Baby formula left out: Infant Formula Preparation and Storage | Nutrition

Formula Feeding FAQs: Preparation and Storage (for Parents)

Whether you plan to formula feed your baby from the start, want to supplement your breast milk with formula, or are switching from breast milk to formula, you probably have questions.

Here are answers to some common questions about formula feeding.

Do I Need to Sterilize My Baby’s Bottles?

Before the first use, sterilize nipples and bottles in boiling water for 5 minutes.

After that, you don’t have to sterilize your baby’s bottles and supplies each time you feed your baby. Do wash bottles and nipples in hot, soapy water (or in the dishwasher) after every use. You can get a store-bought countertop or microwaveable sterilizer, but it’s not necessary.

How Do I Prepare My Baby’s Bottles?

Carefully follow directions on the label when preparing formula. Most store-bought formula comes in three basic forms:

• powders that you mix with water
• concentrates, which are liquids that you dilute with water
• ready-to-use (or ready-to-feed) liquids that can be poured right into bottles without adding water

Do not add more water than directed, or use formula past its expiration date.

Wash your hands well before preparing and feeding your baby. To mix powders or concentrates, use clean tap water. If you have a well, test the water to see if it’s safe before using it to mix infant formula.

If your tap water is not clean (or your baby has a weak immune system), boil it for at least 1 minute to kill germs. Let the water cool to room temperature before using it to mix formula. You also can use bottled water. Talk to your doctor if you’re concerned that your water is not safe.

Once prepared, the formula is ready to feed to your baby right away without refrigeration or warming. Feed your baby or store the prepared formula in the refrigerator within 2 hours.

How Long Can a Bottle Keep at Room Temperature?

Throw out any prepared or ready-to-feed formula that’s been sitting out for 2 hours or more, or within 1 hour from start of feeding.

Can I Save Leftover Formula to Give to My Baby Later?

No, throw away any leftover formula. Harmful bacteria can multiply since the last feeding, which could make your baby sick.

Can I Prepare Formula Ahead of Time?

Some parents make a fresh bottle just before each feeding. But many parents make and refrigerate enough formula ahead of time to use for the day. If you know your baby eats every 3–4 hours, for instance, you can make 6 to 8 bottles to last you all day.

If you prepare formula ahead of time, store it in the refrigerator. You can use pre-made formula for up to 24 hours. Open containers of ready-made formula, concentrated formula, and formula prepared from concentrate can be stored safely in the refrigerator for up to 48 hours. Do not store unmixed powder in the refrigerator.

How Do I Warm My Baby’s Bottles?

You don’t have to warm formula before feeding, but some babies may prefer it. To warm bottles, you can:

• Run the bottle under very warm or hot water for a few minutes.
• Put your baby’s bottles in a pan of hot water. Be sure to remove the pan from the heat source before putting the bottle in it.
• Use bottle warmers that sit on your countertop at home or are portable.

Never use the microwave to warm bottles. It can create dangerous “hot spots” in bottles that can burn your baby’s mouth and throat.

Before warming a bottle, shake it. Then, test the temperature of the formula by squirting a drop or two on the inside or your wrist before feeding your baby. It should be lukewarm (barely warm), not hot.

Reviewed by: Mary L. Gavin, MD

Date reviewed: November 2021

How long can baby bottles sit at room temperature?

Log in
|
Register

Tips & Tools

Tips & Tools

Question

Hailey Nelson, MD, FAAP, IBCLC

Answer

A lot of parents ask how me long a bottle can sit out before it goes bad, especially if their baby takes small amounts at a time.

The answer? It depends. There are several factors that determine how long you can safely feed your baby a bottle of breast milk or baby formula. These include how it was prepared, temperature, prep area cleanliness and whether your baby has already fed from it, for example. Here’s what you need to know.

How to safely prepare your baby’s bottle

How you store and prepare baby’s food have a big impact on its quality and safety. Follow these science-backed tips when preparing your baby’s bottles. Note: If your baby was born prematurely or has other health conditions, reach out to your pediatrician for additional guidance.

