Preparing baby's formula not that easy

Donya Betancourt, Pediatrician, Sanur, Bali, drdonya@hotmail.com

New babies have few defenses against germs and it takes a while for them to build up immunity.

Due to this, it is important to minimize the danger of bacterial contamination of your baby's formula.

Be sure to wash your hands before handling formula or the equipment you use to prepare it. Before every use, wash, rinse and dry all the equipment you use to measure, mix and store formula.

After opening a container of powdered or liquid formula from which you will prepare your baby's bottles, close it promptly and keep it tightly covered.

Liquid formula can be kept in the can, but it must be covered and then refrigerated once it is opened. Whatever type and form of formula you choose, proper preparation and refrigeration are essential because both ensure the appropriate amount of nutrition and safeguard the health of your baby.

Always mix powdered formula or concentrated formula with the exact amount of water specified by the manufacturer on the label. Using too much or too little water can be dangerous for your baby.

If the formula is too diluted, your baby does not get enough nutrition to meet growth needs or to satisfy hunger and your baby could also receive an excessive amount of water. Formula that is too concentrated can be even more dangerous. It puts a serious strain on a baby's digestive system and kidneys and can lead to dehydration.

If you're using powdered formula, always use the scoop provided in the formula can. Check the label to see whether a packed or unpacked scoop of powder should be used. Fill the scoop and shave off any excess formula powder with the flat edge of a knife. Do not use a spoon or any other curved surface.

When using liquid formula concentrate, you can pour directly into the bottle to the exact measurement or into a measuring cup and then add the appropriate amount of water. Always hold the bottle or the cup to eye level to check the amount. Make sure that the quantity is exactly level with the correct measurement mark.

If you prepare and fill several bottles at one time, place any that are not for immediate use in the refrigerator but after 24 hours throw away any remaining unused formula.

If you refrigerate formula, warming a bottle of formula before giving it to your infant is not necessary. Usually, formula is served at room temperature.

The best way to warm chilled formula to room temperature is by placing the filled bottle in a bowl or pan of hot water and letting it stand for a few minutes. Always test the temperature before giving your baby a warmed bottle. You want to make sure it is not too hot or too cold, and you can do this by shaking the bottle after warming it to distribute the warmed milk evenly.

Then turn it upside down and allow a drop or two of the formula to fall on your inner forearm. It should feel comfortable, barely warm.

Throw out leftover milk once it has been warmed. Once you warm a bottle, never put it back in the refrigerator even if your baby goes back to sleep before you're able to give the bottle. If milk is left in a bottle after a feeding, throw it away. Do not put milk back in the refrigerator.

The water you use in preparing your baby's milk is an important part of the formula. You need to make sure that the water contains no hidden contaminants. If you are unsure of the water supply, use bottled water to prepare formula. Well water sometimes poses a problem. You need to be sure it doesn't contain trace levels of contaminants or heavy metals, such as lead. Well water sometimes contains such substances in amounts adults can tolerate but that pose a danger to babies. Bacterial contamination and nitrate content are potential problems.

There are many brands of formula and each infant is different, what we want to do is choose one that the baby likes and one that gives the baby normal bowel movements and good weight gain.