Caring for Our Childen, 3rd Edition (CFOC3)

Chapter 4: Nutrition and Food Service

4.3 Requirements for Special Groups or Ages of Children

4.3.1 Nutrition for Infants

4.3.1.9: Warming Bottles and Infant Foods

Frequently Asked Questions/CFOC3 Clarifications

Reference: 4.3.1.9

Date: 10/13/2011

Topic & Location:
Chapter 4
Nutrition and Food Service
Standard 4.3.1.9: Warming Bottles and Infant Foods

Question:
I have concerns about the standards recommending glass and ceramic containers due to concerns about using plastic.  Once again, it is good in theory, but I don’t feel it is safe. I had a center that had a glass bottle drop and shatter in their infant room. 

Answer:
BPA-free plastic bottles, those labeled #1, #2, #4, or #5, can be used to avoid the use of glass.

For those child care and early education facilities that choose to use glass bottles, a relatively new option is to use a bottle sleeve with the glass bottle to reduce the risk of shattered glass. Efficacy on this product is still being proven. Overall, glass is safer than plastic with BPA.

Content in the STANDARD was modified on 11/5/2013 and on 8/25/2016.


Bottles and infant foods can be served cold from the refrigerator and do not have to be warmed. If a caregiver/teacher chooses to warm them, bottles should be warmed under running, warm tap water or by placing them in a container of water that is no warmer than 120°F. Bottles should not be left in a pot of water to warm for more than five minutes. Bottles and infant foods should never be warmed in a microwave oven.

Infant foods should be stirred carefully to distribute the heat evenly. A caregiver/teacher should not hold an infant while removing a bottle or infant food from the container of warm water or while preparing a bottle or stirring infant food that has been warmed in some other way. Only BPA-free plastic, plastic labeled #1, #2, #4 or #5, or glass bottles should be used.

If a slow-cooking device, such as a crock pot, is used for warming infant formula, human milk, or infant food, this slow-cooking device (and cord) should be out of children’s reach; should contain water at a temperature that does not exceed 120°F; and should be emptied, cleaned, sanitized, and refilled with fresh water daily.

If a bottle warmer is used for warming infant formula, human milk, or infant food, it should be out of children’s reach and used according to manufacturer’s instructions. For both slow-cooking devices and bottle warmers, glass bottles with a silicone sleeve (a silicone bottle jacket to prevent breakage) or those made with safer plastics, such as polypropylene or polyethylene, should be used.  
 

RATIONALE
Bottles of human milk or infant formula that are warmed at room temperature or in warm water for an extended time provide an ideal medium for bacteria to grow. Infants have received burns from hot water dripping from an infant bottle that was removed from a crock pot or by pulling the crock pot down on themselves by a dangling cord. Caution should be exercised to avoid raising the water temperature above a safe level for warming infant formula or infant food. Human milk, formula, or food fed to infants should never be heated in a microwave oven as uneven hot spots in milk and/or food may burn the infant (1,2).

Avoid bottles made of plastics containing bisphenol A (BPA) (3) or phthalates (sometimes labeled with #3, #6, or #7). Use glass bottles with a silicone sleeve (a silicone bottle jacket to prevent breakage) or those made with safer plastics such as polypropylene or polyethylene  (labeled BPA-free) or plastics with a recycling code of #1, #2, #4, or #5.
TYPE OF FACILITY
Center, Large Family Child Care Home
RELATED STANDARDS
4.3.1.3 Preparing, Feeding, and Storing Human Milk
4.3.1.5 Preparing, Feeding, and Storing Infant Formula
4.3.1.8 Techniques for Bottle Feeding
4.3.1.12 Feeding Age-Appropriate Solid Foods to Infants
REFERENCES
  1. Nemethy, M., E. R. Clore. 1990. Microwave heating of infant formula and breast milk. J Pediatr Health Care 4:131-35.
  2. Dixon J. J., D. A. Burd, D. G. Roberts. 1997. Severe burns resulting from an exploding teat on a bottle of infant formula milk heated in a microwave oven. Burns 23:268-69.
  3. Harley, K.G., Gunier, R.B., Kogut, K., Johnson, C., et al. 2013. Prenatal and early childhood bisphenol a concentrations and behavior in school-aged children. Environ Res. 126: 43-50.
NOTES

Content in the STANDARD was modified on 11/5/2013 and on 8/25/2016.