• 
  Make a clean start. Before preparing formula or expressing breast milk, wash your hands with soap and water or use hand sanitizer that contains at least 60% alcohol. Be sure to clean the area you’ll use to mix formula, using sanitizing wipes or hot water and antibacterial soap. Bottles, bottle parts and storage containers should be pre-sanitized and ready to go.

• 
  If you’re pumping, inspect your pump and supplies. Make sure that all valves, tubing and flanges are clean and in good condition. Use only sanitized, food-grade bags and containers to store expressed milk.

• 
  Label everything. Bags and bottles should show the date and time you expressed the milk or mixed the formula. If your baby attends child care, add their name to bottles and containers too. Ask your child care provider about specific guidelines for breast milk storage and administration.

• 
  Consider making smaller batches. This helps reduce waste if your baby doesn’t drink the whole bottle, since leftover milk should always be discarded after one hour. You’ll dump less out if you prepare and use 2-ounce to 4-ounce batches of formula. Consider freezing breast milk in these smaller amounts too, so it’s easy to thaw them as you need them.

• 
  Keep prepared bottles in the back of the fridge. Although it might seem more convenient to stash them in the door, remember that every time you reach for something, warm air rushes in. The temperature stays more consistent toward the back.
  

• 
  Do not put infant cereal or other foods in your baby’s bottle. Contrary to what you may have heard, thickening your baby’s milk or formula will not help them feel fuller or sleep longer. Worse yet, it increases the risk that your baby will choke. Breast milk and formula on their own will provide all the nutrition and hydration your baby needs to feel full and relaxed.

So, how long can bottles sit out safely?

Once you finish feeding your baby, any prepared infant formula left in the bottle should be thrown out within 1 hour. Pre-mixed formula or breast milk stored in clean bottles can be kept longer, depending on the temperature and location.

Here are guidelines for safely storing everything from fresh breast milk to powdered formula supplies:

Remember

As parents, we all want to give our babies the best nutrition to help support their growth and development. If you have any concerns or questions, or if your baby was born pre-term or has special health conditions, reach out to your pediatrician for more guidance.

More information

• Tips for Freezing & Refrigerating Breast Milk
• How to Safely Prepare Baby Formula With Water
• Ask the Pediatrician: Why are we seeing baby formula brands on the shelves from companies I haven’t heard of before?
• 
  Proper Storage and Preparation of Breast Milk | Breastfeeding | CDC
• 
  Frequently Asked Questions | Breastfeeding | CDC
• 
  Infant Formula Preparation and Storage | Nutrition | CDC (includes links to downloadable guides for storing breast milk)
• 
  Feeding From a Bottle | Nutrition | CDC

Hailey Nelson, MD, FAAP, IBCLC

Hailey Nelson, MD, FAAP, IBCLC, is a complex care pediatrician at Valley Children’s Hospital in Madera, California. Dr. Nelson enjoys working with children of all ages and abilities and is especially passionate about providing the best possible care to medically fragile children and their families. She is also a licensed breastfeeding consultant, certified by the International Board of Lactation Consultants to support nursing mothers and their babies.​

Last Updated

8/5/2022

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Ivacaftor: Pediatric Medication | Memorial Sloan Kettering Cancer Center

Pediatric Medicine

Share

Provided by Lexicomp ^® , this document contains all the information you need to know about this medicine, including indications, directions for use, side effects, and when your healthcare provider should be contacted.

Trade names: USA

Kalydeco

Trade names: Canada

Kalydeco

What is this drug used for?

• Used to treat cystic fibrosis.

What do I need to tell the doctor BEFORE my child takes this drug?

• If your child has an allergy to this drug, any of its ingredients, other drugs, foods, or substances. Tell the doctor about the allergy and how it manifested itself in the child.
• If your child has liver disease.
• If your child is taking any other drugs (prescription, over-the-counter, natural products, or vitamins). There are many drugs that interact with this drug, including certain drugs used to treat HIV infection, other infections, or seizures.

