Preparation and handling of powdered infant formula: a commentary by the ESPGHAN Committee on Nutrition.

Carlo Agostoni, Irene Axelsson, Olivier Goulet, Berthold Koletzko, Kim F. Michaelsen, John W L Puntis, Jacques Rigo, Raanan Shamir, Hania Szajewska, Dominique Turck, Yvan Vandenplas, Lawrence T. Weaver

Research output: Contribution to journalArticlepeer-review


Powdered infant formulae are not sterile and may contain pathogenic bacteria. In addition, milk products are excellent media for bacterial proliferation. Multiplication of Enterobacter sakazakii in prepared formula feeds can cause devastating sepsis, particularly in the first 2 months of life. In approximately 50 published case reports of severe infection, there are high rates of meningitis, brain abscesses and necrotizing enterocolitis, with an overall mortality from 33% to 80%. Breast feeding provides effective protection against infection, one of the many reasons why it deserves continued promotion and support. To minimize the risk of infection in infants not fully breastfed, recommendations are made for preparation and handling of powdered formulae for children younger than 2 months of age. In the home setting, powdered infant formulae should be freshly prepared for each feed. Any milk remaining should be discarded rather than used in the following feed. Infant feeds should never be kept warm in bottle heaters or thermoses. In hospitals and other institutions written guidelines for preparation and handling of infant formulae should be established and their implementation monitored. If formula needs to be prepared in advance, it should be prepared on a daily basis and kept at 4 degrees C or below. Manufacturers of infant formulae should make every effort to minimize bacterial contamination of powdered products.

Original languageEnglish
Pages (from-to)320-322
Number of pages3
JournalJournal of Pediatric Gastroenterology and Nutrition
Issue number4
Publication statusPublished - Oct 2004

ASJC Scopus subject areas

  • Gastroenterology
  • Histology
  • Medicine (miscellaneous)
  • Food Science
  • Pediatrics, Perinatology, and Child Health


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