How to Safely Prepare Baby Formula With Water (2024)

How to Safely Prepare Baby Formula With Water (1) How to Safely Prepare Baby Formula With Water (2)

​By: Steven A. Abrams, MD, FAAP

Infant formula comes in three forms: powder formula, concentrated liquid formula and ready-to-feed (non-concentrated) formula. If you use infant formula for your baby, no matter which form, be sure to follow directions closely.

Formula that is diluted with too much water, for example, can cause serious health and development problems for your baby. It's also important to use clean water from a safe source free of bacteria or other microbes (germs) that may cause disease. The water should also be low in certain minerals and contaminants that may be harmful.

Read on to learn more about safe ways to prepare baby formula with water.

When to add water & how much to use

Non-concentrated, ready-to-feed formula

Do not add any water non-concentrated, ready-to-feed formula. Remember, diluting it can be dangerous for your child (see below).

Concentrated liquid formula & powder formula

Use water to prepare concentrated liquid formula and powder formula, but only as directed. Use a safe water source as defined by your state or local government. Unless there is a known contamination of your local water source, you can use tap water to prepare concentrated liquid or powdered formula. In general, though, it is best to primarily use safe tap water that is fluoridated and occasionally use some non-fluoridated bottled water.

Why watering down formula is dangerous

News reports have found parents diluting formula to try and save money or feeding water in addition to breast milk or formula. This can lead to a dangerous condition called water intoxication.

Babies in the first 6 months after birth do not need water or other liquids such as juices in addition to formula or breast milk, unless a pediatrician specifically advises you otherwise.

Adding extra water to formula or giving juices reduces the about of nutrients baby will receive. This can slow growth and development. Extra water also disturbs electrolyte and mineral balances such as calcium, sodium and potassium. This can lead to major health problems, including seizures. So, always mix formula as directed by the manufacturer unless you're given changed instructions for an infant with special health needs.

If you're using formula but having trouble affording it check with your pediatrician, local health department, food pantry or social service agency.

How to mix powder formula & water to prepare a bottle

The Center for Disease Control and Prevention (CDC) provides detailed instruction on preparing infant formula. Also look for instructions on the formula can labels, and from other reliable sources including state WIC agencies. There are a few key points to remember:

  1. Water first, then powder. Always add the powder to the water that is in the bottle, not the other way around.

  2. Boil the water when needed. For infants younger than 2 months of age, those who were born prematurely and those who have a weakened immune system, boiled water should be used to kill any microbes. After boiling the water, let it cool for about 5 minutes. Then, add it to a clean bottle and add the formula based on the instructions on the container.

  3. Cool formula to body temperature. If you are going to use the formula you prepared immediately, be sure to cool the formula to body temperature before feeding your baby. Run the prepared, capped bottle under cool water or place it into an ice bath.

  4. Test the formula temperature to make sure it is not too hot before feeding it to your baby (see below).

How to test your baby's bottle temperature

Test warmed water in advance to make sure it is not too hot for your baby. The easiest way to test the temperature is to shake a few drops on the inside of your wrist. Otherwise, a bottle can be prepared by adding powdered formula and room temperature water from the tap just before feeding. Bottles made this way from powdered formula can be ready for feeding, with no additional refrigeration or warming needed.

How long is the bottle of formula good for after making it?

  • Prepared formula must be discarded within 1 hour after feeding it from the bottle to your baby.

  • Prepared formula that has not been fed to your baby may be stored in the refrigerator for 24 hours to prevent bacterial contamination.

  • An open container of ready-to-feed formula, concentrated formula, or formula prepared from concentrated liquid formula, should be covered, refrigerated and discarded after 48 hours if not used.

More information

About Dr. Abrams

How to Safely Prepare Baby Formula With Water (3)Steven A. Abrams, MD, FAAP, is a board-certified pediatrician and a Professor of Pediatrics at the University of Texas at Austin. Within the American Academy of Pediatrics, he is past chair of the National Committee on Nutrition. Dr. Abrams also served on Dietary Advisory Committee of the U.S. Department of Agriculture.



