Boiling Water for Baby Formula
December 3, 2019 3:55 AM Subscribe
I'm having trouble sorting fact from fiction with regard to boiling water before mixing powdered baby formula. Do I need to boil water before mixing the formula for a healthy 7-month-old? If so, why?
Most explanations for boiling water say that powdered formula (unlike liquid formula) is not sterile. But the directions say you should boil the water and then let it cool before adding the powder. Does that really do anything to kill the bacteria in the formula? Or is it really bacteria in the water we should be worried about?
Also, my son shovels truckloads of bacteria into his mouth everyday. He eats solid foods, licks carpets, puts dirt in his mouth...does boiling water protect him from anything he's not being exposed to anyway?
(I'm in Canada on a reliable town water supply.)
Most explanations for boiling water say that powdered formula (unlike liquid formula) is not sterile. But the directions say you should boil the water and then let it cool before adding the powder. Does that really do anything to kill the bacteria in the formula? Or is it really bacteria in the water we should be worried about?
Also, my son shovels truckloads of bacteria into his mouth everyday. He eats solid foods, licks carpets, puts dirt in his mouth...does boiling water protect him from anything he's not being exposed to anyway?
(I'm in Canada on a reliable town water supply.)
My presumption is that it's meant to kill bacteria in the water. If you have good water supply, I would (and did) skip boiling and use warm tap water instead.
posted by gakiko at 4:15 AM on December 3, 2019 [3 favorites]
posted by gakiko at 4:15 AM on December 3, 2019 [3 favorites]
The WHO recommends always using boiled water, only letting it cool to 70 degrees C, and making it fresh every time (due to the bacteria that may live in the powdered formula). Even in places with water systems deemed safe for adults, there may be microbes, particularly protists like amoebas that can survive water treatment plants but not boiling.
(This is much less likely in Canada, where the cold likely prevents most pathogenic protists from being common in your surface waters. In the warmer parts of the US, it's a very real concern.)
posted by hydropsyche at 4:21 AM on December 3, 2019 [3 favorites]
(This is much less likely in Canada, where the cold likely prevents most pathogenic protists from being common in your surface waters. In the warmer parts of the US, it's a very real concern.)
posted by hydropsyche at 4:21 AM on December 3, 2019 [3 favorites]
The American Academy of Pediatrics says room-temperature tap water is fine unless you have reason to believe your tap water might not be safe. The statement links to a description of the circumstances under which you might consider water potentially unsafe. (Which fwiw does not include being in the southern US.)
posted by lakeroon at 4:44 AM on December 3, 2019 [10 favorites]
posted by lakeroon at 4:44 AM on December 3, 2019 [10 favorites]
We boiled the water and let it cool for our first kid. When number 2 arrived, we just went with warm tap water, with no ill effects. A tiny risk from a few microorganisms in the formula seems likely to be dwarfed by the quantity of random dirt little kids consume. I suspect the warnings are there to protect the manufacturers and/or prevent problems in warmer climates with worse water quality.
posted by pipeski at 4:49 AM on December 3, 2019 [3 favorites]
posted by pipeski at 4:49 AM on December 3, 2019 [3 favorites]
We always made it with boiling water then cooled it down in an ice bath. Confusingly the NHS instructions say to let the water cool for 30 mins, but not less than 70C (so that it still sterilises the formula), then cool the made-up formula down to body temp. I suspect the reason they tell you to leave the water to cool in the kettle is more to do with avoiding scalding yourself with 100C water while making the formula.
posted by EndsOfInvention at 4:51 AM on December 3, 2019 [1 favorite]
posted by EndsOfInvention at 4:51 AM on December 3, 2019 [1 favorite]
Québec's guidelines suggest boiling the water for the first 4 months only.
posted by fmg at 5:03 AM on December 3, 2019 [2 favorites]
posted by fmg at 5:03 AM on December 3, 2019 [2 favorites]
Whoever made these directions never had to follow them while sleep-deprived with a screaming baby.
