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Preparing formula milk
Sales plan period: P10B

After completing this module you will:

  • Understand the importance of sterilising feeding equipment

  • Be confident advising on preparing formula milk.

The Department of Health recommends exclusive breastfeeding for the first six months of an infant's life as this is the best form of nutrition. However, if the mother is unable to breastfeed or decides not to, it is important that formula milk is correctly prepared.

First-time parents may be unsure how to prepare formula for their baby and may turn to the pharmacy for professional advice on how to best make up a bottle. It's important to advise them that bottles, teats and other feeding equipment need to be washed and sterilised before each feed. This reduces the baby's risk of contracting an infection, as their immune systems are immature. Feeding equipment should be sterilised until the baby is at least 12 months old.1

IMPORTANT: Only healthcare professionals can advise on infant feeding and formula milks. If a customer hasn't used formula before and is thinking of starting, check that they have had a conversation with a healthcare professional, such as a pharmacist, technician, midwife or health visitor.

How to prepare formula milk2

This is a general guide on how to prepare formula milk. Remind customers to check formula milk packaging for specific instructions and to use the scoop that comes with the formula. This ensures that the correct amount is made for the baby's age. Feeds should be made as and when needed to reduce the risk of infection. This includes discarding any remaining formula milk that has not been drunk. Formula milk should not be batch prepared.

You should remind customers to wash their hands and clean and disinfect any surfaces that will be used before preparing formula milk.

The kettle should be filled with at least one litre of fresh tap water. Water that has been previously boiled should not be used. Tap water should be used because the salt content in bottled water can be too high for babies. However, this may not always be possible, e.g. when travelling, as tap water is not recommended for drinking in some countries. In these instances, customers should boil bottled water to ensure it is sterile and check bottles for salt content. The bottled water should contain less than 200mg/L sodium (Na) and less than 250mg/L sulphate (SO4).

Once the water is boiled, it should be left to cool for up to 30 minutes. The temperature should be around 70°C.

Following the specific formula instructions, the correct volume of water should be poured into the bottle (before the powdered formula). Use the scoop to measure and add the powdered formula.

The teat and cap should be secured to the bottle, and the bottle shaken until the powder has dissolved.

The formula milk should be cooled so it is not too hot for the baby to drink. You can advise parents to cool the formula by running cool water over the outside of the bottle. The temperature of the formula can be checked on the inside of the parent's wrists. Formula should be body temperature.

CLICK FOR REFERENCES

1. https://www.nhs.uk/conditions/pregnancy-and-baby/sterilising-bottles/

2. https://www.nhs.uk/conditions/pregnancy-and-baby/making-up-infant-formula/

Online references last accessed April 2020.

Information for healthcare professional use only

SMA® ADVANCED

NOW AVAILABLE ON BOOTS.COM

Item codes and prices: See Boots.com

SMA® ADVANCED is the first baby milk range in the UK & Ireland to contain human milk oligosaccharides (HMOs*) 2'FL and LNnT.1-11 The SMA® ADVANCED range is specially designed to help support baby's developing immune system.12-14

SMA® ADVANCED First Infant Milk

  • Contains HMOs 2'FL and LNnT
  • Contains zinc and vitamins A, C & D to help support the normal function of baby's immune system12
  • Easy to digest - Partially hydrolysed, 100% whey protein for softer stools.15,16

SMA® ADVANCED Follow-on Milk

  • Contains HMOs 2'FL and LNnT
  • Contains zinc and vitamins A, C & D to help support the normal function of baby's immune system12
  • Fortified with iron (which UK dietary surveys show can be lacking in infant diets)17 to help support normal cognitive development in baby's brain.18

SMA® ADVANCED Growing Up Milk

  • Contains zinc and vitamins A, C & D to help support the normal function of the immune system12
  • Contains HMOs 2'FL and LNnT
  • Vitamin D and calcium support the normal growth and development of bones.19
Click for important notice and references

* HMOs: structurally identical human milk oligosaccharides, not sourced from breast milk.


IMPORTANT NOTICE: The World Health Organisation (WHO) has recommended that pregnant women and new mothers be informed on the benefits and superiority of breastfeeding - in particular the fact that it provides the best nutrition and protection from illness for babies. Mothers should be given guidance on the preparation for, and maintenance of, lactation, with special emphasis on the importance of a well-balanced diet both during pregnancy and after delivery. Unnecessary introduction of partial bottle-feeding or other foods and drinks should be discouraged since it will have a negative effect on breastfeeding. Similarly, mothers should be warned of the difficulty of reversing a decision not to breastfeed. Before advising a mother to use an infant formula, she should be advised of the social and financial implications of her decision: for example, if a baby is exclusively bottle-fed, more than one can (400 g) per week will be needed, so the family circumstances and costs should be kept in mind. Mothers should be reminded that breast milk is not only the best, but also the most economical food for babies. If a decision to use an infant formula is taken, it is important to give instructions on correct preparation methods, emphasising that unboiled water, unsterilised bottles or incorrect dilution can all lead to illness. SMA ® ADVANCED Follow-on Milk is only suitable for babies over 6 months as part of a mixed diet. It should not be used as a substitute for breast milk during the first 6 months of life. The decision to start weaning or to use this product before 6 months should be made only on the advice of a doctor, midwife, health visitor, public health nurse, dietitian or pharmacist, based on baby's individual needs. SMA ® ADVANCED Growing Up Milk is suitable for young children from the 12th month as part of a healthy balanced diet and is not suitable as a breast milk substitute. ZTT850/04/2020.


References: 1. SMA® ADVANCED First Infant Milk datacard (accessed March 2019). 2. SMA® PRO First Infant Milk datacard (accessed March 2019). 3. SMA® Organic First Infant Milk datacard (accessed March 2019). 4. Aptamil Profutura First Infant Milk datacard (accessed March 2019). 5. Aptamil Pronutra First Infant Milk datacard (accessed February 2019). 6. HiPP Organic First Infant Milk datacard (accessed March 2019). 7. Cow & Gate First Infant Milk datacard (accessed March 2019). 8. Kendamil First Infant Milk datacard (accessed March 2019). 9. Mamia First Infant Milk nutritional information on pack (accessed February 2018). 10. Arla First infant Milk product information (accessed March 2019). 11. Sainsburys Little Ones First Infant Milk nutritional information (accessed March 2019). 12. Mora J, et al. Vitamin Effects on the Immune System: Vitamins A and D Take Centre Stage Nat Rev Immunol 2008; 8(9): 685-98 13. Puccio G, Alliet P, Cajozzo C, et al. Effects of infant formula with human milk oligosaccharides on growth and morbidity: A randomized multicenter trial. J Pediatr Gastroenterol Nutr 2017; 64: 624-31 14. Bode L. Human milk oligosaccharides: Every baby needs a sugar mama Glycobiology 2012;9:1147-1162 15. Billeaud C, et al. Gastric emptying in infants with or without gastro-oesophageal reflux according to the type of milk. Eur J Clin Nutr 1990; 44: 577-83. 16. Czerkies LA, et al. A Pooled Analysis of Growth and Tolerance of Infants Exclusively Fed Partially Hydrolyzed Whey or Intact Protein-Based Infant Formulas. Int J Pediatr 2018; 2018: 4969576. 17. Lennox A et al. (2013) Diet and Nutrition Survey of Infants and Young Children (accessed March 2020). 18. Domellöf M, et al. Iron Requirements of Infants and Toddlers. J Pediatr Gastroenterol Nutr 2014; 58: 119-29. 19. Scientific Advisory Committee on Nutrition. Vitamin D and health (2016) (accessed March 2020).

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