Our children’s hospital gives the following guidelines about boiling water and sterilization:
1. Babies should only get water that was previously boiled up until 6 months.
2. All nipples and bottle parts that come into contact with the baby’s mouth should be sterilized before use for at least 4 months, and ideally up until 6 months.
I’m a big bottle sterilizer, and still sterilize bottles even though Hailey is almost 1.5 years (which I know is obsessive, but we’ve since acquired a microwave sterilizer which helps clean all those little Dr. Brown’s parts, I find). I still do it for Hailey because she’s on a PPI.
I think the school of thought that if you sterilize everything they’ll never build up an immune system would only be true if you were literally sterilizing everything and never exposing them to the outside world. Since we’re only talking about bottles, I go with the better safe than sorry approach. We’ve been told by various sources that best practice is to sterilize the bottles and boil the water mainly because a young baby doesn’t have well developed flora of the gut to fight off foreign bacteria that may be introduced and they can get sick.
We were also told that in most circumstances tap water that has been boiled is preferred to bottled water. Our ped does not like giving bottled water to babies (but that’s just his opinion) because the mineralization is a different composition and can cause an imbalance. (This is just his opinion). Here’s a copy from a document someone once sent me about this. I don’t know the source, so you have to take it with a grain of salt. Either way, we’ve always been told that as long as your area has safe drinking water, it’s better than bottled (especially in young infants). Here’s the info:
Health risks to infants fed with commercial bottled drinking water
In 1993 two infants were admitted to a hospital in Wisconsin and treated for seizures associated with low sodium levels caused by excessive water intoxication(Ref. 3).
In the first case, a 55-day-old infant suffered epileptic fits as a result of low sodium levels in her blood. Furthermore, the infant also experienced respiratory depression. The infant had been fed with infant formula supplemented with bottled water. The mother reported using bottled water as a supplement because the product was inexpensive and because she interpreted the labelling to indicate that the product had been produced specifically for infants and contained nutrients adequate for use as a feeding supplement.
In the second case, a 56-day-old infant was admitted to hospital following an apparent brief seizure. Again, the seizure was diagnosed as a result of low sodium levels. In this case, the mother had used bottled water to supplement feedings of soy based formula. Once again, the mother indicated that she believed the bottle label depicted a product specifically made for infants.
Diarrhoea is the greatest killer of infants worldwide(Ref. 4) and requires Oral Rehydration Treatment to replace lost fluid and minerals. The promotion of bottled water as suitable for infants may encourage parents to use this product to rehydrate their children so increasing the risk of low sodium related seizures.
Too high a concentration of minerals may also put infants at risk. In a 1994 report, Weaning and the Weaning Diet, the UK Department of Health states that (Ref. 5):
“Excessive sodium intake is undesirable especially in infancy.”
“High nitrate content of water is one of the causes of methaemoglobinaemia in infants. Where the concentration exceeds 50 milligrams per litre (as nitrate ion) water undertakers [providers] are obliged to inform the health authorities and professions in the affected area. Water with a concentration of nitrate greater than 100 milligrams per litre is not suitable for infant feeding.”
“High concentrations of nitrate and sulphur are present in some natural mineral waters. High sulphate levels of 400 – 500 milligrams per litre may be purgative [cause excessive bowel movements] especially in children.”
“Natural mineral waters may contain varying amounts of fluoride and those with high levels are unsuitable as part of an infant’s diet or for making up dried foods or drinks because of the risk of fluorosis of the tooth enamel.”
UK Legislation covering water
Although there is no binding legislation relating to the composition and use of bottled water, the Department of Health has indicated that (Ref.5):
“Bottled waters, other than those labelled ‘natural mineral water’, are expected to conform to essentially the same standards as the public water supply and they are therefore suitable for giving to infants or for preparing feeds. As with tap water, bottled waters should be boiled and cooled before using to make up infant formula feeds.”
” ‘Natural mineral water’ is covered by less comprehensive regulations than tap water and may contain higher concentrations of solutes such as nitrate, sodium, fluoride and sulphate which might lead to solute overload if these waters are given to young infants.”
The tap water that we drink every day contains only chloride and flouride – all minerals are removed during the treatment process. However, with mineral water the composition is unchanged – extra minerals are neither added nor removed from it.
In guidelines sent to health authorities (Ref.6), the Department of Health recommends:
“Check the label and avoid using water in bottles labelled ‘natural mineral water’ – they are not required to meet all the standards for tapwater and other bottled waters.”
Concentrations greater than those given in the box should be avoided for infant feeding according to the Department of Health guidelines (Ref. 6):
Maximum mineral concentrations for drinking water (UK Department of Health)
Sodium 200 milligrams per litre (mg/l)
Nitrate 100 mg/l (best below 50 mg/l)
Nitrite 3 mg/l
Sulphate 500 mg/l
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Other Legislation
The Food and Drug Administration (FDA) in the U.S.A. has published a “final rule” governing regulations on bottled water, including mineral water. The regulations require accurate labelling of bottled waters marketed for infants. Any product labelled “sterile” must be processed to meet the FDA’s requirements for commercial sterility. If the water is not sterile, the labelling should indicate this. In this instance it should only be used in the preparation of infant formula as directed by a Doctor or according to infant formula preparation instructions.
In U.S.A. the FDA has recommended to the International Water Association that the labels of bottled water products should indicate clearly their contents and appropriate uses and that they should not be used in lieu of infant formula.
Within the European Community, there are currently no standards governing sterilization of bottled water.
s&h’s mum2006-11-12 14:53:31
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With Kaelyn, we used flouridated bottled water. At some point early on, in the worst stages of her reflux we decided to try switching from tap water to bottled and then we were afraid to switch back.
