1. How is powdered infant formula or follow-on formula to be prepared?
The Food Authority has received enquiries on the correct and safe water temperature for preparing powdered infant formula.
Currently, the Food Authority recommends that the manufacturer’s instructions for healthy infants on the labelling are to be followed. The microbiological criteria for powdered formulas are set out in the EU legislation. The manufacturers of formulas have to regularly monitor for certain microbes causing disease in powdered infant formulas. The microbiological criteria are currently seen as a sufficient precaution and there is no need for using hotter water than recommended in the instructions on the labelling. The food safety authorities ensure that the manufacturers comply with the microbiological criteria.
The water is to be taken from the cold water tap, then boiled and cooled down to about 40 °C. Hot tap water is not to be used. The formula is to be given to the child after the mix has cooled down to lukewarm, or about 37 °C.
When the formula has been prepared in this way it is not sterile, but if the formula is prepared using hotter water than that, it would destroy potential lactic acid bacteria and vitamins that are easily broken down.
If the child has a weakened immune defence or another illness, the formula has to be prepared in accordance with the instructions given by health care personnel. The hospitals can take extra precautions and mix the powdered formula into hotter water than instructed on the label. Often a child that needs fully sterile nutrition is fed products intended specifically for infants (dietary foods for special medical purposes for infants) that are mixed commercially.
The World Health Organisation WHO and some countries recommend in their instructions that the powder is mixed into water that has been boiled and then cooled to 70 °C due to the potential bacteria in non-sterile powdered formula. The WHO guidelines cover the whole world, and not all countries have similar microbiological criteria for foodstuffs as the EU legislation.
2. Can infant formula expose the baby to contaminants?
Extremely low maximum levels are set for contaminants in legislation. However, so far there has not been enough information about all contaminants for purposes of legislative development. Some harmful contaminants may be produced in the processing of, for example, vegetable oils and certain other foods. Because of this, the European Food Safety Authority EFSA has stated that infant formulae can cause exposure to the intake of these contaminants.
At present, there is no cause to issue specific recommendations to restrict the use of any foods.
Such contaminants produced in the processing of foods include, for example, glycidyl fatty acid esters (GE), 3-monochloropropanediol (3-MCPD), and 2-monochloropropanediol (2-MCPD) and their fatty acid esters. These substances are produced particularly when vegetable oils are heated to a high temperature (more than 200°C).
The highest levels have been found in palm oils and palm fats. Clearly lower levels have been detected also in other vegetable oils and fats.
Of these substances, glycidyl is carcinogenic and genotoxic, i.e., it damages the genetic information within a cell. The other compounds have adverse effects mainly on the kidneys and the testicles.
Harmful contaminants may also find their way into infant formulae. Exposure to glycidyl fatty acid esters can be ten times higher than the safe exposure level for babies exclusively fed on infant formulae.
For children over three years of age, the most important intake sources were margarines and baked products.
According to the nutrition recommendations for children that the National Nutrition Council published in January 2016, breast milk is adequate as the sole source of nutrition for the first six months for most babies of normal weight. If breast feeding is not possible, infant formulae shall be used in compliance with the instructions of the child health clinic to satisfy the nutritional requirements of the baby.
After infancy, the best way to avoid any contaminants contained in foods is to follow a balanced, diverse and moderate diet. This will ensure the intake of all necessary nutrients and also support the safety of food.
EFSA published in 2016 an assessment of the substances produced in the processing of foods: