Julie asked for a couple of references on bacterial contamination in powdered infant formula, especially relating to how to reconstitute it. WHO has new guidelines on reconstituting powdered infant formula which can be found at http://www.who.int/foodsafety/publications/micro/pif_guidelines.pdf. WHO recommends that water be boiled first, cooled to 70C (158F), and used at that temperature to reconstitute the formula. Higher temperatures can cause problems with the formula and lower temperatures do not kill Enterobacter sakazakii or other bacterial species that can be in the formula. The idea is to kill intrinsic bacteria in the formula not to sterilize the water. It's not the water that is contaminated, it is the formula!
 
Another good reference is:
 
Bowen AB, Braden CR. Invasive Enterbacter sakazakii disease in infants. Emerg Infect Dis 2006; 12:1185-1189. The authors are from the CDC and recommend that no infants under 4 weeks of age receive powdered infant formula, including full term normal babies.
 
Most parents have no idea that powdered infant formula can harbor pathologic bacteria, which is a good reason not to distribute commercial formula gift bags to mothers as they leave the hospital. If the sample is powdered formula, mothers are not instructed in how to properly prepare the formula and if it is recalled, a hospital has no mechanism to inform the patients, as they employ no stock control procedures. Two formula companies have changed their labels to advise parents that the product is not sterile, but their preparation instructions are still incorrect.
 
All parents using powdered infant formula should be made aware of the proper way to prepare, handle, and store powdered formula. This seems to be a well kept secret.
 
Marsha Walker, RN, IBCLC
Weston, MA
 
 
________________________________________________________________________
AOL now offers free email to everyone.  Find out more about what's free from AOL at AOL.com.

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
Mail all commands to [log in to unmask]
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or [log in to unmask])
To unsubscribe: unsubscribe lactnet or ([log in to unmask])
To reach list owners: [log in to unmask]