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This report examines key organisms of concern, especially Cronobacter spp. and Salmonella spp., and explains why premature infants face heightened risks. Manufacturing cannot eliminate pathogens, so prevention depends on safe reconstitution practices. It evaluates global and current UK guidance, including recommendations to use water boiled and cooled to at least 70°C, and outlines areas needing reassessment and clearer labeling to reduce illness risk.",{"@graph":69,"@context":115},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-bacterial-contamination-of-powdered-infant-formula-risks-and-safe-preparation-guidance-february-2020/402550/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-bacterial-contamination-of-powdered-infant-formula-risks-and-safe-preparation-guidance-february-2020/402550.png","ImageObject",300,407,{"name":92,"@type":93},"Blitz","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-27",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109],{"name":110,"@type":111,"acceptedAnswer":112},"What does the report recommend regarding water temperature for safe preparation?","Question",{"text":113,"@type":114},"It emphasizes that guidance to use water at a temperature of 70°C or more when making up PIF remains essential. Current UK label and national guidance should maintain preparation at 70°C or more, and recommendations call for clear mandatory statements on safe preparation.","Answer","https://schema.org",{"og:url":83,"og:type":117,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":119,"canonical":83},"index,follow",{"doc_id":121,"site_id":62},402550,1790906699,{"code":4,"msg":5,"data":124},{"doc_id":121,"user_id":125,"nickname":92,"user_avatar":126,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":127,"file_id":128,"file_url":129,"file_type":130,"file_size":131,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":132,"language":133,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":134,"faqs":135,"seo_title":136,"seo_description":67,"update_tm":137,"read_time":138,"preview_page_count":4},24464137899374,"https://us-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","The bacterial contamination of powdered infant formula:  \nWhat are the risks and do we need to review current instructions on safe preparation?  \nFebruary 2020  \nThe bacterial contamination of powdered infant formula: What are the risks and do we need to review current instructions for safe preparation? February 2020  \nDr Helen Crawley , Susan Westland and Dr Vicky Sibson  \nDisclaimer:  \nThis report is provided for information only. Individual advice on feeding an infant should always be sought from a clinician or other health professional.  \nFirst Steps Nutrition Trust Studio 3.04  \nThe Food Exchange New Covent Garden Market London SW8 5EL  \nContents  \nPage  \nTerminology 3  \nSummary 4  \nRecommendations 5  \n1. Introduction 6  \n2. Bacterial contamination of powdered infant formula 10  \n2.1 Cronobacter spp. 11  \n2.2 Salmonella spp. 14  \n2.3 Contamination of powdered infant formula 15  \n3. Risks to infant health from contaminated powdered infant formula 17  \n3.1 Infections caused by Cronobacter spp. contamination 17  \n3.2 Documented cases of Cronobacter spp. infection linked to 18  \ncontaminated powdered infant formula  \n3.3 Infections caused by Salmonella spp. contamination 22  \n3.4 Documented cases of Salmonella spp. infection linked to 23 contaminated powdered infant formula  \n3.5 Product recalls due to contamination or suspected contamination of 25 powdered infant formula  \n4. Why do instructions for making up powdered infant formula vary? 26  \n4.1 The addition of probiotics to powdered infant formula for term 26 infants  \n4.2 The addition of probiotics to powdered infant formula for preterm 27 infants  \n4.3 Potential risks associated with the addition of probiotics to 28 powdered infant formula  \n4.4 Can the acidification of powdered infant formula reduce the risk of 29 bacterial contamination?  \n5. Current UK advice on reducing the risk of infection due to contamination of powdered infant formula  \n5.1 Current practices in making up powdered infant formula  \n5.2 Does the current advice ensure that the water is above 70oC when powdered infant formula is reconstituted?  \n5.3 Using other methods for reconstituting powdered infant formula  \n6. Conclusion  \n7. References  \n30  \n34  \n36  \n40  \n40  \n41  \nAppendix 1: Reported bacterial contamination of powdered infant milk samples 51  \nAppendix 2: Examples of infant milk recalls due to risk of bacterial contamination 53  \nTerminology  \nThere are a number of names and terms used for milks marketed to infants ad young children. Whilst they are all covered by the term 'breastmilk substitutes', the terms 'artificial milks' or'formula milks' are commonly used. The products which are considered in this report are milks sold in powdered form, manufactured and marketed for use by infants and young children as abreastmilk substitute after preparation with water.  \nWe are using the term powdered infant formula (PIF) throughout this report as an umbrella term to include powdered infant formula, follow-on formula and infant milks marketed as foods for special medical purposes.  \nSummary  \nBreastfeeding protects infants from infection and a mother who breastfeeds does not introduce additional bacterial hazards through the use of powdered infant milks (PIF) or through the contamination of bottles and teats. Infants are particularly susceptible to infection via foodborne pathogens because they have immature immune systems and permeable gastrointestinal tracts.  \nCurrent manufacturing processes are unable to produce sterile PIF and the pathogens of greatest concern in PIF are Cronobacter spp. and Salmonella spp. The risk to infants of serious illness or death from the bacterial contamination of PIF is well known. Although the number of infants who may become ill, or die, from infections caused by the consumption of contaminated formula is difficult to quantify, the true number is likely to be underrepresented in the literature. There is particular risk to premature infants related to serious infec","cbCaibIqzlKHWBjA","https://ap.wps.com/l/cbCaibIqzlKHWBjA","pdf",785723,55,"English","# Terminology\n# Summary\n# Recommendations\n# 1. Introduction\n# 2. Bacterial contamination of powdered infant formula\n## 2.1 Cronobacter spp.\n## 2.2 Salmonella spp.\n# 3. Risks to infant health from contaminated powdered infant formula\n## 3.1 Infections caused by Cronobacter spp.\n## 3.3 Infections caused by Salmonella spp.\n# 4. Why do instructions for making up powdered infant formula vary?\n## 4.1 The addition of probiotics\n# 5. Current UK advice on reducing infection risk\n## 5.2 Ensuring water is above 70°C\n# Conclusion\n# References\n# Appendix 1: Reported bacterial contamination of powdered infant milk samples\n# Appendix 2: Examples of infant milk recalls","[{\"question\":\"What does the report recommend regarding water temperature for safe preparation?\",\"answer\":\"It emphasizes that guidance to use water at a temperature of 70°C or more when making up PIF remains essential. Current UK label and national guidance should maintain preparation at 70°C or more, and recommendations call for clear mandatory statements on safe preparation.\"}]","The Bacterial Contamination of Powdered Infant Formula - Risks and Safe Preparation Guidance - February 2020 | PDF",1790531734,139]