This list of drugs and conditions that may interact with this drug is not exhaustive.

Talk to your doctor or pharmacist about all medicines your child is taking (both prescription and over-the-counter, natural products and vitamins) and any health problems. You need to make sure that this drug is safe to use for your child’s illnesses and in combination with other drugs he or she is already taking. Do not start, stop taking, or change the dosage of any drug your child is taking without the doctor’s approval.

What do I need to know or do while my child is taking this drug?

• Tell all health care providers who care for your child that your child is taking this drug. These are your child’s doctors, nurses, pharmacists and dentists.
• Perform blood tests as directed by your doctor. Consult with your doctor.
• Monitor your child’s lung function as directed by the doctor. Consult your doctor.
• Have your child avoid tasks or activities that require attention until you see how this drug works for your child. This includes cycling, playing sports, or using items such as scissors, lawn mowers, electric scooters, toy cars, or motorized vehicles.
• Do not give your child grapefruit or grapefruit juice.
• Cataracts have been reported in children taking this drug. Have your child have their eyes tested before and while taking this drug. Consult your doctor.
• Various forms of release of this drug may be intended for use in children of different ages. Talk to your doctor before giving this drug to a child.

If your daughter is pregnant or breastfeeding:

• Consult physician if your daughter is pregnant, pregnant, or breastfeeding. The benefits and risks for your daughter and her baby will need to be discussed.

What side effects should I report to my child’s doctor right away?

WARNING/CAUTION: Although rare, some people may have very serious and sometimes deadly side effects of this drug. Call your child’s doctor right away or get medical help if your child has any of the following signs or symptoms that could be associated with a very bad side effect:

• Signs of an allergic reaction, such as rash, hives, itching, red and swollen skin with blisters or peeling, possibly accompanied by fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue or throat.
• Signs of liver problems such as dark urine, fatigue, lack of appetite, nausea or abdominal pain, light-colored stools, vomiting, yellowing of the skin or eyes.
• Signs of high blood sugar such as confusion, drowsiness, unusual thirst and hunger, increased urination, flushing, rapid breathing, and fruity breath.
• Vision change.
• Chest pain.

What are some other side effects of this drug?

Any drug can cause side effects. However, for many people, side effects are either minor or non-existent. Contact your child’s doctor or seek medical attention if any of these or other side effects bother your child or if they persist:

• Dizziness or headache.
• Signs of a cold.
• Irritation of the nose or throat.
• Abdominal pain or diarrhea.
• Nausea.
• Acne.
• Pain in the joints or muscles.

This list of possible side effects is not exhaustive. If you have any questions about side effects, ask your child’s doctor. Talk to your child’s doctor about side effects.

You can report side effects to the National Health Board.

What is the best way to give this drug?

Give this drug to your child as directed by your doctor. Read all the information provided to you. Strictly follow all instructions.

Tablets:

• Give this drug with a fatty meal. There are a lot of fatty foods. Some such products are eggs, butter, peanut butter, cheese pizza, or whole milk dairy products such as whole milk, cheese, or yogurt. If you are not sure which foods are fatty, check with your doctor.
• Keep giving this drug as directed by your child’s doctor or other health care provider, even if your child is feeling well.

Granules:

• Mix contents of sachet with 1 teaspoon (5 ml) of soft food or liquid. It can be pureed fruits or vegetables, yogurt, applesauce, water, breast milk, infant formula, milk or juice. Food or liquid should be at room temperature or slightly colder.
• This medication must be given within 1 hour of mixing.
• Give this drug just before or right after eating fatty foods. There are a lot of fatty foods. Some such products are eggs, butter, peanut butter, cheese pizza, whole milk dairy products such as whole milk, cheese or yogurt, breast milk or baby food. If you are not sure which foods are fatty, check with your doctor.
• Keep giving this drug as directed by your child’s doctor or other health care provider, even if your child is feeling well.

