Preparing and handling powdered infant formula

Young children, especially infants, are vulnerable to foodborne illness. Babies can have difficulties fighting off infections because their immune systems are not yet fully developed. 

Health Canada recommends breastfeeding your baby. Human milk is the best food for your baby. When a baby is not breastfed, liquid infant formula and powdered infant formula are acceptable alternatives. 

Liquid Infant Formula

Health Canada recommends that infants who are premature, have a low birth weight, or weakened immune systems, drink commercially produced sterile liquid infant formula, if they're not being breastfed.

There are two types of liquid infant formula:

  • ready-to-feed
  • liquid concentrates.

Ready-to-feed liquid infant formula is heat‑treated by the manufacturer to produce a formula that is sterile. 

Liquid concentrate requires water in order to dilute it. You should use boiled water cooled to between room and body temperature to dilute the concentrated formula.

For caregivers and parents that may not have access to liquid infant formula, or when a suitable liquid infant formula is not available, powdered infant formula can be used if it's prepared properly.

Powdered Infant Formula

Powdered infant formula can be used for infants who are healthy and full term and also for infants who are premature, have a low birth weight, or weakened immune systems in situations where sterile liquid infant formula is not available. Powdered infant formula isn't sterile. As a result, if it's not prepared properly, powdered infant formula could expose a child to potentially harmful bacteria such as Cronobacter spp. Caregivers and parents need to make sure that powdered infant formula is prepared properly to reduce the risks of foodborne illness.

Preparing and Handling Powdered Infant Formula

You can reduce the risk of foodborne illness for your infant by following these steps at home:

Prepare your space:

  • Clean your countertops and hands with soap and warm water before beginning.
  • Clean and disinfect utensils and digital food thermometers.
  • Sterilize bottles, nipples, spoons, lids and other equipment by boiling in an open pan of water for two minutes. Allow them to air dry and cool. Cover them with a clean tea towel if you're not going to use them right away.

Prepare the formula:

For premature and low birth weight infants under two months of age or infants with a weakened immune system

  • Boil water for 2 minutes.
  • Cool water to 70°C (this takes about 30 minutes), pour the required amount of water into a sterilized bottle and add the formula powder according to the manufacturer’s instructions. Maintaining water at 70°C kills potential harmful bacteria.
  • Serve formula as soon as possible after it has been prepared and cooled to between room and body temperature. Always check the temperature of the formula on the inside of your wrist before serving it to your baby to make sure it isn't too hot. 
  • Some powdered infant formula cannot be prepared with boiled water cooled to 70°C because of heat-sensitive ingredients, such as human milk fortifiers or formulas for special medical purposes. Consult and follow the advice from your doctor or health professional before using these formulas.
  • Once you have started feeding your child, the bottle should be used within 2 hours. All leftovers should be thrown out.

For healthy, full‑term infants

  • Boiled water that has been cooled to room temperature can be used to prepare powdered infant formula.
  • Serve formula as soon as possible after it has been prepared. 
  • Remember, once you've started feeding your child, the bottle should be used within 2 hours.

For later use

  • Follow the instructions above for preparing powdered infant formula for premature and low birth weight infants under two months of age or with weakened immune systems.
  • Place the formula in individual sterilized bottles and quickly cool under cold running water. 
  • Keep refrigerated at a temperature of 4°C or below until you're ready to use it because harmful bacteria can grow at temperatures above 4°C.
  • Use any prepared, refrigerated formula within 24 hours or as specified by the manufacturer.
  • Warm up prepared formula by placing the bottle in a bottle warmer or a container of hot water for no more than 15 minutes until it's between room and body temperature. The longer you warm it, the greater the chances that harmful bacteria might grow.
  • Avoid using a microwave oven to warm prepared formula because it can create hotspots that can burn your child's mouth.
  • Once you’ve warmed the prepared formula, feed your child immediately. The bottle should be used within 2 hours. Don’t refrigerate and reuse warmed prepared formula.

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