Below is some info from another listserve, and discusses the concerns about
NICUs and the use of powdered formula, due to the discovery of a nasty
bacteria lurking in the formula, Portagen which is used for infants with
kidney ds.   Wonder how this might help us eliminate the use of Human Milk
fortifiers (or Human Milk Diluters, as Jack calls them)?    Now maybe I can
get some attention when I suggest using the skimmed cream from extra
breastmilk to fortify for the infant who needs extra calories.   Michelle
Scott, MA,RD,IBCLC in NH

Sent: Tuesday, April 09, 2002 3:47 PM
Subject: [pedi-rd] Formula use & preparation in light of Portagen fiasco


> One of the neonatologists that I work with is concerned about using
powdered formula in the NICU, after reading the correspondence mailed to us
from Mead Johnson (re: Portagen recall and an infant death due to
Enterobacter sakazakii).  In the letter, the VP of MJ's Global Medical
Affairs recommends that powdered formulas not be used for neonates or
immunocompromised patients because they are not sterile.  He also recommends
use of aseptic technique for formula preparation under a laminar flow hood.
We do concentrate powdered formulas for patients on fluid restrictions or
for those needing catch-up growth.
> I am wondering what other facilities are doing.  Please respond with name
of facility if possible.  I will post responses.  My questions are:
> 1)  Do you concentrate powdered formulas in the NICU?
> 2)  Are the utensils & equipment used for preparing the formula sanitized?
If so, how?
> 3)  Are the utensils & equipment used for preparing the formula
sterilized?  By an autoclave?
> 4)  What has Joint Commission asked of you regarding formula preparation
(sanitize or sterilize equipment)?
> 5)  Do you re-use sterile water bottles?
> 6)  Who prepares your formulas?
> 7)  Does your facility prepare formulas under a laminar flow hood?
> Thanks for your help!

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