Seriously, the WHO says you should boil but the AAP says you don’t need to, and that has to do with the fact that water supplies in much of the world aren’t up to US standards. I’m assuming Canadian standards are like American ones.
posted by madcaptenor at 5:15 AM on December 3, 2019 [3 favorites]
Seriously, the WHO says you should boil but the AAP says you don’t need to, and that has to do with the fact that water supplies in much of the world aren’t up to US standards. I’m assuming Canadian standards are like American ones.
posted by madcaptenor at 5:15 AM on December 3, 2019 [3 favorites]
Yes, the recommendation is to kill bacteria. The same reason they want you to sterilize baby bottles.
I have just a couple things to add here.
Only use cold tap water to make baby formula. Let the water run a bit till it runs cold and only use that water. Don't use hot water. The water from hot water tanks can have particulates and/or bacteria. For consumption, everyone should follow this rule, but it's even more important for babies and children.
Another tip, if you are in an area or have a house with a risk of lead, get a filter (the kind rated for lead removal) and then boil that water. You cannot boil out lead from water. In fact, the boiling is only concentrating those contaminants that cannot be boiled out.
posted by jraz at 5:28 AM on December 3, 2019 [6 favorites]
I have just a couple things to add here.
Only use cold tap water to make baby formula. Let the water run a bit till it runs cold and only use that water. Don't use hot water. The water from hot water tanks can have particulates and/or bacteria. For consumption, everyone should follow this rule, but it's even more important for babies and children.
Another tip, if you are in an area or have a house with a risk of lead, get a filter (the kind rated for lead removal) and then boil that water. You cannot boil out lead from water. In fact, the boiling is only concentrating those contaminants that cannot be boiled out.
posted by jraz at 5:28 AM on December 3, 2019 [6 favorites]
We bought and kept ‘nursery water’ (pre boiled) in the fridge as I don’t trust our water from the tap + filter without boiling. But we used very limited formula; most friends boiled a lot, let it cool, made up the formula, and kept a pitcher of formula in the fridge or then made bottles up to fridge.
posted by tilde at 6:16 AM on December 3, 2019
posted by tilde at 6:16 AM on December 3, 2019
Your water company is required to test the water and make results public. Call them. I trust my local water far more than any bottled water, which has no testing requirements. Your water my vary, but it's easy to check.
posted by theora55 at 6:22 AM on December 3, 2019 [2 favorites]
posted by theora55 at 6:22 AM on December 3, 2019 [2 favorites]
To add to theora55 above. Water utilities are required to do testing and have that data posted for the public. That information is good for finding general water quality information or if there is are lead mains in the system, but keep in mind that they don't test *your* house and *your* taps which is where the majority of bacteria and lead comes from. Even within a residence, water quality can vary from tap to tap based on usage, condition, materials in the faucet, etc.
I work in drinking water in the US, but I would give the same advice to folks in Canada. Not sure where you are, but I know there are a bunch of areas in Canada with lead mains or service lines (from the main to the house).
posted by jraz at 7:00 AM on December 3, 2019 [3 favorites]
I work in drinking water in the US, but I would give the same advice to folks in Canada. Not sure where you are, but I know there are a bunch of areas in Canada with lead mains or service lines (from the main to the house).
posted by jraz at 7:00 AM on December 3, 2019 [3 favorites]
Please use cold tap water & heat it unless you have on demand hot water or set your hot water heater thermostat to 135F +, you may then want to install anti scald devices if you have a child. The things that can grow & survive in the lovely warm swampy interior of your hot water tank if it's not hot enough include Legionella bacteria.
My SIL boiled & cooled it for the first month or so then keeping the pre boiled & cooled water in sterilized canning cars in the fridge for night feeds. Then used to just heat the cold tap water to the right temp in the microwave & stir, she had the timing down pat through a bit of trial & error.
posted by wwax at 7:24 AM on December 3, 2019 [2 favorites]
My SIL boiled & cooled it for the first month or so then keeping the pre boiled & cooled water in sterilized canning cars in the fridge for night feeds. Then used to just heat the cold tap water to the right temp in the microwave & stir, she had the timing down pat through a bit of trial & error.
posted by wwax at 7:24 AM on December 3, 2019 [2 favorites]
For Kid1 I think we boiled and cooled water, then mixed it, then heated in hot water or with a bottle warmer for a little while but I think we moved on fairly quickly from that.