Last Updated
1/4/2024
Source
American Academy of Pediatrics Committee on Nutrition (Copyright © 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 circ*mstances.

How to Safely Prepare Baby Formula With Water (2024)

FAQs

What is the safest water to mix with formula? ›

Unless there is a known contamination of your local water source, you can use tap water to prepare concentrated liquid or powdered formula. In general, though, it is best to primarily use safe tap water that is fluoridated and occasionally use some non-fluoridated bottled water.

How to prepare formula with distilled water? ›

For the formula, it has been shown that you should use distilled water. Boil your water and let it cool to 70 C, then add the formula mixture. According to Health Canada, any water you give a baby under four months of age should be brought to a boil for two minutes and then cooled to make sure it is sterile.

Is it safe to water down baby formula? ›

Adding too much water to formula reduces its nutrient levels and could slow a child's development. It could also cause an electrolyte imbalance that can lead to severe health problems, including seizures.

Is purified or distilled water better for baby formula? ›

Using distilled water will minimize the risk of your baby developing fluorosis. You could also use the following alternatives to lower their risk: Mixing their formula with purified, demineralized, or deionized water. Using the ready-to-feed formula, although this can be quite costly.

Why can't you use tap water for baby formula? ›

The American Dental Association recommends that water containing high levels of fluoride should not be used for making baby formula. This is because increased levels of fluoride in water can put your tiny human at risk for developing enamel fluorosis, potentially affecting developing teeth.

What happens if you don't boil water for formula? ›

Powdered infant formula milk is not sterile. Even though tins and packets of milk powder are sealed, they can still contain bacteria. Water that hasn't been boiled can also contain bacteria. Formula therefore needs to be made up with water hot enough to kill the bacteria, which is at least 70 degrees C.

Why wait 30 minutes before making formula? ›

On average it will take a full kettle around 30 minutes to reduce down in temperature to 70 degrees Celsius. This is the ideal temperature to make up a feed, as any bacteria present will be killed and the powder will also mix effectively.

What happens if you don't use distilled water for formula? ›

A significant concern when selecting water for baby formula is the risk of dental fluorosis. This condition, caused by excessive fluoride during tooth development, leads to changes in the appearance of tooth enamel. In the United States, many local water supplies contain fluoride, which helps prevent tooth decay.

Is it okay to dilute milk with water? ›

While diluting milk with water may not directly impair calcium absorption, it can lead to lower calcium intake.

Can I water down baby formula at night? ›

If that does not work, water down their milk e.g. 2 scoops to 6 ounces of water. The idea is to make it not so tasty so the baby will not bother to wake in the night for it and encourage him to take all the milk he needs during the day.

Can you boil water for formula in advance? ›

Boiled water can be kept in sterilized, properly sealed containers in the refrigerator for 3 days or for 24 hours if kept at room temperature out of direct sunlight.

Do I have to boil filtered water for baby formula? ›

Distilled or purified water can be used without boiling it.

What is the best water to use in formula? ›

Parents have multiple safe options when choosing water for formula mixing. The two safest options are boiled tap water that has been cooled to room temperature, or any type of bottled water. If tap water is going to be the primary water source for formula, use bottled water occasionally to reduce fluoride exposure.

Is baby distilled water the same as distilled water? ›

Distilled water for babies is the same as baby water except for added minerals. After baby water is purified, a few trace minerals are added for taste. So, baby water contains a small amount of magnesium, potassium, and calcium. Distilled water does not.

Why can't babies drink cold formula? ›

“Cold formula is typically not recommended for premature infants, who often require sterilized formula, which has been hot enough to kill bacteria and then cooled to human temperature before serving,” she says, “It's also not recommended for those with slow weight gain because bringing the formula up to body ...

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