What’s in your baby’s formula? Bacteria in baby formula is a serious concern and can lead to health problems and even death. As a breastfeeding Mom, I admit that I don’t know a lot about formula. My experiences have been primarily through friends, family and babysitting. When researching online about the idea that Fed is Best, I started reading about infant deaths from bacteria in baby formula.While this bacteria may not impact an adult, it can cause serious illness and even death in infants and it can be prevented.
I immediately pictured my relative dumping powdered formula into a plastic bottle of water and feeding it to her baby. It even had a special lid just for water bottles! I thought this was a safe way to prepare powdered formula. I even asked “don’t you need to heat that” and was told, by more than one Mom, that it was okay to give at room temperature. Isn’t formula sterile? It’s not and I want to share this information with you.
What should you walk away with? Think of powdered formula as a raw food. It needs to be heated to a certain temperature just to kill any bacteria that may lurk inside. Giving this food raw to infants can have serious health consequences. Details below. Post contains affiliate links.
My next move was to hop on the phone. I called several formula companies and customer service at the Formula Pro. Formula does need to be cooked, and I thought that by now there would be a fast and easy way to do it. Customer service at Baby Breeza said that their machine does not get hot enough to kill bacteria in powdered formula. What’s the point then?
If powdered formula can contain scary bacteria, is any formula safe? Although it can run at a higher price-tag and not be provided by organizations like WIC, ready to feed formula is sterile and remains so as long as it’s handled properly. It’s recommended for use with high-risk infants including premature babies and infants with other health concerns. (1,2) Powdered formula is another story and needs to be treated properly.
Bacteria in baby formula can lead to serious illness and death
Reading through article after article, I quickly learned that “powdered infant formula products are not sterile and may be colonized with bacterial organisms.” (1) In an old study (2002) where 141 powdered formula samples were tested from 35 different countries, over half contained bacteria. (1) Surprisingly, more recent studies and references continue to report the presence of this, sometimes deadly, bacteria in powdered infant formula.
In April of 2016, the CDC warned about Enterobacter sakazakii in powdered infant formula. They noted that while adults don’t commonly get sick from the bacteria, it can be deadly to infants. (2) “Enterobacter sakazakii kills 40%–80% of infected infants.” (5) Also known as Cronobacter, or Cronobacter sakazakii, this germ occurs naturally in the environment and can survive in very dry conditions. (3) It’s found in powdered foods such as infant formula, dry milk, herbal teas and starches. (3) In fact, the Center for Disease Control recommends using hot water (158 degrees F/70 degrees C and above), cooled from boiling, to make infant formula. (3)
E. Sakazankii/Cronobacter is a nasty bug. Infections caused by these organisms includes septicemia, meningitis, and urinary tract infection all which can be fatal to infants.(1) “Reported outcomes in neonatal meningitis are often severe: seizures; brain abscess; hydrocephalus; developmental delay; and death in as many as 40%–80% of cases” (5) To help families and facilities prepare formula correctly, the World Health Organization (WHO) published a set of standards for infant formula preparation. It reports that in order to kill E. Sakazankii/Cronobacter formula should be prepared with water that is no cooler than 70 degrees Celcius/158 degrees F. (4) How does one achieve this?
Personally, I know that my hot water heater is set to 140 and boiling water is 212. Although it feels hot, not even my hottest tap water will kill this germ. How do you get it to the right temp? Water can be boiled and monitored with a thermometer. The WHO recommends boiling and then using the cooling water at a point no lower than 70C/158F to mix formula. Measuring with a food thermometer can make sure it’s at the right temperature. As an avid cook, having both a non-digital and digital, I prefer the digital because you can even set an alarm to go off when the temperature is right and the read is instant and in bold numbers.
The World Health Organization recommendations for preparing a formula bottle feed:
- Clean and disinfect the preparation surface
- Wash your hands, using soap & water, and dry with a clean or disposable cloth
- Boil water. Make sure water comes to a rolling boil
- If using an automatic pot make sure it switches off
- Check the formula container for water to powder ratio
- Adding more or less can make an infant ill
- Add the exact amount of powdered formula to the water in a bottle
- Mix by gently shaking or swirling the bottle
- Dry the outside of the bottle using a clean or disposable cloth
- If at a facility, label the bottle with the infant’s name and info
- Check the temperature by placing a drop on the inside of your wrist, if it feels too hot wait until it feels luke warm
- Feed baby!
- Throw away any formula that has not been consumed within 2 hours
- Read the Full WHO Recommendations in their Brochure.
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What about the microwave
The WHO recommends never using the microwave because it can heat unevenly and create hot spots. (4). It also can not heat all of the formula to the recommended temperature to kill any germs that may be present. If you’re feeding formula full-time or supplementing breastfeeding, making sure to heat formula to the right temperature is important. Remember, hot tap water is not typically hot enough, but the microwave has it’s own issues too.
Maintaining sterile conditions
It’s also important to wash your hands with soap and water, use sterile bottles and nipples and to make sure that pacifiers and other objects baby may place in his/her mouth are clean. Make sure to prepare bottles in a clean environment and to ensure that dust or organisms that may lie on the lids and outer surface of formula containers don’t make their way into baby’s mouth. (2)
Walk away info
What should you walk away with? Think of powdered infant formula as a raw food. You wouldn’t feed your family raw chicken, right? Don’t feed your baby “raw” formula. Follow heating instructions and if heating is not an option, such as on trips, you can always turn to ready to feed formula.
Good articles referenced here: