Say No To Chrono
I remember reading the MMWRs (Morbidity and Mortality Weekly Report — the CDC’s weekly update on selected causes of disease and death) about Enterobacter sawazakii meningitis many moons ago, when I was a resident. They were chilling accounts of neonates succumbing to overwhelming bacterial infections. Sadly, thirty years later, such cases still happen.
In 2007, the sneaky bacteria underwent a name change to Cronobacter sawazakii, but the creature didn’t change its stripes. Despite advances in neonatal care, mortality rates related to Cronobacter meningitis remain around 50%. And babies that survive often have neurological disabilities.
While Cronobacter bacteria can be found anywhere in the environment, the disturbing connection is the presence of this varmint in powdered infant formula. From a biological perspective, this is a remarkable achievement. It eludes eradication that virtually all other bacteria cannot. From a humanitarian perspective, this is unacceptable. So we need to take extra precautions. Yesterday on The PediaBlog, my colleague Sara DePierre reviewed the recommendations from the World Health Organization on the safe preparation, storage and handling of powdered infant formula. (You can read Sara’s post here and the guidelines here.)
Meticulous attention to detail can minimize exposure to bacteria from the environment (like the kitchen). The crucial point in preparing powdered formula is to boil the water and add the water to the powder when it is no cooler than 70 degrees Centigrade (158 degrees Fahrenheit). The formula mix should then be shaken, not stirred. (Martini aficionados should be able to remember this one easily. : > )
For some, avoiding powder formula may be the best solution. But if that is not in the budget, these extra steps should help protect the babies, especially those born prematurely. Of course, breastfeeding is an even cheaper and safer option. When that is not possible, we should do what we can to keep babies safe from Cronobacter.
Forewarned is forearmed.
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