If you are formula-feeding your newborn, or topping up with formula, chances are you started with ready-to-feed or the concentrated liquid formula. Many parents do this simply because there are less steps to take in preparing it. It’s just easier! As time goes on, however, you may wonder about using powdered formula for the cost savings as the other kinds are more expensive. So when is it safe to start giving powdered formula to your baby?
For babies that are considered high-risk, it is best to use either ready-to-feed or the concentrated liquid formula for the first 2 months. High risk babies include: babies born premature (less than 37 weeks), babies weighing less than 2500 grams (5.5 pounds) at birth, and/or babies whose immune system is weak. These babies are at greater risk for developing an infection, which is why powdered formula is not recommended for them, as it is not sterile.
If powdered formula is the only option available for a high-risk baby, then it must be prepared using water that has been boiled for 2 minutes, then cooled to no less than 70 degrees Celsius, in order to kill the harmful bacteria that may have contaminated it. Once the powdered formula is mixed into the water, then the formula should be cooled to room temperature or body temperature and fed to the baby immediately. (Health Canada – Recommendations for the Preparation and Handling of Powdered Infant Formula).
ALL OTHER BABIES
Powdered infant formula can be safely used for full-term infants over 37 weeks gestation, born weighing over 2500 grams, and who are otherwise healthy. Even for these babies, it is very important that you prepare powdered formula correctly, as it is not sterile, and you want to avoid your baby being exposed to potentially harmful bacteria.
HOW TO PREPARE POWDERED INFANT FORMULA?
Regardless of what type of formula you are using, all equipment should be sterilized until your baby is at least 4 months old (HealthLinkBC File 69a). That means placing all bottles, nipples, lids, spoons and other items used to prepare the formula in a pot of boiling water for 2 minutes on a rolling boil. If not using the items right away, cover and store in a clean place. Health Canada also recommends preparing formula in a clean environment, where the counters have been sanitized and hands have been thoroughly washed.
There are two ways to prepare infant formula for babies that are NOT considered high risk. The safest way is to use water that has been boiled for 2 minutes on a rolling boil, and cooled to no less than 70 degrees Celsius, then mixed. Best practice is to use a digital kitchen thermometer to measure the temperature of the water, or you may allow the water to cool for no less than 30 minutes at room temperature if no thermometer is available. Formula prepared in this manner should be cooled quickly and can either be fed to the baby right away or may be stored in the fridge for up to 24 hours. Ideal fridge temperature should be between 0 and 4 degrees Celsius.
The alternative way to prepare formula for babies that are NOT high risk, is to use previously boiled water that has been cooled to room temperature, mix, and serve to the baby immediately.
WARMING UP PREVIOUSLY MADE FORMULA
Formula that has been previously made and stored in the fridge, may be warmed by running under warm water or by using a bottle warmer. The warming process should take no more than 15 minutes, and warmed formula should be fed to your baby right away. Once feeding has started, the individual bottle should be used within 2 hours and after that time, leftovers discarded.
Special types of formulas or fortifiers that have been recommended by your physician for medical reasons, may have specific preparation and storage instructions and you should always consult and follow your health care practitioner’s advice in this regard. As always, your local Mama Coach is available to answer any feeding questions you may have, and/or refer you to someone who can help!