Bottle feeding abroad
Nadia, a 25-year-old woman, comes into the pharmacy with her four-month-old baby son, Tanvir, and asks for your advice.
She explains that Tanvir is her first child and she's still new to "the mum thing" and would like a bit of guidance to make sure she's got everything right. While she breastfed initially, Nadia wants to combine breast and bottle feeding going forward. However, she can't remember the best advice for making up bottles, and asks if you can go through it with her.
"I'm not sure if I can make up more than one bottle at a time, so I've got some ready to go if he needs a feed," she says. "I'm also worried about getting the temperature right – I know the water needs to be boiled properly and I'm afraid that I'm going to scald him."
"There's another problem, too," she confides.
"My family back in Pakistan are dying to meet the latest addition, and we're heading back there shortly for a two-week trip to see everyone. But I'm worried about making up the formula while I'm there.
"Tap water isn't safe to drink where we're going, and I'm not sure what I should do."
Can you tell me?
1 What general advice can you give on making up infant formula?
2 What is the best way to make up bottles of formula in a place where tap water is not safe to drink?
What OTC says…\
1 Formula feeds should be prepared one at time as the baby needs them, using freshly boiled water. The water must be at a temperature of 70°C or higher to ensure any harmful bacteria are killed; water in a kettle should not fall below 70°C for around 20-30 minutes after the kettle has boiled. Because a baby's immune system is not as strong as an adult's, good hygiene is essential when making up feeds –so hands should be washed and all bottles and teats should be cleaned and sterilised before use. Water should be poured into the bottle first to ensure the correct amount is used, then the required number of scoops of milk powder added, making sure the scoop provided with the formula is used and that the scoops are levelled off rather than being heaped. The teat and cap should be replaced and the bottle shaken until the powder has dissolved, then the contents cooled (hold the bottom half of the bottle under cold running water if it is needed quickly), and the milk's temperature should be checked by squirting onto the inside of the wrist before being given to the baby. Any unused milk should be thrown away.
2 Bottled water is not usually recommended to make up infant formula feeds because it may contain too much sodium or sulphate. However, if the local water is not recommended for drinking (or if the usual source of drinking water has been contaminated, for example due to flooding), bottled water may be the only option. If this is the case, check the label to ensure that the water contains less than 200mg sodium (this may be written as Na) and no more than 250mg sulphate (possibly written as SO or SO4) per litre. Bottled water will need boiling before preparing the feed as – like tap water – it is not sterile.
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