Infant feeding & food safety

A very important part of looking after babies younger than 1 year old is to ensure their food is safe and healthy.

Food safety is particularly important for the early months of a baby's life. Food poisoning can be especially severe for babies because their digestive and immune systems are immature.

These tips are for healthy full-term babies only.

If your baby is premature, of low birth weight or very sick talk to your health professional for advice on feeding.

Breastmilk

Australian and international authorities recommend that breastmilk is the best source of nutrition:

• for infants in their first 6 months, without other solids or liquids
• after 6 months in combination with solids.

Breastmilk gives infants the best possible start, even if its only for the first few months or weeks.

Important safety tips include:

• use fresh breastmilk whenever possible
• if expressing breastmilk, wash & dry hands first
• use sterile equipment & containers
• store expressed breastmilk in a sterile, food-grade container and label the container with the date it was expressed
• store expressed breastmilk in the:
  • fridge (in the back where it is coldest) for up to 48 hours, or
  • freezer for up to 3 months
• thaw frozen milk in the fridge. Thawed breastmilk should be used within 24 hours.
• rewarm expressed milk by standing the container in heated shallow water for no more than 15 minutes
• microwave ovens are not recommended to rewarm milk as they heat unevenly and overheated parts of milk can contain ‘hot spots’ that can burn an infant’s mouth
• check temperature of milk before feeding infants by placing a drop of liquid on the inside of the wrist. It should feel warm
• do not re-freeze expressed breastmilk
• discard expressed milk after 4 hours at warm temperatures, and
• use extra care with hygiene if caregivers are suffering illnesses with vomiting or diarrhoea.

Diet tips:

• Breastfeeding women should eat a balanced and varied diet in line with the Australian Guide for Healthy Eating
• Pregnant and breastfeeding women should try to eat an appropriate amount of fish: for a guide see mercury in fish.

If you are ill or taking any medications talk to your health professional.

Formula: prepare safely

Some parents & caregivers choose formula as an alternative to breastmilk or might be advised to use it for health reasons.

Powdered and liquid infant formulas are available.

Always follow the instructions closely that come with the formula.

Powdered infant formula is not sterile. Take care to prepare and store formula safely, to help reduce any risk of illness.

Powdered formula

Before preparing formula

• Wash thoroughly hands & food contact surfaces with soap & warm water and dry thoroughly
• Wash thoroughly all bottles, teats, & cups before each use
• Sterilise bottles, teats, cups, utensils and tongs before use
• Use sterile tongs to remove bottles and so on, to avoid re-contaminating the equipment.

Preparing formula

• Wash thoroughly with soap & warm water and dry hands again with a disposable paper towel
• Whenever possible, make a fresh batch of formula before each feed
• Prepare formula exactly according to manufacturer’s instructions
• Check temperature of formula before feeding infants by placing a drop of liquid on the inside of your wrist. It should feel warm
• Discard unfinished formula
• Avoid preparing formula if caregivers are suffering illnesses with vomiting or diarrhoea, and take extra care with hygiene.

After preparation, storage

• When made-up formula needs to be stored:
  • place it immediately in a closed container at the back of the fridge, in the centre, where it is coldest.
• Discard after 24 hours if refrigerated
• Discard after 2 hours at room temperature.

Re-warming stored, made-up formula

• Remove the prepared formula just before it is needed
• Rewarm by placing the container in heated, shallow water for no more than 15 minutes or use a commercial bottle warmer
• Microwaves are not recommended to rewarm formula as they heat unevenly and overheated parts of formula can burn the infant’s mouth
• Discard rewarmed formula that has not been consumed after 2 hours
• Discard unfinished formula

Liquid formula

Liquid infant formula is sterile before the package is opened.

It may be a good alternative when travelling, but consult a health professional to ensure it is appropriate for the infant.

Follow the instructions for the product.

Discard any unfinished liquid formula.

Once opened, if the liquid formula is not to feed to the infant immediately:

• pour into a sterile food-grade container
• store immediately in the coldest part of the fridge: at the back, in the centre
• discard after 2 hours out of the fridge, and
• discard after 24 hours in the fridge.

Standards

All infant formulas in Australia have to meet food and safety standards.

Infant formulas are a breastmilk substitute for infants and satisfy the nutrition requirements of infants aged up to 6 months.

Special formulas are available where parents’ families have a history of allergies. Talk to your health professional about these.

Most formulas are derived from cow’s milk with other varieties such as soy and goats milk also available. Extra nutrients needed by human infants may be added.

How to sterilise

Everything that comes into contact with baby’s food needs thorough cleaning and sterilising. This includes bottles, teats, cups, utensils & dummies or pacifiers.

All equipment should be rinsed in cold water after use, washed in soap & hot water using a bottle brush to thoroughly clean everything, then rinsed again, before being sterilised.

There are a number of ways to sterilise bottles and other equipment including:

• boiling
  put utensils in a large saucepan of water and boil for 5 minutes.
• chemicals
  add an approved sterilising liquid or tablet to the container of water used to soak clean equipment. Follow manufacturer’s instructions.
• steam sterilisers
  automatic units which sterilise clean equipment. Follow manufacturer’s instructions.
• microwave steam sterilisers
  put bottles and other equipment into steriliser, which is then heated in the microwave. Follow manufacturers instructions.

For more information about bottle feeding and sterilising equipment, talk to your Child and Family Health Nurse or a pharmacist.

Risks

Harmful microorganisms such as Cronobacter sakazakii (previously known as Enterobacter sakazakii) and Salmonella occur naturally in the environment and can be present in many foods, including powdered infant formula. Manufacturers have strict controls in place to minimise contamination but powdered infant formula is not sterile.

Once breastmilk is expressed or formula products are opened prepared & stored, they can be contaminated. Careful preparation and storage will help minimise any opportunity for harmful microorganisms to grow.

Honey should not be given to infants younger than 12 months. At this age even small amounts of the organism that causes botulism can be harmful. Honey has been linked to some cases of infant botulism overseas.