Infant Food Safety

    Promoting proper food handling and preparation for patient safety

    What feeding risks are your patients exposed to?

    Breast milk and formula provide babies with many beneficial nutrients, but improper handling of both can present potentially serious feeding risks.

    Understanding powdered formula risks

    Once opened, powdered formula containers risk exposure to moisture, foreign matter and oxygen. Use without proper hygiene may lead to bacterial contamination1.

    Although they are rare, certain bacteria such as Enterobacter (E.) sakazakii can cause serious infection and illness in infants1.

    Understanding breastfeeding risks

    Everything breast milk comes in contact with outside the body leaves it susceptible to potentially harmful bacteria that can pose serious health risks2.

    Certain processes, such as indirect breastfeeding and pump expression, can increase the chances of breast milk contamination if not done correctly2.

    Point parents to this helpful preparation and safety guide:

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    Teach parents how to reduce risks through proper techniques

    Preparing breast milk

    Make sure parents follow these protocols for safely expressing and handling breast milk3:

    • Clean hands thoroughly with soap and water
    • If using a pump kit, make sure all components are clean
    • If thawing breast milk, always start with the oldest and never use a microwave
    • If heating breast milk, don’t do it directly over the stove or in the microwave

    Storing breast milk

    Storing breast milk properly can help safeguard against contamination3:

    • Clearly label breast milk with expressed date
    • Store containers away from refrigerator and freezer doors to protect against unwanted temperature changes
    • Immediately freeze expressed breast milk that will not be used within four days
    • If traveling, breast milk can be stored in an insulated cooler with ice packs for up to 24 hours

    Download Full CDC Guidelines

    Educate parents on correct formula preparation and handling protocols

    Preparing formula

    Following these steps can help ensure parents are preparing formula as safely as possible1,4:

    • Pick a designated preparation space and sanitize it thoroughly
    • Wash hands well before preparing bottles and feeding
    • Mix powdered formula with water from a safe source, and always measure water first
    • Take extra precautions if a baby is younger than 3 months old, was born prematurely or has a compromised immune system

    Storing formula

    After preparing powdered formula, parents should feed immediately or cover and store in the refrigerator for no longer than 24 hours1,4:

    • Label cups and bottles with important information (like date and time of preparation) for better traceability
    • If possible, having a designated refrigerator for formula is recommended

    Download Full WHO Guide

    Cleaning and sterilizing feeding equipment

    Between feedings, it’s crucial for parents to properly clean and sterilize cups, bottles, pump kits and other infant feeding items.

    Educate parents on the steps they can take to help prevent bacteria from contaminating breast milk or infant formula5,6:

    • Separate and inspect all bottle and pump kit parts before placing in dishwasher or washing by hand
    • Check with product manufacturer to ensure dishwasher safety, then use the “sanitize” setting for extra protection
    • Wash hands before handling and storing cleaned equipment
    • Don’t use a dish towel to dry equipment, as it may transfer germs

    Whether fortifying breast milk or formula-feeding, safe preparation and storage are paramount.

    With a wide range of infant formulas available and in-depth resources for preparation, Mead Johnson Nutrition always has the health and safety of your patients in mind.

    Learn More

    Non-FDA registered formulas can come with safety concerns—find out if your patients are at risk

    Help caregivers make informed decisions

    Imported formulas are readily available to U.S. consumers through third-party vendors.

    Because there’s no guarantee these formulas have been reviewed or inspected by the Food and Drug Administration (FDA), the American Academy of Pediatrics (AAP) expressed concern about their consumption.

    View AAP Article

    Make sure your patients’ formulas are meeting their allergy requirements

    Infants with certain food allergies may require special hypoallergenic formulas, but definitions of hypoallergenic differ between the U.S and other countries7.

    For example, certain European formulas labeled as hypoallergenic on third-party sites contain partially hydrolyzed milk proteins, which are not suitable for infants with cow’s milk allergy (CMA)8.

    In the U.S., formulas must demonstrate 90% tolerability among children with CMA in clinical studies before they can be considered hypoallergenic. Most of these formulas are either extensively hydrolyzed or amino acid-based9.

    Don’t leave formula preparation to interpretation

    When preparing imported formulas, certain crucial instructions can get lost in translation.

    Mixing a formula incorrectly or misinterpreting an expiration date because of language barriers can lead to nutrient imbalances that impact growth and contribute to certain illnesses7.

