Let’s really go back to the very beginning and review some basics of baby formula preparation. Of course, we pediatricians still advise that the best infant nutrition is breastfeeding, but at some point most babies’ diets will likely include some formula. The AAP recommends the following:
- Prepare the formula according to the manufacturer’s directions ONLY. DO NOT dilute the formula (to save money) or concentrate it (to increase calorie concentration). Both can cause diarrhea at least and sometimes disruption of blood electrolyte levels like sodium and potassium which can lead to severe problems with normal nerve or heart function.
- Make sure the water source is safe. If your home has well water, it’s best to boil the water for 1 minute (“rolling boil”) and then allow 30 minutes to cool before mixing your formula.
- Be careful to maintain proper formula temperature. Use a bottle warmer or place the bottle in a container of hot water for 5-10 minutes. It is best not to microwave the bottle. Microwaving can heat the insides of any container in an uneven fashion which can cause burns, and also it can disrupt the nutritional value of some formula ingredients. At any rate, its best to always check the formula temperature on yourself prior to giving it to the baby.
- “Cleanliness is next to Gdliness.” Always wash your hands prior to preparing or feeding your baby. Wash all countertops and surfaces carefully. A dishwasher will not clean the inside of a long, thin bottle very well, so wash by hand using a bottle brush for the inside. Bottles and nipples should all be cleaned with hot, soapy water and be sure to rinse all soap off thoroughly. By the way, best to boil nipples for approximately 10 minutes prior to using for the first time. This is not for cleanliness as much as to boil off residue of chemicals used to soften the rubber.
- Be aware of proper storage times. All leftover formula should be discarded 1 hour after feeding to the baby. Powder based preparations can be refrigerated for 24 hours; bottles of unused concentrate can be refrigerated for 48 hours prior to usage.
As stated initially, breastfeeding is still best and what I and all pediatricians recommend as the first line nutritional source for your baby’s best health. This seems like a good place for me to give a shout out to Dr. Rose St. Fleur and my colleagues at the Center for Breastfeeding at Jersey Shore Medical Center. They can be reached at 732-776-3329 and are an excellent resource/clearinghouse for questions from nursing mothers. Tell them Dr. G sent you (they won’t care).