Preparing baby milk in nurseries

[becsltd]

We are reviewing our policy on Baby Milk preparation. For the past 6 months we have been making up baby formula bottles up fresh each time. This means boiling the water and allowing it to cool before giving it to the babies. This obviously has to be thought through in advance and has some serious disadvantages. This was based on NHS guidelines claiming that bacteria would be killed off if prepared in this way. The guidelines also recommended not heating up bottles in a microwave because of the potential hot spots forming in the milk.

However, after a recent discussion with a local health visitor, she suggested that to minimise the stress for the babies (and staff!) formula feeds can be prepared in advance and stored in the back of the fridge. (for up to 24 hours)

I would like to find out what other nurseries do with milk preparation so that we can confirm our ongoing approach and adjust policy accordingly.

Looking forward to hearing what you all do.

[Sox]

We prepare the bottles as and when they are needed! We used to ask the parents to prepare them before nursery, but our guidelines changed recently

[Stargrower]

We do the same. We cool them under cold running water if we really need them in a hurry.

We haven't heated in a microwave for several years now for the reasons you said.

[daffodilnursery]

We have invested in a bottle maker, Tommee Tippee do one (Closer to nature perfect prep) it is expensive but we have found it invaluable. It heats the water to the correct temperature so you can make a bottle in under 2 minutes, the staff find it great as it is easy and has taken away all the hot water issues and milk standing about.

[becsltd]

Thanks for the replies, does the bottle warmer heat the water to a high enough temperature to kill of any bacteria from the formula?

[woodlands1997]

We make fresh although the guidelines do say can make in advance if you really need to and store in fridge - personally I'm not willing to take this risk and so just do as we go along! I am wary of the machine as heard some bad reviews, it doesn't make according to guidelines, it only uses a shot of hot water and then tops off with cold!? Is that right??

These are guidelines we use:

 

http://www.who.int/foodsafety/publications/micro/PIF_Care_en.pdf

[green hippo]

The most important thing is to ensure that you make the formula up with boiling water in the first place as formula powder is not sterile. As long as it is made up in a sterilised bottle it can then be stored in the fridge and heated up in a bottle warmer or in a pot of hot water.

Green Hippo x

[Poohshouse]

Taken from Department of Health guidance on safe preparation,

storage and handling of powdered infant formula)

What is the safest option for feeding babies?

Breastmilk is the safest way to feed a baby. Ready to use liquid feeds are sterile

until opened and are the safest option if using infant formula. Powdered infant

formula is not sterile and should be made using water that is hotter than 70° C.

 

Why is powdered infant formula not sterile?

The bacteria Enterobacter sakazakii is ubiquitous in the environment and may

contaminate powdered infant formula during manufacture. It is impossible to be sure

of avoiding this contamination. The bacteria may also be present on work surfaces in

homes and nurseries and can contaminate feeds while they are being prepared by

parents or carers.

 

Why should the water be 70 degrees Celsius?

Water at 70° C will kill most of the bacteria present in the powdered formula. This is

the most important step in making up powdered infant formula as powdered infant

formula cannot be guaranteed to be free of bacteria

Why should made up formula be cooled quickly?

Bacteria multiply most quickly between 7 and 63° C. The longer formula is at this

temperature, the greater the increase in the bacterial content and so the risk of

infection for the baby will increase.

 

Why should storage times of made up formula be minimised?

Even when formula is made up with water at more than 70° C it may still contain

some bacteria which will continue to multiply during storage. At less than 5° C the

rate of multiplication of the bacteria will reduce but will not completely cease.

 

How long can made up formula be stored in a fridge?

Made up formula can be stored for a maximum of 24 hours but this is no longer

considered ideal particularly for young babies because the bacterial content

continues to increase during storage. This increases the risk of infection for the baby.

 

Once a feed is ready for feeding, how long before it should be discarded?

Discard any feed that has not been used within 2 hours. All left-over feed should be

discarded and never saved for later.

 

If you are out and cannot boil water how do you make up a feed?

Mothers should be advised to fill a vacuum flask with boiling water. If the flask is full

and sealed the water will stay above 70° C for several hours. This flask can be

safely transported and used to make up a feed when necessary.

 

Do vacuum flasks need to be sterilised if they are used to store boiled water for making up a feed later?

No, the vacuum flasks do not need to be sterilised but they should be washed

thoroughly and rinsed with boiling water before being filled with boiling water

intended for the feed. The boiling water should kill bacteria present in the vacuum

flask.

If water is boiled and put into the sterilised feeding bottles can it be stored in the fridge like this until the powder is added?

No, the water must be above 70° C when the powder is added otherwise the bacteria

in the powder will not be killed.

 

 

We keep water hot in a thermos and change it twice a day (have checked and it is always over 70), its tehn ready to make up bottles.