Safely Preparing Infant Formula

Be sure to use the type of formula and the concentration that your baby's healthcare provider prescribed. If your baby was born prematurely or had any complications, they may need a special formula that has more calories or certain nutrients. Formula comes in concentrated powder, concentrated liquid, and ready-to-feed forms. Ask your baby's healthcare provider if you have questions.

• Make sure the formula is not expired or recalled and the container is in good condition. (No dents, puffy ends, or rough spots.)
• Wash your hands with soap and clean, running water for at least 20 seconds.
• Clean and sanitize the area where you will be preparing the formula.
• Clean your baby’s bottles and feeding supplies. They should be cleaned after each feeding. Your baby’s healthcare provider may advise sanitizing your baby’s bottles and feeding supplies daily or more often. This is especially important if your baby is less than 3 months old, was born prematurely, or has a weakened immune system.

Use clean water from a safe source when preparing your baby's formula. Tap water is usually OK to use. You can check with your baby's healthcare provider or local health department to help find out if your water supply is safe. Ask your baby's healthcare provider which type of water is best for your baby. They may advise:

• Tap water from your faucet
• Bottled water that is labeled for infants and sterile
• Tap or bottled water that has been boiled and then cooled
• Fluoridated water

Concentrated powdered formulas need to be mixed with water before using. Follow the directions on the container closely. Powdered formula is not sterile and may contain germs, such as cronobacter bacteria. Use extra safety steps when preparing powdered formula. See the section on cronobacter below for more information.

• Wash your hands with soap and clean, running water.
• Use the scoop that comes with the formula to measure the correct amount. Close the container as soon as possible.
• Put water in the bottle first, then the formula, and shake well to mix. Do not use a blender, whisk, or spoon to mix. Test the formula temperature to make sure it's not too hot before feeding it to your baby
• Use prepared infant formula within 1 hour from the start of feeding and within 2 hours of preparing it. If your baby does not finish the entire bottle of formula, throw away leftover formula. Infant formula and your baby’s saliva can cause bacteria to grow.
• If you do not plan to feed your baby with the prepared powder concentrate formula right away, put it in the refrigerator immediately. Use mixed formula in the refrigerator within 24 hours, or as directed on the package.
• Use all the powder within 1 month after opening the package, or as directed on the package.
• Keep lids and scoops clean, and close containers of formula as soon as possible after using.
• Keep powdered formula in the container dry to prevent germs from growing.
• There is no need to wash the scoop unless it becomes wet or dirty (such as falling on the floor). If the scoop needs to be washed, clean it as carefully as you would your baby’s bottles. The formula scoop must be completely dry before putting it back into the container

Liquid concentrate formula needs to be mixed with water before using. Follow the directions on the container closely.

• Liquid concentrate calls for equal amounts of water and concentrate. You may choose to prepare the entire container at once. Or prepare just what you need for each feeding.
• Wash your hands with soap and clean, running water.
• Pour equal parts of liquid concentrate and water together into a clean container or your baby’s bottle. Shake to mix. Don’t use a blender, whisk, or spoon to mix. Test the formula temperature to make sure it's not too hot before feeding it to your baby.
• Use prepared infant formula within 1 hour from the start of feeding and within 2 hours of preparing it. If your baby does not finish the entire bottle of formula, throw away leftover formula. Infant formula and your baby’s saliva can cause bacteria to grow.
• If you do not plan to feed your baby with the prepared liquid concentrate formula right away, put it in the refrigerator immediately. Use mixed formula in the refrigerator within 48 hours, or as directed on the package.
• If you do not mix all the liquid concentrate at once, seal the package and keep it in the refrigerator after opening. Use within 48 hours of opening the package, or as directed on the package.

Ready-to-feed formula does not need to be mixed with water. It’s ready to pour right into your baby’s bottle. It is the easiest to use, but it also costs the most.

• Wash your hands with soap and clean, running water.
• Pour the desired amount of ready-to-feed formula into the baby's clean bottle.
• Use ready-to-feed formula within 1 hour from the start of feeding and within 2 hours of preparing it. If your baby does not finish the entire bottle of formula, throw away leftover formula. Infant formula and your baby’s saliva can cause bacteria to grow.
• Unopened ready-to-feed formula can be stored at room temperature. Once opened, unused portions of ready-to-feed formula can be covered and then refrigerated for up to 48 hours, or as directed on the package.

Baby formula does not need to be warmed, but some caregivers like to warm their baby's bottle. Never heat a bottle of formula in the microwave. The liquid may heat unevenly and can burn your baby's mouth and throat. To warm a bottle, place it under warm (not hot) running water or in a cup of warm (not hot) water. Put a few drops of formula on the back of your hand to make sure it’s not too hot. It should be lukewarm.

Cronobacter is a common germ found naturally in the environment. It can live in dry foods such as powdered infant formula, or the water used to prepare formula. It can also live on kitchen counters and sinks where you may prepare formula. Infections with cronobacter are rare. But they can cause serious illness in newborns. Infants under 3 months of age, infants born prematurely, and infants with a weak immune system are at higher risk for illness. To help prevent infection:

• Be sure to thoroughly clean, sterilize, and store your baby’s bottles and feeding supplies.
• Wash your hands with soap and clean, running water for at least 20 seconds before preparing formula and feeding your baby.
• Consider using liquid formula when possible. This is especially true if your baby is less than 3 months old, was born prematurely, or has a weak immune system. Liquid formula is sterile (without germs). Powdered infant formula is not sterile and may have germs in it.
• Prepare and store infant formula safely.

• For more information on safe formula feeding, go to the CDC site at www.cdc.gov/nutrition/infantandtoddlernutrition/formula-feeding/infant-formula-preparation-and-storage.html.

• For more information on cleaning, sanitizing, and storing infant feeding items, go to the CDC site at www.cdc.gov/hygiene/childcare/clean-sanitize.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fhealthywater%2Fhygiene%2Fhealthychildcare%2Finfantfeeding%2Fcleansanitize.html.

• For more information on cronobacter and infants, go to the CDC site at www.cdc.gov/cronobacter/infection-and-infants.html.

What formula should I feed my baby? ________________

How often should I feed my baby? ________________

How much should I feed my baby? __________________

At each feeding ________________

Total each day ________________

How much weight should my baby gain per week? _____________

How many wet or dirty diapers should my baby have each day? ___________

How should I clean and sanitize my baby's feeding items? _____________