    To help avoid illnesses caused by improper preparation, the FDA requires formulas manufactured and distributed in the U.S. to comply with specific labeling requirements10.

    Point caregivers to this helpful piece that compares European and U.S. formulas:

    Download PDF

    Know where your formula has been, from manufacturing to use

    Without federal regulation, unofficial distribution and improper storage at various points of the supply chain can lead to deterioration in product quality9.

    Imported formulas that skirt FDA review may not be tested for harmful pathogens before they’re consumed by your patients, and there’s no guarantee the formula packaging meets FDA safety requirements11.

    If a formula is tainted for any reason, you and your patients’ caregivers need to know as soon as possible. However, because imported formulas are manufactured in another country, news of a recall may not reach the U.S. right away7.

     

    Help ensure that your patients receive the proper nutrients in supported amounts

    Imported formulas that haven’t been submitted for FDA review may be nutritionally incomplete11.

    In a review of 14 European formulas, 10 did not list one of the FDA-required nutrients on their labels8. More specifically, eight had less than the recommended 1 mg of iron per 100 calories, yet none indicated that additional iron may be needed8.

    While U.S. formulas are designed for the first year of life, imported infant formulas may be staged differently, such as from 0-6 months and 6-12 months. Caregivers who don’t realize this may not be feeding babies the appropriate amounts and combinations of nutrients for their age8.

    Download this study for a more thorough comparison of U.S. and European formulas:

    See Study

    Advise caregivers to always choose FDA-reviewed infant formulas

    Imported formula use is on the rise. Talk to parents about the potential risks and encourage them to choose formulas manufactured in the U.S.

    Mead Johnson strictly adheres to FDA safety and quality standards, so your patients get the nutrients they need.

    Discover our closest-ever formula to breast milk:

    See Formula

    Easy-to-digest proteins:

    See Formula

    References

    1. World Health Organization. How to Prepare Powdered Infant Formula in Care Settings. https://www.who.int/foodsafety/publications/micro/PIF_Care_en.pdf. Published 2007. Accessed August 13, 2020.
    2. Moossavi S, Sepehri S, Robertson B, et al. Composition and Variation of the Human Milk Microbiota Are Influenced by Maternal and Early-Life Factors. Cell Host Microbe. 2019;25(2):324-335.e4. doi:10.1016/j.chom.2019.01.011
    3. Proper Storage and Preparation of Breast Milk. https://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm. Published January 22, 2020. Accessed August 13, 2020.
    4. Infant Formula Preparation and Storage. https://www.cdc.gov/nutrition/infantandtoddlernutrition/formula-feeding/infant-formula-preparation-and-storage.html. Published May 7, 2018. Accessed August 13, 2020.
    5. How to Clean, Sanitize, and Store Infant Feeding Items. https://www.cdc.gov/healthywater/hygiene/healthychildcare/infantfeeding/cleansanitize.html. Published July 8, 2020. Accessed August 13, 2020.
    6. How to Keep Your Breast Pump Kit Clean: The Essentials. https://www.cdc.gov/healthywater/hygiene/healthychildcare/infantfeeding/breastpump.html. Published July 8, 2020. Accessed August 13, 2020.
    7. Is it OK to buy imported formulas online?. March 2020. https://www.healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/Is-it-OK-to-buy-imported-formulas-online.aspx. Accessed August 19, 2020.
    8. DiMaggio DM, Du N, Scherer C, et al. Comparison of Imported European and US Infant Formulas: Labeling, Nutrient and Safety Concerns. J Pediatr Gastroenterol Nutr. 2019;69(4):480-486. doi:10.1097/MPG.0000000000002395
    9. Caron C, Grose J. European Baby Formula That Is Illegally Sold in the United States Carries Risk, Pediatricians Warn. https://www.nytimes.com/2020/04/18/parenting/baby/european-formula.html. Published April 18, 2020. Accessed August 20, 2020.
    10. Labeling of Infant Formula: Guidance for Industry. https://www.fda.gov/media/99701/download. Published September 2016. Accessed August 19, 2020.
    11. Imported infant formula not reviewed by FDA may pose health risks. May 2018. https://www.aappublications.org/news/2018/05/11/nutrition051118#:~:text=These%20products%2C%20however%2C%20might%20not,pose%20health%20risks%20to%20infants.&text=Infants%20are%20susceptible%20to%20ill,of%20physical%20and%20psychomotor%20development. Accessed August 19, 2020.