What if my child misses a dose of medication?

• Give the missed dose as soon as possible.
• If it has been 6 hours or more since a dose was missed, skip that dose and return to your child’s normal schedule.
• Do not take 2 doses or an additional dose at the same time.
• If you are not sure what to do if your child misses a dose, contact your doctor.

How do I store and/or discard this drug?

• Store at room temperature in a dry place. Do not store in the bathroom.
• Keep all medicines in a safe place. Keep all medicines out of the reach of children and pets.
• Dispose of unused or expired drugs. Do not empty into a toilet or sewer unless instructed to do so. If you have any questions about disposing of medicines, ask your pharmacist. Drug disposal programs may be in place in your area.

General information about medicines

• If your child’s symptoms or health problems do not improve, or worsen, contact your child’s doctor.
• Do not share your child’s medicine with others and do not give anyone else’s medicine to your child.
• Some medicines may come with other patient information leaflets. If you have questions about this drug, talk with your child’s doctor, nurse, pharmacist, or other health care professional.
• If you think you have overdosed, call a poison control center or get medical help right away. Be prepared to tell or show what drug you took, how much, and when it happened.

Consumer Use of Information and Limitation of Liability

This summary information includes a summary of the diagnosis, treatment, and/or drug product. It is not intended to be a comprehensive source of data and should be used as a tool to help the user understand and/or evaluate potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a particular patient. It should not be considered medical advice or a substitute for medical advice, diagnosis or treatment provided by a physician based on a medical examination and assessment of the patient’s specific and unique circumstances. Patients should consult with their physician for full information about their health, medical issues, and treatment options, including any risks or benefits regarding the use of medications. This information is not a guarantee that a treatment or drug is safe, effective, or approved for a particular patient. UpToDate, Inc. and its subsidiaries disclaim any warranties or liabilities related to this information or its use. The use of this information is subject to the Terms of Use found at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last revision date

2021-01-13

Copyright

© UpToDate, Inc. and its affiliates and/or licensors, 2023. All rights reserved.

Date last updated

Monday, December 12, 2022

How to drink medicines correctly

Taking medicines and vitamins is, it would seem, a common thing. Because the periods of health for many are naturally combined with periods of illness. But few people think about how to properly take a handful of medicines prescribed by a doctor. Meanwhile, the effectiveness of treatment can be lost by 10-20% just because of the wrong approach to the use of medicines. In the article we tell the subtleties and features of the use of certain drugs.

Rule #1.

Chew or swallow

The specialist who prescribed them, the pharmacist at the pharmacy or the instructions for the drug can tell you whether it is worth violating the integrity of the pill. But how often does it matter? Many people think why swallow whole, if I can chew it, it still splits in the stomach. But this can be one of those disorders in which the effectiveness of the pill is instantly lost.

But the load from its entry into the body arises.

Oral intake (swallowing)

It is impossible to violate the integrity of the tablet in the case when the tablet shell is provided just for transporting the active substance through the gastric juice. For example, enteric tablets should act directly in the intestines, but due to the broken integrity, the active substance simply cannot get there.

Therefore, if it is said – to swallow without chewing, it is very important to follow this instruction.

Sublingual intake (absorption)

Theoretically, resorption of the drug on the oral mucosa has an advantage over the usual way. This way the drug passes into the body faster. Due to the high density of blood vessels, sublingual resorption allows the active substance to penetrate the bloodstream faster and get to the place of demand faster.

This method allows you to bypass the aggressive environment of the gastrointestinal tract, as well as minimize the load on the liver, where it can be significantly split. This process is referred to as the “first pass effect” of the drug in the overall metabolism of the body.

Rule #2. What to drink with

If the medicine requires swallowing, then it becomes important what you drink it with. In most cases, medicines are washed down only with water! Water is the simplest in terms of chemistry, a universal solvent.

