Anonymous wrote:I am so confused by this thread. Is this specifically a question on how to use recalled formula?? The CDC guidelines make no mention of boiling water and say tap water is generally fine. I was instructed to use distilled water for my full term baby upon discharge from the hospital. I still use it and only avoid tap to avoid any fluoride. https://www.cdc.gov/nutrition/downloads/prepare-store-powered-infant-formula-508.pdf

If you read it closely it also says: If your baby is younger than 3 months old, was born prematurely, or has a
weakened immune system, you may want to take extra precautions when preparing infant formula.
Visit https://www.cdc.gov/cronobacter/infection-and-infants.html to learn more

Note the you MAY want to. Not you "should" etc. Only 2-4 infections/year are reported to the CDC it is a rare risk much more rare than burns due to boiling water infants... In any case I used filtered tap to prepare formula when my baby was less than 3 months and she was fine. Really depends on resources and risk avoidance. I would be more risk avoidant if she was a preemie or had immune system or other health issues.

I am so confused by this thread. Is this specifically a question on how to use recalled formula?? The CDC guidelines make no mention of boiling water and say tap water is generally fine. I was instructed to use distilled water for my full term baby upon discharge from the hospital. I still use it and only avoid tap to avoid any fluoride. https://www.cdc.gov/nutrition/downloads/prepare-store-powered-infant-formula-508.pdf

Unless it’s a probiotic formula you’re very unlikely to “kill” nutrients. You may alter the structure of some vitamins but ins, we gave probiotic plus vitamin D. Boil the water, add formula, cool to body or room temperature depending what you prefer.

I would typically follow the advice to do this for the under 3MO crowd, but with the current outbreak And the weirdness the FDA is putting out about it, I would just do it until it’s fully resolved (yes it’s a pain). As others have explained it’s not about the water, it’s about killing potential bacteria in the formula powder.

I boiled water for my first. However, I was not able to BF and he had a host of health and feeding issues. I did not boil water for my second. In fact, I used plain tapwater with my doctors blessing.

Anonymous wrote:

Anonymous wrote:Was your baby a preemie? This is the only case where I’ve heard anything other than tap/filtered tap water.

Well that’s the thing. You never heard about this due to the dismal lack of education about formula preparation in the US. Knowing the need to sterilize formula powder is standard in Europe. No this is not a preemie thing. To find out this info you actually have to dig deep into the websites at the CDC.

Ideally for the first three months of a newborns life since ready to feed is sterile it is recommended to feed rtf. If you need to use powder sterilize the powder. If those four babies’ parents were aware of this maybe those babies won’t be dead of severely ill.

As for my baby was fed formula prepared with room temperature water and did just fine, plenty of people eat raw cookie dough but some are the unlucky ones who get salmonella. It is impossible to remove all contaminated formula powder through food inspection, some will slip through the cracks.

Like any other type of food, formula powder is a food product. Just like a piece of meat is cooked to get rid of pathogens, formula powder has to be treated with hot water to sterilize it. The question of how hot is ~158F, hot enough to kill germs, but not so hot you strip the powder of nutrients. Essentially this is a food safety issue.

BC people wouldnt use it as much if you had to do all this. It has been marketed as easy and no fuss AND that infants cant/wont die from formula specifically. Especially for infants in daycare. They expect the bottles pre-made or just mix and pour. They will not prepare formula with boiling water and not everyone can afford RTF.

Anonymous wrote:

Anonymous wrote:Is cronobacter widespread in infants?

Cronerbacter isn't in infants, it's in formula. It's a bacteria in formula. It is very rare but popping up now because of covid supply chain issues. Boiling water and then cooling it doesn't get rid of cronerbacter in formula. Boiling water gets rid of germs in the water.

The powder formula isn't sterilized. On and off its had its issues. Not sure about now but when my kids were little they recommend using the liquid/ready to feed formula for at least a few months after birth for this reason.

https://www.cdc.gov/cronobacter/infection-and-infants.html

You have to scroll half way down to find out how to prepare formula. It states especially for babies under three months or immunocompromised babies. Even most peds in the US don’t know about this. Notice in L&D they provide rtf, there’s a reason for this.

