Before supermarket price-wars drove the price of milk down to just a couple of dollars, your mother might have added a little water to the carton to make the last of the milk stretch until pay day.
However, what is okay for your morning cereal can have devastating health impacts if applied to your baby’s primary food source.
When your baby directly feeds from your breast, the milk he receives is perfectly balanced for his needs at that moment. The rich balance of nutrients, immune factors, fats and fluids is biologically produced without you having to do a thing.
That same balance needs to be maintained when you bottle feed your baby – it’s vital to their wellbeing.
Babies do not need bottles of boiled water — they naturally quench their thirst with breastmilk or formula. Despite the old wives’ tales, a little boiled water doesn’t cure colic and won’t help your baby burp. In fact, there are reasons to delay introducing water until your baby learns to drink from a cup after she starts solids.
Water, though vital to life, also has the power to kill. A condition known as Hyponatremia or “water intoxication” occurs when too much water is consumed, upsetting the fine balance of salts in the body. While an older child or adult would have to consume extreme amounts for this to occur, babies are especially vulnerable due to the size of their body.
Just recently, a baby girl died in the US, after her parents’ bottle fed her breastmilk that had been diluted with water.
If your baby is partly or fully bottle fed, here are four important things you need to know:
#1: Expressed Breastmilk Should Not Be Mixed With Formula
When you pump or hand express your breastmilk, it can be used immediately or combined with other breastmilk you have collected and stored in the fridge or freezer. It is important not to mix your expressed breastmilk (EBM) with infant formula, water or anything else.
The reason not to mix formula with breastmilk is a very good one. We recommend first giving expressed breastmilk and then any formula, separately. This way, the valuable, nutritious breastmilk is not wasted if not all the feed is taken. Of course, the baby fills up on breastmilk first, meaning he'll get the most nutrition from a feed.
If you'd like to see what's in breastmilk compared to what's in formula, check out this link.
#2: Using Other Mother’s Breastmilk
Some Australian hospitals have milk banks, which are facilities that collect donated breast milk. They pasteurise it and make it available to their most vulnerable patients – premature or sick babies in the Neonatal Intensive Care Unit (NICU), whose mothers are unable to supply enough breastmilk to meet their baby’s needs.
Informal milk sharing is a privately arranged gift of milk from one mother to another, organised most commonly through social media groups such as Eats On Feets or Human Milk For Human Babies. Although unregulated, these mothers share a belief in the importance of breastmilk and offer excess or intentionally-collected milk to babies who have short or long term barriers to being fed exclusively by their mothers.
In some countries, buying and selling human milk as a commodity is a growing business. Adults, as well as infants, are consuming milk expressed and sold by the litre. Celebrity parents like Elton John and his partner David Furnish are high profile examples of gay parents happy to buy what they cannot provide naturally. It's a growth industry.
But the buying or selling of human milk is illegal in Australia – and for good reasons! Researchers from the Nationwide Children’s Hospital in Columbus, Ohio counted more than 55,000 ad postings to buy or sell breast milk in 2014, up from 11,000 in 2011. Alarmingly, some 10% of samples of breastmilk bought online also contained cows’ milk, according to a study recently published in the journal Paediatrics.
#3: Always Use Only As Directed
For babies who are formula fed, it is very important to follow the instructions carefully when preparing feeds. Always use the scoop from that brand, as they may vary in sizes, and carefully count the scoops. If you lose count – stop and start again. Always boil the water freshly for each mix. The milk powder is not sterile and it's the heat of the water which makes it safe to drink. As per World Health Organisation guidelines for formula preparation, it should never be cooler than 70 degrees Celcius when you mix it. Cool to feeding temperature after you thoroughly mix the powder and water. Always use within 30 minutes of mixing.
It is imperative that you boil the water first, then cool it to drinking temperature, in order to kill any bacteria. Not doing so puts your baby at risk of infection — and any city around the world can have bacteria outbreaks. Some years ago, this happened in Sydney, Australia and everyone, including adults, had to boil water before use. Babies are especially vulnerable with weaker immune systems. Please see the World Health Organization's official formula preparation guidelines for more information.
#4: Specialty Baby Water – Not So Special
You might be surprised to find water bottled just for babies on your supermarket shelves, ready to use, teat and all. While this might seem like to ultimate in convenience, these products are not appropriate as drinks for babies under six months and are not necessary as drinks for older babies (who do not need drinking water boiled in Australia). This product may not be suitable for mixing and heating formula according to the World Health Organisation guidelines.
Learn more about expressing breastmilk in our article here.