What You Don’t Know May Hurt You and Your Baby (Or What You Need to Know if You’re Giving Your Child Powdered Milk)

If you are giving your child powdered milk, especially if he or she is two years old or younger, there are some things that you need to know. First, powdered milk is NOT sterile. Never mind melamine – the substance has intrinsic bacterial contamination that may cause illness and even death. I know it is hard to imagine that a child’s health problems may be stemming from his drinking milk formula, since we’ve all been raised to believe that milk is a good and healthy thing. For older children and adults, it probably is. But milk formula for infants and young children is another matter.

If powdered milk formula is not prepared properly, the inherent contamination may likely cause diseases such as diarrhea and even meningitis in some cases. Now, this is fact and not just some the rabid claim of some hippy, new-age breastfeeding advocate. It is an accepted fact to most of the international scientific and pediatric community – except perhaps to the quarters beholden to the milk formula companies, or to those who unfortunately have not been updated.

What follows is the executive summary of the World Health Organization’s GUIDELINES on SAFE PREPARATION, HANDLING, and STORAGE OF POWDERED INFANT FORMULA. (The full text is available here ). If you have a child who drinks powdered milk formula, or you know anyone who does, this is very important information.

Regardless of what the milk industry and their fancy advertising says, anything other than breastmilk is an inferior and possibly dangerous food for your child. Wala nang papanatag pa sa inang nagpapasuso. Gatas lamang ng ina ang makapagbibigay ng 100% kumpleto, nararapat, at ligtas na nutrisyon sa isang sanggol.

Executive Summary:
Powdered infant formula (PIF) has been associated with serious illness and death in infants due to infections with Enterobacter sakazakii. During production, PIF can become contaminated with harmful bacteria, such as Enterobacter sakazakii and Salmonella enterica. This is because, using current manufacturing technology, it is not feasible to produce sterile PIF. During the preparation of PIF, inappropriate handling practices can exacerbate the problem.

Recognizing the need to address such hazards in PIF, Codex Alimentarius decided to revise the Recommended International Code of Hygienic Practice for Foods for Infants and Children. In doing so it requested specific scientific advice from the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO). FAO and WHO have provided this advice in the reports of two expert meetings held in 2004 and 2006 on Enterobacter sakazakii and other microorganisms in powdered infant formula (PIF). Part of this advice included recommendation to develop guidelines for the preparation of PIF.

The World Health Assembly (WHA) of WHO requested in 2005 the Organization to develop such guidelines on the safe preparation, handling and storage of PIF in order to minimize the risk to infants. The FAO/WHO advice on E. sakazakii in PIF includes a quantitative microbiological risk assessment of E. sakazakii in PIF. One of the aspects of the risk assessment was to determine relative risk reduction associated with different preparation, storage and handling scenarios. The recommendations made in the present guideline document are largely based on the findings of the quantitative risk assessment. No risk assessment was carried out for Salmonella, but the group reported that the basic risk control principles for E. sakazakii would also hold true for S. enterica.

In general, sterile liquid infant formula is recommended for infants at the highest risk of infection. Where sterile liquid infant formula is not available, preparation of PIF with water at a temperature of no less than 70 °C dramatically reduces the risk. Minimizing the time from preparation to consumption also reduces the risk, as does storage of prepared feed at temperatures no higher than 5 °C.

Users of PIF are made aware that powdered infant formula is not a sterile product and may be contaminated with pathogens that can cause serious illness. Correct preparation and handling of PIF reduces the risk of illness.

The present guidelines are presented in two parts. One part provides guidance for the preparation of PIF in care settings where professional care providers are involved in the preparation of large quantities of PIF for a large number of infants. The second part provides guidance for the preparation of PIF in a home environment, aimed at parents and those involved in the care of infants in the home environment.

The document provides specific guidance on the most appropriate practices in the different steps during the preparation of PIF in these two types of settings. Cleaning and sterilization of feeding and preparation equipment is an important prerequisite to the safe preparation of PIF. The specific guidance focuses on the most important parameters during preparation such as the temperature of reconstitution, the cooling, holding and feeding times, as well as the storage and transportation of prepared PIF. The rationale behind the recommendations is provided in both sets of guidance.


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