I’m surprised by this since I asked my pediatrician and they said brita water is fine. I asked my friend with a premie and they did boiled but then cooled to room temp. I asked a peds nurse and they did distilled water. The boiled water to make the formula makes sense, I just feel like this isn’t publicized anywhere.

Anonymous wrote:Was your baby a preemie? This is the only case where I’ve heard anything other than tap/filtered tap water.

Well that’s the thing. You never heard about this due to the dismal lack of education about formula preparation in the US. Knowing the need to sterilize formula powder is standard in Europe. No this is not a preemie thing. To find out this info you actually have to dig deep into the websites at the CDC.

Ideally for the first three months of a newborns life since ready to feed is sterile it is recommended to feed rtf. If you need to use powder sterilize the powder. If those four babies’ parents were aware of this maybe those babies won’t be dead of severely ill.

As for my baby was fed formula prepared with room temperature water and did just fine, plenty of people eat raw cookie dough but some are the unlucky ones who get salmonella. It is impossible to remove all contaminated formula powder through food inspection, some will slip through the cracks.

Like any other type of food, formula powder is a food product. Just like a piece of meat is cooked to get rid of pathogens, formula powder has to be treated with hot water to sterilize it. The question of how hot is ~158F, hot enough to kill germs, but not so hot you strip the powder of nutrients. Essentially this is a food safety issue.

Was your baby a preemie? This is the only case where I’ve heard anything other than tap/filtered tap water.

Again, there are two components to making formula. Water and powder.

You don’t boil the water to make it hot to ensure quality of the water. You boil the water to make it hot to sterilize the formula powder.

Anonymous wrote:I remembered my mom sterilizing bottles (glass back then) and preparing formula using, I think, evaporated milk, maybe corn syrup?, probably boiled water to dilute the milk. I never boiled water for the powdered formula, no issues with water quality where I live, but it was a strange contrast against the memory of what my mom had to do (not to mention the cloth diapers)

I had my babies in the 70s. When my first was projectile vomiting the stuff they sent home from the hospital (Similac?) across the room like in the movie The Exorcist my mom suggested switching to Dr. Spock's recommendation of carnation evaporated milk and corn syrup. I did not sterilize glass bottles or boil the water. I used tap water and plastic bottles. The baby did fine on that, as did my second.

Anonymous wrote:Is cronobacter widespread in infants?

Cronerbacter isn't in infants, it's in formula. It's a bacteria in formula. It is very rare but popping up now because of covid supply chain issues. Boiling water and then cooling it doesn't get rid of cronerbacter in formula. Boiling water gets rid of germs in the water.

Is cronobacter widespread in infants?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:You are supposed to boil the water and let it cool to 98.6 degrees or so (body temperature) before mixing. Don’t mix the formula with boiling water! Boil enough for the whole day. We filtered the water, boiled it, then let it cool in an aluminum lined thermos-type jug (meant to hold coffee, I think).

Depends on who you follow. WHO and CDC add formula to boiling water then cool. AAP boil water, let it cook then add formula.
https://publications.aap.org/pediatrics/article/143/6/e20182525/37124/Mixed-Message-on-Formula-Mixing

To add-- the AAP says "if one is concerned or uncertain," not that everyone should.

I posted the link and that is an important point. I’m also one who used filtered tap water and never warmed a bottle. The other issue not addressed is the baby. A robust healthy full term baby will do fine with non boiled tap water. Preemies, immunocompromised, other health issues - I would definitely be more conservative depending on the situation - but in those cases would go with ready to feed since the other point of the linked article is that boiling water can be a lot for parents. (Not everyone can afford the zojurishi)

It is advised if not able to boil to at least feed rtf for the first three months even if it’s a full term robust baby. Salmonella and cronobacter can impact full term healthy infants, especially newborns. We don’t eat sushi when we are pregnant even when the risk is small, I’ll boil hot water to sterilize powder for my baby. Even with stringent inspections it is impossible to detect all traces of contamination.