(gentle music)
- Hello, my name is Olivia.
I am a registered and licensed dietician
at St. Louis Children's Hospital.
Today, we are going to review formula preparation
for your baby.
There are three different types of formula,
powder, concentrate, and ready to feed
both the ready to feed and concentrate are sterile products.
This means that they have been heated
to a safe temperature to prevent spoiling.
Powdered formula is not considered a sterile product.
So, it is important to take the proper safety
and sanitation precautions when preparing it.
When preparing any type of formula,
it is important to wash your hands for at least 20 seconds,
clean your workspace,
and use soap and water to make sure all your equipment
and bottles are clean and sanitized.
Before preparing the formula,
make sure to check the expiration date on the product.
Tap water is usually safe to use for formula preparation,
unless there is a known boil order in your area.
Bottled nursery water without fluoride is safe
for the first six months,
but baby six to 12 months old need water with fluoride,
because it is a mineral that can help prevent tooth decay.
Fluoride is in tap water
and may be in some bottled water too.
Distilled bottled water is also safe to use.
Well water is not safe
unless it is tested yearly for bacteria
and nitrates that can come from plant fertilizers.
First, we will prepare a bottle of formula using powder.
Unless instructed differently
by your medical team or pediatrician,
you will prepare the formula
based on the mixing instructions written on the can.
Take the lid off the can and place it on a clean counter
with the inside of the lid facing up.
The CDC recommends boiling the water
that you are going to use,
if your infant is in a high risked category.
The high risk category includes preterm infants,
infants less than two months old,
and infants that may have a weakened immune system,
which means they may not fight off an infection very well.
The formula companies test the formula for bacteria
before it leaves the facility,
but mixing the powder with hot water
that is at least 158 degrees Fahrenheit
ensures that any bacteria that may be in the product
will not survive the temperature.
Boil the water for two minutes.
Then, turn the flame off.
Measure out the volume of water you need
based on the can's instructions,
being especially careful not to burn yourself.
Then, you will measure out the scoops of powder
as instructed on the formula can.
The scoop is often buried in the powder.
You can use a clean knife to get the scoop out.
Some formula requires an unpacked level scoop,
while others instruct you to measure a packed level scoop.
Once you have measured a full scoop and leveled it off,
add the powder to the water.
The water will still be hot enough to kill any bacteria.
Attach the nipple to the bottle and shake well to mix.
Cool the formula quickly by placing the bottle
in a cup or bowl of ice water.
Allow it to cool for five minutes,
then test the temperature of the formula
on the inside of your wrist
to make sure it is a safe temperature for your baby.
If you are not going to feed your baby right away,
you may place the bottle in the refrigerator
for up to 24 hours.
Next, we will prepare formula using concentrate.
Not all formulas are made in the concentrated form.
It looks like a 13 ounce soup can.
Shake the can before opening,
then use a clean cloth to wipe off the top of the can.
Alright.
You will need a can opener to open the formula.
Once you have opened the can,
pour the concentrate into a pitcher.
Then, fill the can with water.
Add it to the pitcher and stir.
You can use tap water unless you feel your water is unsafe.
You can also use bottled nursery water.
Once prepared, it is good in the refrigerator
for up to 48 hours.
Finally, ready to feed.
You don't need to add water to ready to feed formula.
You just shake the container
and pour the formula directly into a bottle.
It's good for 48 hours after opening.
And, it needs to be stored in the refrigerator.
Your dietician may give you a recipe to follow
to make your baby's formula higher calorie per ounce.
Typically, it may be 22, 24, 27 or 30 calorie per ounce.
You will follow instructions using a teaching tool
instead of following the instructions on the formula can.
It's important to use the correct amount of water and powder
that is listed on the recipe.
If the formula has too much water or powder,
it could harm your baby.
We will practice making a 24 hour batch of formula
using the instructions written on the teaching tool,
measure the total volume of water you need in a bowl.
Then, add the amount of powder you need
using measuring cups.
Use a wire whisk to mix the formula.
Once a bulk batch of formula like this is prepared,
it can be kept in the refrigerator
for up to 24 hours in a covered pitcher.
Any bottle that has been in your baby's mouth,
regardless of the type of formula used
is good for about one hour at room temperature,
then it needs to be thrown away
if your baby does not finish it.
If you have any questions about formula preparation,
estimated amounts of formula recommended
for your baby,
or questions about appropriate infant growth,
ask your medical team to consult the dietician.
(gentle music)