For Kid 2 We bought water but mostly because the water here is HARD (is it liquid diamonds? I wish it was, maybe I could make some money off all the scaling around the house) and I wanted to mitigate the risk of mineral build-up in our formula maker. Did not reboil that water.
Obviously the calculus changes depending on the immunocompromised status of your kid, your geography and its water quality.
posted by emkelley at 7:27 AM on December 3, 2019
For Kid 2 We bought water but mostly because the water here is HARD (is it liquid diamonds? I wish it was, maybe I could make some money off all the scaling around the house) and I wanted to mitigate the risk of mineral build-up in our formula maker. Did not reboil that water.
Obviously the calculus changes depending on the immunocompromised status of your kid, your geography and its water quality.
posted by emkelley at 7:27 AM on December 3, 2019
I used filtered water, cold from the filter. Heated it up to appropriate temperature 20 seconds in a glass pyrex in the microwave.
No, adding hot water to powdered formula wouldn't make it sterile. The boiling water step is meant to kill off any microorganisms in the water itself.
posted by fingersandtoes at 9:03 AM on December 3, 2019
No, adding hot water to powdered formula wouldn't make it sterile. The boiling water step is meant to kill off any microorganisms in the water itself.
posted by fingersandtoes at 9:03 AM on December 3, 2019
With our now-two-year-old granddaughter, it was simply a bottle of distilled water at room temperature. Not warmed or heated.
posted by Thorzdad at 10:07 AM on December 3, 2019
posted by Thorzdad at 10:07 AM on December 3, 2019
At 7 months we boiled water and poured a little bit into the bottle to dissolve the formula. So for like 6 oz, poured in 1 oz., add formula and shake, then filled the rest with cold water from the tap. Bit of trial and error with the ratio so that the resulting formula was warm but not hot. We used an electric kettle to speed up the boiling water process.
This was when we were travelling. At home we have a Tommee Tippee perfect prep machine. I don’t know if it’s worth it at 7 months (unless you’re still doing a lot of bottles and night feeds) but it’s been amazing for us and I’d highly recommend to those with younger babies on bottles. (You don’t need to use tommee tippee bottles)
posted by like_neon at 10:39 AM on December 3, 2019
This was when we were travelling. At home we have a Tommee Tippee perfect prep machine. I don’t know if it’s worth it at 7 months (unless you’re still doing a lot of bottles and night feeds) but it’s been amazing for us and I’d highly recommend to those with younger babies on bottles. (You don’t need to use tommee tippee bottles)
posted by like_neon at 10:39 AM on December 3, 2019
Nthing that I have never boiled water to use in formula. I've fed plenty of formula to two different healthy babies.
posted by toomuchkatherine at 11:16 AM on December 3, 2019
posted by toomuchkatherine at 11:16 AM on December 3, 2019
Warm or hot tap water is more likely to contain elevated lead levels, so I would avoid that and use cold that then gets heated if you want to give warm bottles.
posted by nouvelle-personne at 1:00 PM on December 3, 2019
posted by nouvelle-personne at 1:00 PM on December 3, 2019
Do not waste your time or mental energy. If your Canadian tap water has enough detrimental bacteria that a healthy 7 month old gets sick then I will eat my hat. Preemies or immunocompromised babies are a different story of course.
I followed AAP's recommendation and did not boil. Also I microwaved the bottles so my kid might become a mutant, jury's out.
posted by pintapicasso at 3:11 AM on December 4, 2019
I followed AAP's recommendation and did not boil. Also I microwaved the bottles so my kid might become a mutant, jury's out.
posted by pintapicasso at 3:11 AM on December 4, 2019
The NHS advice in the UK is very specific that the water should still be over 70 degrees Celsius when you use it to make the formula so that it will kill some of the bacteria in the powdered formula.