Any other drinks are actually chemicals dissolved in water that can react with drug components. Because of what the effectiveness of the drug may decrease, the effect of the drug may begin faster or slower.

Our usual drinks – tea and coffee – contain theanine and caffeine. These substances can reduce the effectiveness of contraceptive drugs, disrupt the absorption of certain drugs. Drugs that affect the nervous system, antidepressants, or tonic drugs, when taken with drinks, can increase their effect. Drugs from the category of NSAIDs can increase the toxic effect on the liver and gastrointestinal tract.

Juices and carbonated drinks contain acids, which can have a damaging effect on the shells and active ingredients of drugs. Milk inhibits the action of antibiotics. But especially close attention should be paid to grapefruit juice. It can cause an overdose of drugs for the treatment of heart disease and hypertension, antibiotics, statins, hormones, antiepileptic drugs, anticancer, antihistamines, antifungal drugs.

Grapefruit juice delays the components of drugs that must be excreted from the body, passing in transit. Thus, accumulated substances and toxins can cause irreparable harm to the body and provoke unpredictable reactions.

Rule #3. Reception time

You can often hear that the drug is drunk once a day, two or three times a day, four, and so on. Which does not mean at all that the medicine is taken during the period of wakefulness. This means that all 24 hours of the day are included in the calculations.

For example, if a drug is prescribed three times, this means that it is taken at regular intervals every 8 hours. if you need to drink a pill 2 times a day – the gap between doses will be 12 hours. And further on this principle.

The fact is that an infection or a bacterium, like all systems of our body, functions 24 hours a day without breaks for sleep. This means that the impact on the problem should be carried out evenly, in the same dose, at equal intervals of time.

Rule #4. Missing tablet

The criticality of skipping a pill depends on how much time passed before you remembered it.

When taking the medicine twice, the missed tablet should be drunk as soon as you remember about it. However, now the multiplicity of daily intake should be adjusted starting from the last pill that you remembered. If a little time has passed since the missed pill, then you can not shift the time of admission, but continue as before.

It is impossible to double the dose of the drug at one time, and then continue the treatment as before.

If the course of pills has just begun and a lot of time has passed since the moment of taking the forgotten pill, then it is more advisable to start the course all over again.

True, such a recommendation is not suitable for antibiotics, in which the course usually lasts 5-7 days. So, if the tablet was missed towards the end of the course, it would not be advisable to start it all over again.

Special care should be taken when skipping oral contraceptives. Each OK manufacturer has its own recommendations on this matter, which are necessarily prescribed in the instructions for the drugs. It’s best to remember your birth control pills and set a reminder, because the hormonal fluctuations that skipping can cause can be detrimental to your health. This is especially true for those contraceptives that indicate the color order of taking pills. The doses of hormones in these tablets vary depending on the day on which it should be taken.

Rule #5. Combining drugs with each other

Not all drugs are compatible with each other. Incompatibility may lie in the reactions of the body, side effects, therapeutic effect. Some active substances of drugs are able to neutralize each other’s actions. And in the “best” case, no therapeutic effect will occur. But some combinations can not only lead to unpredictable consequences, but also become deadly.

So, there are absolute contraindications for the simultaneous use of certain drugs and relative ones. Drug compatibility is one of the reasons why self-medication can be dangerous.

If a specialist has prescribed several drugs for therapy, it is very important to separate them among themselves, even if there are no prohibitions on the joint use of drugs. So you can facilitate the work of the liver and gastrointestinal tract, which secrete certain enzymes for the processing of certain substances.

Incompatible drugs

Aspirin for the heart to prevent heart attacks and vascular diseases and any non-steroidal anti-inflammatory drugs (NSAIDs) like nise, ketorol, ibuprofen.

Both groups of drugs have one pronounced side effect – the effect on the gastric mucosa. So even one painkiller can provoke discomfort in the stomach, especially if there is a predisposition. And with prolonged and systematic use of aspirin (in order to affect the cardiovascular system) and NSAIDs as an analgesic, an exacerbation of chronic diseases of the digestive tract, including the “opening” of an ulcer, can occur.

