Sterilization of Infant Formula

Gerber, Michael A.; Berliner, Benjamin C.; Karolus, John J.

doi:10.1177/000992288302200504

Cited by 5 publications

(3 citation statements)

References 16 publications

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“…At the present time, pediatric textbooks and the instructions from several infant formula companies recommend sterilization when mixing formula from concentrate or powder or when adding ready-to-feed formula to bottles (Gerber et al, 1983;Feder and Pugno, 1986). It is well established that, in the Maillard reaction after heat treatment, lysine is lost through its interaction with reducing sugars to form biologically unavailable deoxyketosyl derivatives (Adrian, 1974;Desrosiers and Savole, 1994).…”

Section: Discussionmentioning

confidence: 99%

“…Infant formulas are often heat sterilized in hospitals where water contamination or nosocomial infection is an issue, especially in developing countries and when large quantity of prepared milk is needed daily for nursery and hospitalized infants. However, only a few studies have investigated the effect of heat on the nutritional value of infant formula (Adrian, 1974;Kilshaw et al, 1982;Gerber et al, 1983). High heat has been shown to cause substantial loss of several vitamins, including thiamin, vitamin B6, ascorbate, folate, and vitamin B12.…”

Section: Introductionmentioning

confidence: 99%

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Negative effect of heat sterilization on the free amino acid concentrations in infant formula

et al. 2005

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Infant formulas are often heat sterilized in hospitals where water contamination or nosocomial infection is a concern, but there are few studies of the effect of high heat on the nutritional value of infant formula. In particular, the effect of heat sterilization on free amino acid (FAA) concentrations is seldom discussed. In view of the importance of these nutrients for infant growth, we investigated the FAA concentrations of infant formula after heat sterilization. Powdered infant formulas were reconstituted with hot water (801C) in glass bottles and placed in an autoclave for 5 min at 1051C and 5600 kg/m 2 of pressure. Additional samples of formula were prepared by conventional methods to serve as controls. After autoclaving, we measured the FAA concentrations with ion exchange chromatography. The results were compared with those obtained after conventional preparation. We found a 19.5% lower amount of total protein after autoclaving compared with conventional preparation. Concentrations of total FAA were significantly lower after autoclaving (696.57101.4 vs 899.47152.2 mmol/l, P ¼ 0.01). The concentrations of individual amino acids were also lower in autoclaved infant formulas, with differences ranging from À4.1 to 71.5% (mean 22.6%). Concentrations of certain amino acids were more than 30% lower, such as valine (71.5%), citrulline (61.1%), glutamine (60.6%), ethanolamine (54%), and lysine (39.2%). Both essential and nonessential amino acids were similarly affected by autoclaving, 28.17 and 27.13%, respectively, lower than in controls (P ¼ 0.37). The concentration of ammonia was significantly higher after autoclaving (645.2776.2 vs 393.27140.7 mmol/l, P ¼ 0.0003). However, the urea level was significantly lower after autoclaving than after conventional preparation (1110.87162.7 vs 1426.57209.5 mmol/l, P ¼ 0.0004). The accumulation of ammonia may reflect degradation of protein and amino acids. Autoclaving clearly results in decreased concentrations of FAA in infant formula. The increased concentration of ammonia after autoclaving is of concern if it leads to deleterious effects.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Negative effect of heat sterilization on the free amino acid concentrations in infant formula

et al. 2005

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“…It was during the 1950s that there was a steady improvement in infant mortality rate due to the reduction in deaths from childhood infectious diseases, including gastroenteritis (30 , 39 , 40) . This was in part due to the recognition of the dangers of contaminated water and the introduction of chemical sterilisation methods for infant feeding equipment (41) , and forms of sterilisation used in the 1950s are still recommended. Only one study (18) tested more recent approaches (electric and microwave steam sterilisation) and found both to be more effective than chemical sterilisation.…”

Section: Discussionmentioning

confidence: 99%

Cleaning and sterilisation of infant feeding equipment: a systematic review

Renfrew

McLoughlin²,

McFadden

2008

Public Health Nutr.

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Aim: To assess the clinical and cost-effectiveness of different methods of cleaning and sterilisation of infant feeding equipment used in the home. Design: Systematic review of studies from developed countries on the effectiveness of methods of cleaning and sterilisation of infant feeding equipment used in the home. A brief telephone survey of UK-based manufacturers of infant feeding equipment and formula to ascertain the evidence base used for their recommendations, and a comparison of current relevant guidelines in developed countries, informed the work. Results: National guidelines from six countries demonstrated variation and lack of evidence to support current guidance. Manufacturers did not report evidence of effectiveness to support their recommendations. Nine studies were identified; eight conducted between 1962 and 1985 and one in 1997. All had methodological weaknesses. Hand-washing was identified as fundamentally important. Health professionals were reported as not providing appropriate education on the importance and methods of cleaning and sterilisation. Mothers of subsequent babies and women from lower socio-economic groups were less likely to follow recommended procedures. Conclusion: There is a lack of good-quality evidence on effective ways of cleaning and sterilising infant feeding equipment in the home. The evidence base does not answer the question about which of the methods in common use is most effective or most likely to be used by parents. Hand-washing before handling feeding equipment remains important. Further research on the range of methods used in the home environment, including assessment of the views of parents and carers, is required.

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Infant feeding in Sydney: A survey of mothers who bottle feed

Lilburne

Oates

Thompson

et al. 1988

J Paediatrics Child Health

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Two hundred and seventy-four mothers who were bottle feeding their infants aged from 1 to 9 months, were interviewed. Particular attention was paid to mixing technique, storage of reconstituted formulae, the reasons for deciding to bottle feed and what influenced the choosing of a particular milk. Following the interview, a sample of milk from a previously prepared bottle was taken to measure osmolality and bacterial colony count. Eighty-two per cent of the mothers had initially attempted breast feeding. The commonest reason for changing to a bottle was that the mother felt she was not able to produce enough milk to satisfy the baby. Thirty per cent chose the milk they were using on the recommendation of the maternity hospital. Errors in reconstituting the formulae, compared with the manufacturer's instructions were made by 100 (30%) mothers. In 52 cases these were potentially serious errors, usually erring on the side of preparing an overconcentrated formula. This finding from the interviews was confirmed by osmolality analysis of milk samples. Twenty-two per cent of samples collected grew potential pathogens. There was no correlation between the presence of bacterial growth and the use of prewarmed formulae stored in insulated carriers. No correlation was found between triceps skinfold thickness, age of introduction of solids or method of reconstitution of formula.

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Sterilization of Infant Formula

Cited by 5 publications

References 16 publications

Negative effect of heat sterilization on the free amino acid concentrations in infant formula

Negative effect of heat sterilization on the free amino acid concentrations in infant formula

Cleaning and sterilisation of infant feeding equipment: a systematic review

Infant feeding in Sydney: A survey of mothers who bottle feed

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