References:

1. Government of Canada – Preparing and Handling Powdered Infant Formula
2. HealthLinkBC – Feeding Your Baby Formula: Safe Making and Storing Formula

General Information:

• Store bought infant formula is made from cow’s milk to meet baby’s nutritional needs
• Ensure infant formula is iron-fortified
• Any store bought infant formula can meet your baby’s nutritional needs due to the strict manufacturing standards
• Home-made infant formula is not safe for babies
• Offer infant formula until your baby is 9-12 months of age

Types of Infant Formula:

• Liquid  infant formula
  • Health Canada recommends this for non-breast/chest fed infants who are born prematurely, those with low birth weights and those with weakened immune systems
  • Both types of liquid infant formula are sterile until opened             
    • Ready-to-feed
    • Liquid concentrate
• Powdered infant formula
  • For healthy and full term infants
  • Infants who are premature, have a low birth weight, or weakened immune systems in situations where sterile liquid infant formula is not available

How to Clean Bottles and Equipment:

1. Gather all equipment including bottles, nipples, measuring cups, and spoons.
2. Ensure you have glass or BPA free plastic bottles and nipples that are not cracked, stained and have no loose pieces.
3. Wash your hands with soap and warm water, dry with a clean towel.
4. Wash the sink and work area with soap and warm water.
5. Wash all equipment in hot, soapy water.
6. Use a bottle brush to clean inside bottles and nipples.
7. Rinse all equipment in hot water.

How to Disinfect Bottles and Equipment:

1. Place cleaned equipment in a large pot.
2. Fill the pot with water until all equipment is submerged.
3. Bring water to a rolling boil for 2 minutes.
4. Use disinfected tongs to remove items from pot.
5. If not using right away, let items dry on a clean towel.
6. When items are dry, cover and store them in a clean place.

Preparing and Storing Ready-to-Feed Formula:

• Do not add water to the formula
• Pour the amount of formula you think your baby will drink into a clean and disinfected bottle
• Store unopened cans in a cool, dry place
• Store opened cans, with lid tightly closed in the fridge
• Throw cans out after being open for 48 hours, or follow the instructions on the label

Preparing Water for Formula:

• Sterilize all water used for formula for babies of all ages
• Boil cold, municipal tap water for 2 minutes
• Store cooled, boiled water in a tightly closed container for:
  • 24 hours at room temperature
  • 2 to 3 days in the fridge

Preparing and Storing Liquid Concentrate Formula:

• Boil cold, municipal tap water for 2 minutes
• Let boiled water cool to room temperature before mixing with formula
• Measure and mix formula following directions on the label which will tell you how much liquid concentrate formula and how much water to use
• If making more than 1 bottle, store in the fridge for use within 24 hours
• Store unopened formula in a cool, dry place
• Store opened cans, with lid tightly closed in the fridge
• Throw cans out after being open for 48 hours, or follow the instructions on the label

Preparing and Storing Powdered Formula:

• Boil cold, municipal tap water for 2 minutes
• For premature and low birth weight infants let water cool to no less than 70°C, use a food thermometer to measure temperature
  • Mixing powdered formula with water this temperature helps lower bacteria growth
• For healthy, full term infants, water can be cooled to room temperature before use
• Follow the directions on the formula package which will tell you how much formula powder and how much water to use
• Cool to feeding temperature and use right away
• If making more than 1 bottle, cool quickly under cold running water and store in the fridge for use within 24 hours
• Do not freeze prepared formula
• Store unopened cans in a cool, dry place
• After a can is open use within 1 month, before the expiry date and store in a cool, dry place with the lid tightly closed

What Temperature Should I Feed Previously Prepared Formula?

• Formula stored in the fridge can be given to your baby right away or warmed first
• Your baby will show you what temperature formula they prefer
• Warm a bottle by putting it in a bowl of hot water for no longer than 15 minutes
• Do not microwave the bottle, this creates hot spots and can burn your baby’s mouth
• Test the temperature of the formula by shaking a few drops on the inside of your wrist
• The formula should feel warm but not hot
• Once you begin feeding, use the bottle within 2 hours, throw out any leftover formula
• Do not put formula you have already offered to your baby back in the fridge

Feeding Your Baby Away From Home:

• If you are going to be away for 2 hours or less, place prepared formula in a insulated bag with ice packs and use within 2 hours
• If you are going to be away for longer than 2 hours, use unopened ready-to-feed formula

Further Your Learning:

1. Sick Kids-About Kids Health – Formula feeding when you cannot provide breast milk for your baby
2. Government of Canada – Preparing and Handling Powdered Infant Formula

Shareable Resource For Clients: 

1. Baby Friendly Initiative Strategy Ontario – Safe Formula Prep

Referral Sources:

1. NRPH Bottle Feeding