Thanks to Evi for the report from the Codex meeting. It
seems that they
still refuse to get it right about warning parents of the
possible intrinsic
contamination of powdered infant formula with Enterobacter
sakazakii (and other
bacteria).
"There was also controversy regarding the need to alert
parents through
warnings on labels to the presence of intrinsic
contamination of Enterobacter
Sakazakii and other disease-causing pathogens in powdered
infant formula. WHO
informed the meeting of the serious risks to health and the
need to make up
feeds with previously boiled water. The industry –
eager to promote not
only formula but also bottled water insisted that it a
reference to ‘safe water
’ was sufficient. Finally it was agreed to include a
reference to boiled
water, but not agreed to include a warning of intrinsic
contamination."
During the Code monitoring NABA just finished conducting in
the US, we
noticed that both Ross and Mead Johnson have changed the
preparation instructions
on their labels of powdered infant formula. Both warn that
powdered formula
is not sterile and should not be fed to premature infants or
infants who might
have immune problems, in keeping with the FDA warning letter
sent to
neonatal intensive care nurseries. Most other brands of
formula do not carry this
statement. None of the labels contain the correct
preparation instructions
which call for water to be brought to a rolling boil, cooled
to 70-90C or
158-194F and added to the formula, then cooled to body
temperature before feeding to
the baby. This is not to make the water bacteriologically
safe but to
reconstitute the formula at a high enough temperature to
kill the E sakazakii
within the formula without denaturing or altering its
nutritional composition. All
labels should warn not to feed the powdered version of
formula to any infant
under 4 weeks of age (Drudy 2006).
Drudy D, Mullane NR, Quinn T, et al. Enterobacter
sakazakii: an emerging
pathogen in powdered infant formula. Clin Infect Dis 2006;
42:996-1002
Marsha Walker, RN, IBCLC
Weston, MA
In a message dated 11/3/2006 1:03:40 P.M. Eastern Standard
Time,
LISTSERV PEACH.EASE.LSOFT.COM writes:
There was also controversy regarding the need to alert
parents through
warnings on labels to the presence of intrinsic
contamination of Enterobacter
Sakazakii and other disease-causing pathogens in powdered
infant formula. WHO
informed the meeting of the serious risks to health and the
need to make up
feeds with previously boiled water. The industry –
eager to promote not
only formula but also bottled water insisted that it a
reference to ‘safe water
’ was sufficient. Finally it was agreed to include a
reference to boiled
water, but not agreed to include a warning of intrinsic
contamination.
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