Reinforce instruction to the mother about formula preparation.

a. Identify the mother requiring reinforcement of teaching.

b. Review the mother’s records to identify information previously given.

(1) Facts about formula preparation and storage.

(2) Facts about feeding equipment.

c. Formula preparation and storage.

(1) Commercially prepared formulas should be stored in cool places until opened. Once opened, the formula should be refrigerated at temperature and times suggested by the manufacturer.

(a) Once formula (or powder) has been constituted with water, follow the manufacturer’s suggestions for length of time constituted formula is good.

(b) Once the newborn starts to feed, constituted formula should be used within 30 minutes. If not discarded, formula serves as an excellent medium for bacterial growth.

(2) Formulas prepared in the home should be stored in the refrigerator after the initial cool-down period following sterilization.

(a) Bottles of formula that have been sterilized are considered “good” until opened.

(b) Once opened, these bottles should be used within 30 minutes time frame. The unused portion should be discarded and not saved for the next feeding.

(3) Ready-to-feed formulas should be stored in a cool place. Once opened, these feedings should be used within 30 minutes and not saved for subsequent feedings.

(4) Dilution of formulas is of extreme importance. Improper dilution may cause problems such as diarrhea (if too concentrated) and weight loss (if too dilute).

d. Feeding equipment.

(1) Bottles.

(a) May be sterilized at home.

(b) May be cleansed by meticulous washing with warm, sudsy water and rinsing in hot water, and then air-dried.

(c) Plastic bottle inserts may be used but should be discarded after each use. The folds of plastic around the junction of the bottle’s neck and the nipple provide a good source of growth medium.

(d) Ready-to-feed bottles pre-filled with formula may be purchased but are quite expensive.

(2) Nipples may be meticulously cleansed at home or may be purchased as a nipple-cap combination.

e. Clarify the mother’s understanding of initial instructions.

(1) Provide information to correct any misunderstanding.

(2) Refer any questions you cannot answer to the Charge Nurse.

f. Provide additional instruction, as necessary, to the mother.

g. Determine the mother’s understanding by questioning key points.

h. Report and record the mother’s instruction appropriately.