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Pediatrician Judy Larkin: Preparing formula is simple, but you have to have the right equipment and the right ingredients.
Narrator: Pediatrician and mother of three Judy Larkin, from Thomas Jefferson University Hospital in Philadelphia, is meeting with first-time mom Maria.
Dr. Larkin will show Maria how to safely prepare baby formula at home for her son, Dominic.
She'll also show Maria how to mix a single bottle on the go.
Doctor: There are three basic types of formula. The first is "ready to feed." Ready to feed is, as it's described, open up the can, pour it out, ready to go.
The other two types are concentrate and powder. Both of them require being mixed with water before they can be given.
Narrator: It's critical to mix them with the right amount of water. Using either too much or too little is bad for your baby.
Doctor: If a formula is too dilute, it can cause problems such as poor nutrition, low sodium levels, but if it is too concentrated it can also cause other problems including diarrhea, dehydration, and electrolyte imbalances.
Narrator: Read the instructions on the formula packaging to find out how much water to use.
Dr. Larkin recommends four simple steps to safely prepare formula.
Step one: Clean or sterilize your bottles and equipment.
Doctor: When we first get bottles from the store and nipples from the store, you need to make sure that they are appropriately sterilized, which means usually boiling them for three minutes.
You only need to do this the first time you use the equipment. After that, washing it in the dishwasher or with hot, soapy water is fine.
Let the equipment air dry or dry it with a clean paper towel, since dish towels can harbor bacteria.
Step two: Use water safely.
If you trust the safety of your water supply, you can use tap water. Bottled water is fine too.
If you're not sure that your water is germ-free, boil it for one minute. You don't need to boil bottled water that's labeled as sterile.
Find out your water's fluoride content by asking your local water authority or your baby's doctor. If the fluoride level is too high, you may need to buy low- or no-fluoride water. If it's too low, you may need to give your baby a supplement.
A note for parents using powdered formula: If you want to be extra cautious and fight bacteria that can be present in formula powder, mix the powder with piping hot water. Use water soon after boiling it, or before it drops below 158 degrees Fahrenheit.
Cool the formula so your baby can drink it by placing the bottle in cold water.
Step three: Wash your hands thoroughly with soap and warm water for at least 20 seconds. Dry them with a paper towel.
Now you can open the formula container.
Doctor: There is usually a little tab here that's a snap tab that you can pull up and then open up. And hearing that pop generally means that it has never been opened or cracked and that it's safe.
Narrator: Step four: Follow the preparation directions exactly.
Maria has chosen powdered formula for Dominic.
Doctor: The powder comes with its own scoop and it's important to use that scoop for exact measurements.
Today we are making six 6-ounce bottles of formula.
Why don't you start counting the scoops?
Narrator: Be sure to check with your doctor to find out how much to feed your baby. Over- or under-feeding can cause problems.
Doctor: The reason we only make a day's worth of formula is because formula will not last longer than that. It can be stored in the refrigerator for 24 hours, but beyond that it may no longer be safe.
Narrator: It's best to prepare each bottle fresh, right before a feeding. Since that isn't always practical, you can prepare a batch, like Maria and Dr. Larkin are doing.
Doctor: I will start to measure up some of the water.
So we need to stir this up until all the pieces of powder are dissolved.
Now we can take the formula that we have prepared and pour it into our cleaned or sterilized bottles.
Now when you put it in the refrigerator, it's best not to put it on the door but to put it closer to the back of the refrigerator because it's cooler there.
Great, Dominic will be well fed for the day.
Narrator: If you need to leave the house and take a chilled bottle of formula with you, you can store it in a cooler with ice packs for up to two hours.
You'll need to throw it out if it sits at room temperature for more than an hour. You can serve formula warm, cold, or at room temperature, though most babies prefer it warm.
Never use a microwave, which can create dangerous hot spots that can burn your baby.
Doctor: There are warming machines that are made to warm up bottles. There is also the simpler way, which is getting warm or hot water and putting it into this container and then setting the bottle into the warm water and letting it sit there until it gets to the temperature that you would like.
Narrator: After warming formula, always test the temperature on the inside of your wrist to make sure it's not too hot.
Mom: And if I am out and I don't have water, what should I use?
Doctor: Bottled water is the best option.
Narrator: Pouring in the water first will help you get accurate water measurements.
Then add the formula powder or concentrate. You can buy single-serving packets or bring along a small container of formula from home.
Doctor: Once you put in the three scoops of powder into the 6 ounces of water, you're going to shake it up and shake it up well so that all of the powder gets dissolved.
OK, great. Let's give Dominick another bottle.
Well, let's see how he likes it.
Narrator: If your baby doesn't finish a bottle of formula within an hour, toss it out. Bacteria from his mouth can seep into the bottle, contaminate the formula, and make your baby sick.
When you're about to mix a new batch of formula, discard any that your baby didn't drink from the previous day.
Now that she knows what to do, Maria will have a safe and tasty bottle of baby formula ready for Dominic whenever he needs one.
Doctor: Looks like he likes it.