NHS advice
posted by kadia_a at 10:55 AM on December 4, 2019 [2 favorites]
NHS advice
posted by kadia_a at 10:55 AM on December 4, 2019 [2 favorites]
We used filtered cold water and Costco formula for two kids. A lactation consultant told us that if we never heated it, they wouldn’t miss it. For overnights, we prepped a few bottles in the evening and carried them upstairs in a cooler with ice so we wouldn’t have to run downstairs. We also got a mixing formula pitcher which we washed every evening and used for 24 hours.
posted by melodykramer at 4:41 PM on December 4, 2019
posted by melodykramer at 4:41 PM on December 4, 2019
We purchased water that had been run through a reverse osmosis filter, and used it at room temperature. We trust our municipal water, but not necessarily all of the pipes in our 100 year old house.
Seconding the idea of using room-temp water, always. It's a lot easier to get one ready one-handed at 3:00am if you don't need to get it warm but not hot before the kid takes it.
At some point you're going to get caught out with a hungry kiddo and will use some random water from an outdoor fountain in a town you've never been in. It's ok, even if it's not what you would prefer or what you'd do at home. You're not going to make a habit of it, but one outlier isn't going to hurt.
posted by toxic at 8:40 PM on December 4, 2019
Seconding the idea of using room-temp water, always. It's a lot easier to get one ready one-handed at 3:00am if you don't need to get it warm but not hot before the kid takes it.
At some point you're going to get caught out with a hungry kiddo and will use some random water from an outdoor fountain in a town you've never been in. It's ok, even if it's not what you would prefer or what you'd do at home. You're not going to make a habit of it, but one outlier isn't going to hurt.
posted by toxic at 8:40 PM on December 4, 2019
Many of these comments are missing the fact that the recommendation is not just about the quality of your water, but actually about mixing the formula at a temperature that kills any potential cronobacter bacteria that could exist in the powdered formula.
The recommendation is to let it cool to a temperature that's still warm enough to kill cronobacter (158°F/70°C), but not warm enough to mess with the texture/structure of the proteins in the formula.
The risk of cronobacter being in your formula powder is small, but it is a risk. Recommendations in the US are to only worry about this for very young babies (up to 12 weeks), those that are born premature, and any other babies that you know could be immunocompromised in some way. For these most vulnerable of babies, cronobacter could have very serious consequences, including a risk of death. For older, healthy babies, it's not likely to cause anything more than upset stomach or diarrhea, so it's not necessary to be so vigilant.
https://www.cdc.gov/nutrition/infantandtoddlernutrition/formula-feeding/infant-formula-preparation-and-storage.html
https://www.cdc.gov/features/cronobacter/index.html
My kid's 11 months now, and we don't boil water, but we did use ready to feed for the first few months because she was a premie.
posted by terilou at 11:02 AM on December 5, 2019 [1 favorite]
The recommendation is to let it cool to a temperature that's still warm enough to kill cronobacter (158°F/70°C), but not warm enough to mess with the texture/structure of the proteins in the formula.
The risk of cronobacter being in your formula powder is small, but it is a risk. Recommendations in the US are to only worry about this for very young babies (up to 12 weeks), those that are born premature, and any other babies that you know could be immunocompromised in some way. For these most vulnerable of babies, cronobacter could have very serious consequences, including a risk of death. For older, healthy babies, it's not likely to cause anything more than upset stomach or diarrhea, so it's not necessary to be so vigilant.
https://www.cdc.gov/nutrition/infantandtoddlernutrition/formula-feeding/infant-formula-preparation-and-storage.html
https://www.cdc.gov/features/cronobacter/index.html
My kid's 11 months now, and we don't boil water, but we did use ready to feed for the first few months because she was a premie.
posted by terilou at 11:02 AM on December 5, 2019 [1 favorite]
The formula we use says to boil the water and then let cool to below 40°C before adding the powder specifically so that you DON'T kill the live cultures.
Nan supreme instructions
posted by trialex at 3:49 PM on December 8, 2019
Nan supreme instructions
posted by trialex at 3:49 PM on December 8, 2019
This thread is closed to new comments.
I think though that as many babies don't like cold tap water and that it wouldn't be good to add warm tap water (sediment) or microwave the bottle (hot spots) that maybe the idea is to use boiling water for safety and cool it if you need too. I think we would also top up cold formula with boiling water.
posted by biggreenplant at 4:10 AM on December 3, 2019