<[log in to unmask]> wrote:

> > http://www.who.int/foodsafety/publications/micro/pif_guidelines.pdf

> It does not say don't use it.

The introduction says:

"Although E. sakazakii can cause illness in all age groups, infants
(children <1 year) are at most risk with neonates and infants under two
months at greatest risk."

The section on care settings says:

"Where feasible, sterile liquid infant formula should be used in care
settings, especially when feeding high-risk infants. These feeds do not
contain harmful bacteria. Care settings, such as neonatal intensive care
units, provide care for infants at greatest risk of E. sakazakii
infection, i.e. neonates and those less than two months of age."

And the section on feeding in the home also says:

"Where available, commercially sterile ready-to-feed liquid infant
formula should be used for infants at greatest risk."

The use of "at greatest risk", taken in isolation, does have the
potential to muddy the issue: which infants are "at greatest risk"? Only
the most vulnerable 10%? The most vulnerable 1%? The most vulnerable
0.1%? There is always someone sicker. So I think we have to go with the
introductory statement and reiteration, which includes "infants under
two months" in the population of infants at greatest risk.

So while the document doesn't exactly say "don't use PIF in infants
under 2 months of age" in so many words -- it does, I believe, assert
that sterile liquid infant formula is the least risky non-human-milk
food for neonates, followed by correctly prepared PIF where sterile
liquid formula is not an option.

Lara Hopkins 

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