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The safety of at home powdered infant formula preparation: A community science project
Aimee Grant1, Sara Jones1, Vicky Sibson2
1Centre for Lactation, Infant Feeding and Translational Research, Swansea University, Swansea, UK.
Insights
Powdered infant formula (PIF) preparation machines often dispense water below the recommended 70°C, increasing risks of bacterial contamination and infant gastrointestinal infections. Kettle users were significantly more likely to reach safe temperatures.
Area of Science:
- Food Safety
- Public Health
- Pediatrics
Background:
- Formula-fed infants face higher infection rates than breastfed infants, linked to bacteria in powdered infant formula (PIF) and equipment contamination.
- The UK NHS recommends water ≥70°C for PIF reconstitution to eliminate bacteria, aligning with WHO guidance.
Purpose of the Study:
- To investigate the safety of PIF preparation methods compared to UK NHS guidelines.
- To explore parents' understanding and adherence to PIF preparation safety recommendations.
Main Methods:
- Community science methods were used to co-design an at-home experiment and online questionnaire ('research diary').
- 200 UK parents of infants ≤12 months participated, with 143 providing data on water temperatures for PIF reconstitution.
Main Results:
- Only 14.9% of PIF preparation machines reached ≥70°C, compared to 78.3% of kettles (p<0.001).
- Mean water temperature from PIF machines was 9°C lower than from kettles (65.78°C vs 75.29°C).
- Many parents did not fully follow guidelines and seemed unaware of contamination risks.
Conclusions:
- Parents need advisement that PIF machines may dispense water below 70°C, risking bacterial contamination and infant infections.
- PIF labeling should clearly state the ≥70°C water requirement and associated risks, per WHO Europe.
- Enhanced consumer protection for PIF preparation devices is urgently needed.
Abstract:
Formula fed infants experience gastrointestinal infections at higher rates than breastfed infants, due in part to bacteria in powdered infant formula (PIF) and bacterial contamination of infant feeding equipment. The United Kingdom National Health Service (UK NHS) has adopted the World Health Organization recommendation that water used to reconstitute PIF is ≥70°C to eliminate bacteria. We used community science methods to co-design an at home experiment and online questionnaire ('research diary') to explore the safety of PIF preparation compared to UK NHS guidelines. 200 UK-based parents of infants aged ≤12 months were recruited; 151 provided data on PIF preparation, and 143 were included in the analysis of water temperatures used to reconstitute PIF. Only 14.9% (n = 11) of 74 PIF preparation machines produced a water temperature of ≥70°C compared with 78.3% (n = 54) of 69 kettle users (p < 0.001). The mean temperature of water dispensed by PIF preparation machines was 9°C lower than kettles (Machine M = 65.78°C, Kettle M = 75.29°C). Many parents did not always fully follow NHS safer PIF preparation guidance, and parents did not appear to understand the potential risks of PIF bacterial contamination. Parents should be advised that the water dispensed by PIF preparation machines may be below 70°C, and could result in bacteria remaining in infant formula, potentially leading to gastrointestinal infections. PIF labelling should advise that water used to prepare PIF should be ≥70°C and highight the risks of not using sufficiently hot water, per WHO Europe advice. There is an urgent need for stronger consumer protections regarding PIF preparation devices.