Antiallergic drugs and powders for colds, sedatives.

The fact is that the usual cold and flu powders are not just a hot sweetened drink. This medicine contains, in addition to paracetamol, an antihistamine. So, an additional dose of an antihistamine substance contained in antiallergic tablets can increase drowsiness and knock you out of your usual state. This is especially important to know for people whose activities are related to concentration and concentration.

Calcium preparations and fixing preparations

The effect of diarrhea remedies is that they slow down intestinal motility. Exactly the same effect is in calcium preparations. So, when taken together, constipation can be provoked. And then toxic substances will accumulate in the body, leading to undesirable consequences.

Cardiac glycosides (antiarrhythmic heart drugs) and diuretics, high blood pressure medicines

The combined use of drugs can not only reduce the effect of cardiac glycosides, but also increase arrhythmia. You can not take diuretics for edema and high blood pressure when taking glycosides together. Since the former are able to remove calcium from the body, damaging the work of the heart.

Rule #6. Combination of drugs with food

If the instructions for the drug do not contain a specific recommendation on how to combine the intake with food, then this point is of no fundamental importance. But more often you can find items where there is a clear mention of eating.

Fasting

• Drugs are taken to treat diseases of the gastrointestinal tract and the stomach itself. For example, antacids that reduce acidity in the stomach.

• Decoctions, tinctures and liquid preparations based on plant materials are also drunk on an empty stomach so that in the presence of hydrochloric acid, the valuable components of the preparations are not destroyed in the stomach.

• Drugs that relax smooth muscles. Despite the fact that they calmly tolerate interaction with acids and food, they can slow down or disrupt the process of digestion of food due to their inhibitory effect.

Before meals

A few minutes before the meal, cholagogues, digestive enzymes, drugs that stimulate the secretory function of the digestive glands are allowed to be taken.

After meals

Immediately after eating, it is better to take drugs that irritate the gastric mucosa: indomethacin, acetylsalicylic acid, steroids, metronidazole, and others.

As well as drugs that block the production of hydrochloric acid. This is necessary in order to avoid blocking the digestive process at the initial stage.

Vitamins and multivitamin complexes are also consumed after meals, in order not to be destroyed by the aggressive environment of the stomach.

While eating

Gastric juice substitutes and bile substitutes are taken to stimulate the digestive process.

An absolute contraindication to the joint use of drugs are citrus juices. They can suppress the production of enzymes in the liver or intestines. This can slow down the breakdown and elimination of toxic substances from the body. So, just a glass of juice is enough to delay the components of drugs that were supposed to be quickly removed for a whole day.

Dairy products are also not recommended for co-administration with drugs, especially antibiotics, as they can inhibit their absorption. And calcium salts, reacting with antibiotics, distort the effect of antibiotics on the body.

Drug and food incompatibilities

• antibiotics of the tetracycline group, lincomycin, preparations containing caffeine (ascofen, citramon, caffetin) – with milk, kefir, cottage cheese;

• iron preparations – with tea, coffee, milk, nuts, grain products;

• calcium preparations – with carbonated soft drinks and juices containing citric acid;

• erythromycin, ampicillin – with fruit and vegetable juices;

• sulfadimethoxine, sulgin, biseptol, cimetidine, theophylline – with meat, fish, cheese, legumes containing a lot of protein;

• aspirin and drugs containing acetylsalicylic acid, furagin, 5-NOK – with butter, sour cream, fatty foods;

• paracetamol, sulfadimethoxine, biseptol, furosemide, cimetidine – with prunes, beets, sweet and flour dishes;

• sulfonamides: biseptol, etazol, sulfalene – with herbs, spinach, milk, liver, cereal products;

• baralgin, analgin, panadol, spazgan, paracetamol, maxigan – with smoked sausages.