The temperature of the water for preparing milk powder is not a trivial matter. Improper method will harm the health of the baby.

Breast milk is the best food for babies, providing comprehensive nutrition and promoting growth and development. At the same time, breast milk also contains many ingredients, such as growth factors, hormones, antibodies, enzymes and living cells, which can not only enhance the baby\’s immunity and prevent the occurrence of various diseases, but also help digest and absorb nutrients. Unfortunately, some mothers are unable to exclusively breastfeed due to various reasons, so formula feeding becomes one of the options. Do you prepare milk powder for your baby? Should the water temperature be 50℃ or 70℃? What other precautions should be taken during the preparation of milk powder? Du Ma will have a good chat with you today. Formula is not a sterile product! Du\’s mother always thought that milk powder was sterile, so she could just prepare it for her baby. Unfortunately, due to the current production and processing technology of formula milk, it is impossible to make it sterile. In other words, pathogens in formula may cause serious infections. Enterobacter sakazakii and Salmonella enterica are two pathogens of greatest concern. During the production stage or the preparation stage of milk powder, serious infant illnesses and even death caused by Enterobacter sakazakii or Salmonella enterica have occurred. In 1958, the existence of Enterobacter sakazakii was first suggested in a case of neonatal meningitis. Approximately 70 cases of E. sakazakii infections have since been reported; two outbreaks of E. sakazakii in 2004, one in New Zealand and one in France (FAO/WHO, 2006), were linked to formula milk. Among them, 9 cases broke out in France, resulting in the death of 2 infants; since 1995, at least 6 outbreaks of salmonellosis related to formula milk have been described in Canada, France, South Korea, Spain, the United Kingdom and the United States. The most recent outbreak of Salmonellosis agona occurred in France in 2005, affecting 104 infants under the age of 12 months. According to reports in the United States, the incidence of Enterobacter sakazakii infection is 1 in 100,000 infants. Among infants with extremely low birth weight (weighing less than 1.5 kg), the incidence increases to 9.4 cases per 100,000 births. The incidence rate of Salmonella is 139.4 cases per 100,000 infants. The incidence rate in infants is eight times higher than that in the general population. Although Enterobacter sakazakii can cause disease in all age groups, infants (<1 year old) are most at risk, with neonates and infants under 2 months at greatest risk. Among the infant groups most at risk, premature infants, low birth weight infants (less than 2.5 kg) or immunocompromised infants are particularly prominent. Therefore, you must use the correct preparation method to reduce the risk of your baby getting sick. 70℃ water! It is helpful to kill pathogens. The topic of how many degrees Celsius of water to use to prepare milk powder has always been a hotly debated topic. Some people believe that the temperature cannot be higher than 50°C, which will damage the nutrients in the milk powder, and this is also written in the instructions of some formula milk. Some people believe that the water temperature should not be lower than 70°C. The reason mentioned above is that milk powder is not sterile and may contain Enterobacter sakazakii and Salmonella, which may cause serious pathogenic infections in babies. Water at 70°C can kill bacteria. Then someone said,Will such a high water temperature reduce the content of nutrients in formula milk, which is detrimental to the growth and development of the baby? In addition, some people are worried about scalding the baby or the formulator themselves, and causing lumps in the milk powder. In this regard, the FAO/WHO expert meeting (2006) provided data to prove that vitamin C is the only vitamin that is seriously affected. In order to make up for this loss, the actual content of vitamin C in all dry formula milk powder will be higher than the label. The content may be higher than the minimum standard in infant formula standards. It can be seen that the loss of vitamins caused by water above 70℃ is not significant. But if the mother is still worried about the loss of nutrients, she can choose nutritionally fortified milk powder. As for the problem of scalding the baby, there should be no mother who feeds the milk powder directly to the baby after preparing it, right? After preparing the milk, it will go through a cooling process. Put the prepared formula milk in the refrigerator to refrigerate, or rinse it under cold running water, then put a drop on your wrist to test the temperature, and then feed it to the baby after confirming it is suitable. . WHO guidelines for preparing milk powder. The outbreak of Enterobacter sakazakii infection was once caused by the equipment used to prepare feeding solutions. Moreover, Enterobacter sakazakii is widely present in the environment and can easily adhere to and form biofilm on equipment, such as rubber. , silicon and stainless steel, etc. Therefore, in order to prevent your baby from being infected by pathogens, it is still recommended to clean and disinfect it thoroughly before use. Disinfection methods can be boiling sterilization, steam sterilization or chemical sterilization. The specific method of preparing milk powder is shown in the figure below: Other questions about formula milk preparation Q1: How to ensure that the water temperature is not lower than 70°C? According to the FAO/WHO risk assessment (FAO/WHO, 2006), the risk of infection can be significantly reduced if milk powder is prepared with water no lower than 70°C, as this temperature will kill any Enterobacter sakazakii in the milk powder. The water temperature is not lower than 70℃, which means that after boiling, the cooling time at room temperature shall not exceed 30 minutes. Q2: What should I do if there is no boiling water? If boiling water is temporarily unavailable, sterilized liquid infant formula can be used, but this seems to be rare in China. So, make it with clean, fresh room temperature water and eat it right away. In other words, if water below 70°C is used to prepare formula milk, it must be consumed immediately and must not be stored to avoid excessive reproduction of Enterobacter sakazakii and infection. Q3: What should I do if I don’t finish the prepared milk powder? Although Enterobacter sakazakii and Salmonella do not grow in dry formula, they can survive for a long time. Enterobacter sakazakii has been shown to survive in dry formula for up to a year. The formula milk restored by adding water provides an ideal environment for the growth of pathogens. If the temperature is higher than 5°C, it may cause rapid growth, especially if it is left for too long, which greatly increases the risk of infection. The best and safest way is to prepare fresh formula for each feeding and feed immediately. If you prepare too much milk at one time, throw away the remaining milk immediately after drinking and do not keep it for next time, because harmful bacteria in it will grow rapidly during this opportunity. If it is undrinkable, fresh milk, it can be cooled and stored inRefrigerate in a refrigerator below 5°C for no more than 24 hours. Do not give milk that has been kept at room temperature to your baby for 2 hours. Q4: Can bottled water be used to prepare milk powder? Different mineral waters contain different mineral contents, and some may not be suitable for babies, so it is not recommended to use mineral water to prepare milk powder. If you absolutely want to use it, you can boil the water first. Q5: How to heat refrigerated formula milk? The bottle can be reheated in a container of hot water, but the time must not exceed 15 minutes. During this period, the bottle should be shaken continuously to maintain even heating. But remember, do not heat milk in a microwave oven, because the microwave does not heat evenly and will produce \"hot spots\" that may burn the baby\'s mouth. Q6: When traveling, can I prepare formula milk in advance? Yes, but make sure it is kept refrigerated during the entire carrying process, which can delay or suspend the growth of harmful bacteria. Prepare the formula milk normally, cool it quickly and then place it in the refrigerator (the temperature does not exceed 5℃). Just before departure, take out the refrigerated milk bottle and place it in an ice bag filled with ice cubes to refrigerate. When you arrive at your destination, place it in the refrigerator, or heat it and drink it immediately. The storage time in an ice pack should not exceed 2 hours at most. Otherwise, do not prepare it in advance. Instead, bring formula milk powder with you and prepare it before consumption.