiled water...... no?

catrionanic

Wesser wrote: »

im just saying nobody has ever done a trial with the 3 different methods as listed above , with thousands of babies enroled.... to see which was the best.

And rightly so because that would be completely unethical. Deliberately feeding babies formula in what is known to be an unsafe way to prepare it would never get ethics approval. The point you are trying to make here is redundant.

Gael23

Measure out boiled water in bottles, then cool and add formula as needed

anndub

Wesser wrote: »

Yes i totally agree.

All 3 methods as listed in the op advocate using boiled water...... no?

I feel like you're not even reading what I'm writing. One option suggested using COOLED boiled water. As in COLD water. As I've said unpteen times now, the water must be at, or above 70C when the powder is added. It must be! That is a fact and cannot be argued unless you are in the habit of argueing science.

Wesser

My understanding from the original post is that the formula is added to boiling water in all 3 cases.

fits

Wesser wrote: »

My understanding from the original post is that the formula is added to boiling water in all 3 cases.

Really. That’s your understanding?

Public health nurse says to put measured out boiled water in bottles in a fridge after it's been cooled under a tap. Add formula powder to bottle just before feeding.

Wesser

Oh sorry. Just read it again there. Yes make sure that the formula is added to boiling water
But outside of this i don't think it matters. Different parents use different systems and whatever suits your routine is fine

Milly33

The caos it all causes ... I think from all just remember use boiling water when adding formula, do whatever you fancy after that..

The Mighty Quinn

Milly33 wrote: »

The caos it all causes ... I think from all just remember use boiling water when adding formula, do whatever you fancy after that..

Except freshly boiled water is so hot that it destroys some nutrient in the formula.

noplacehere

screamer wrote: »

I cringe when I see idiots mixing with cold water only.

Nutramigen has to be made with room temperature water (cooled from boiling). The amount of people who jumped on me shouting about it needing to be 70 degrees….


For me my son was in tallaght hospital at three days old end. They made up the bottles in the morning for the day for us. So that’s what I did. Although nutramigen on the second was painful and so freaking stinky ugh. No idea how he drank it

Moonbeam

so formula is not sterile neither is non boiled water.
This is the issue and most of the time this is ok but there are the other times that could make the baby very sick.

the perfect prep machine is a goood solution for bottles fast or pre-made formula.

noplacehere

Moonbeam wrote: »

so formula is not sterile neither is non boiled water.
This is the issue and most of the time this is ok but there are the other times that could make the baby very sick.

the perfect prep machine is a goood solution for bottles fast or pre-made formula.

To be clear for anyone reading just in case nutramigen is a medical infant formula and it is sterile. Ours was on prescription. You cannot make it up with hot/warm water or you kill some of the good stuff in it. The instructions are clear it must be made with boiled water (as it’s sterile) cooled fully to room temp

Moonbeam

noplacehere wrote: »

To be clear for anyone reading just in case nutramigen is a medical infant formula and it is sterile. Ours was on prescription. You cannot make it up with hot/warm water or you kill some of the good stuff in it. The instructions are clear it must be made with boiled water (as it’s sterile) cooled fully to room temp

We had it for #2 , it was a nightmare at times!!! and the smell ugh

noplacehere

Moonbeam wrote: »

We had it for #2 , it was a nightmare at times!!! and the smell ugh

It’s absolutely gross. And wow if you accidentally didn’t wash out the bottle straight away. Disgusting!!! I mean it was necessary but yeah not pleasant

Moonbeam

Wesser wrote: »

Do whatever suits you. There is no evidence of any increased illness in the baby no matter what method you use.

That is not entirely true.

Moonbeam

https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/bottle-feeding/making-up-baby-formula/
https://www.who.int/foodsafety/publications/micro/PIF_Bottle_en.pdf
https://www2.hse.ie/wellbeing/child-health/preparing-baby-formula/preparing-baby-formula.html

CheerLouth

noplacehere wrote: »

It’s absolutely gross. And wow if you accidentally didn’t wash out the bottle straight away. Disgusting!!! I mean it was necessary but yeah not pleasant

We are weaning our baby off Nutramigen onto cow's milk....I will not be sad to see the back of it. The smell of those baby burps after it - rotten

noplacehere

CheerLouth wrote: »

We are weaning our baby off Nutramigen onto cow's milk....I will not be sad to see the back of it. The smell of those baby burps after it - rotten

Oh I had definitely blocked that memory out..... yuk!!

Moonbeam

CheerLouth wrote: »

We are weaning our baby off Nutramigen onto cow's milk....I will not be sad to see the back of it. The smell of those baby burps after it - rotten

Good Luck!!

I think mine was 3 before she could tolerate cows milk, it can take a while if ever.

CheerLouth

Moonbeam wrote: »

Good Luck!!

I think mine was 3 before she could tolerate cows milk, it can take a while if ever.

Thanks, we've started with the lactose free stuff...not sure if it was the right thing to do but her brother is on it and it suits him so hoping for the same with her!

catrionanic

CheerLouth wrote: »

Thanks, we've started with the lactose free stuff...not sure if it was the right thing to do but her brother is on it and it suits him so hoping for the same with her!

Have you spoken to a dietitian about this? Lactose is the sugar in milk which some people have an intolerance to. CMPA is an allergy rather than an intolerance, and has nothing to do with lactose - it is an allergy to the protein in cows milk. If she has CMPA and has been on nutrimagen, you should be doing the milk ladder. Lactose free stuff still contains cows milk protein (it only has the lactose sugar removed) and could make her very sick.

I am lactose intolerant and my son has CMPA. They are two completely different things.

CheerLouth

catrionanic wrote: »

Have you spoken to a dietitian about this? Lactose is the sugar in milk which some people have an intolerance to. CMPA is an allergy rather than an intolerance, and has nothing to do with lactose - it is an allergy to the protein in cows milk. If she has CMPA and has been on nutrimagen, you should be doing the milk ladder. Lactose free stuff still contains cows milk protein (it only has the lactose sugar removed) and could make her very sick.

I am lactose intolerant and my son has CMPA. They are two completely different things.

Thanks for this - we are liaising with our GP on it.