A Guide to Formula Feeding · • All babies need vitamin D. Babies who drink formula only, will get vitamin D from the formula they drink and do not need a supplement. Babies who

A Guide to

A helpful guide for formula feeding your baby.

FormulaFeeding

2

© Sudbury & District Health Unit, 2016

Adapted with permission from materials produced by Hamilton Health Sciences, St. Joseph’s Healthcare Hamilton and the City of Hamilton Public Health Services.

This resource was prepared by staff at the Sudbury & District Health Unit.

This resource may be reproduced for educational purposes, on the condition that full credit is given to the Sudbury & District Health Unit, Hamilton Health Sciences, St. Joseph’s Healthcare Hamilton and the City of Hamilton Public Health Services.

Adapted with permission from the Sudbury & District Health Unit.

3

Inside this Booklet

Chapter 01: Introduction

Making an Informed Decision

Formula Feeding Your Baby

Buying Formula

Choosing Supplies

Choosing Safe Water

Sterilizing & Storing Water

Chapter 02: Sterilizing Supplies & Preparing Formula

Getting Ready to Sterilize

Steps to Sterilizing Supplies

Preparing Liquid Concentrate Formula

Preparing Powdered Formula

Preparing Ready-to-feed Formula

05

06

07

08

09

10

11

13

14

15

16

18

20

Chapter 03: Feeding Your Baby

Feeding Your Baby Formula

Knowing When it is Feeding Time

Getting Ready to Feed

Keeping Your Baby Close

Giving Your Baby a Bottle

Finishing a Feeding

After Feeding Your Baby

Cleaning Gums & Teeth

Chapter 04: After Feeding Your Baby

When You Are Travelling

During an Emergency

Formula Recalls & Safety

Questions?

Glossary & References

23

24

24

25

26

27

28

28

28

29

30

30

31

31

33

01Introduction

• Making an Informed Decision• Formula Feeding Your Baby• Buying Formula• Choosing Supplies• Choosing Safe Water• Sterilizing & Storing Water

6

01 Making an Informed Decision About Feeding Your Baby

How you feed your baby will be one of the most important decisions you make. That’s why you want to make sure you make an informed decision. The following information will provide you with what you need to know so you can make the best decision for you and your baby.

BREASTMILK

• Protects your baby from infections and illnesses.• Promotes bonding between you and your baby.• Promotes healthy brain development.• Is convenient and available anytime.• It is free.• Controls postpartum bleeding and reduces your risk of some cancers.• Changes to meet the needs of your growing baby.

INFANT FORMULA

• Does not change to meet your growing baby’s needs.• Takes lots of time to prepare and it is easy to make mistakes when preparing the formula.• Is not sterile (powdered).• Increases your baby’s risk of getting infections and some illnesses.• Increases your risk of postpartum bleeding and some cancers.

If you have made an informed decision to feed your baby infant formula, this booklet will provide you with up to date and reliable information on how to feed it to your baby in a safe way.

7

01 Formula Feeding Your Baby

Formula will provide enough nutrition for your baby for their first six months of life.

At six months, you can start feeding your baby solid foods in addition to formula. There is no need to give solid foods, including infant cereal, to a baby less than six months of age. If your baby is drinking some breastmilk, you can continue for as long up to two years of age and beyond.

If your baby is not fed any breastmilk, you should offer infant formula to your baby until 9 to 12 months of age.

Once your baby is between 9 to 12 months of age and eating a variety of iron rich foods (such as meat, fish, eggs, legumes), you can replace infant formula with homgenized (3.25% M.F.) cow’s milk.

TYPES OF FORMULA

There are three forms to choose from:

1. liquid concentrate (add water as directed)2. powdered formula (add water as directed)3. ready-to-feed (do not add water)

Instructions are different for each type of formula. Follow instructions for how to make and store all types of formula so your baby does not get sick.

Important: Powdered formula is not sterile; it may contain harmful bacteria that can make your baby sick. Take extra care when you make and store powdered infant formula. Liquid concentrate and ready-to-feed formulas are sterile until you open the can.

If your baby is premature or has a low birth weight and is under two months of age or has a weakened immune system, it is safest to use liquid concentrate or ready-to-feed formula.

8

01 Buying Formula

• Buy a formula that is iron fortified and made from cow’s milk protein.• The brand of the formula you buy does not matter. All brands of formula need to meet

specific standards that ensure your baby gets enough nutrition.• Do not use soy formulas or other specialty formulas unless your health care provider tells you to.• Formulas with extra ingredients, like probiotics, can be used, but they cost more. They

are not needed.• Buy formula by the case because it is cheaper than buying single cans.• All babies need vitamin D. Babies who drink formula only, will get vitamin D from

the formula they drink and do not need a supplement. Babies who are drinking bothbreastmilk and formula, should be given a vitamin supplement of 400IU each day. Askyour healthcare provider about when you can stop giving a supplement.

The following drinks offer less nutrition than infant formula. Do not replace formula with:

• regular milk (cow or goat’s milk)• soy, rice or other vegetarian drinks• evaporated milk recipes• supplements like Enfagrow®

9

01 Choosing Supplies

Formula can be fed from a bottle, tube at breast, an open cup or by finger feeding method. Your health care provider can help you make an informed decision about which method to use.

If you are using bottles, choose glass bottles or plastic bottles labelled as bisphenol - A free (BPA-free). Do not use unmarked plastic bottles, since there is no way of knowing if they are made with BPA or not.

10

01 Choosing Safe Water

It is safe to use tap water, tested well water and store-bought bottled water to mix formula. All types of water must be boiled before you use them to prepare formula.

1. Tap water (municipal water) is the best choice of water to make formula because it istested regularly:

• Always use the cold water tap to make formula.• Do not use softened water. It may be too high in salt.• Replace filters from home treatment systems regularly, as they wear out and are less effective,

and may add bacteria or chemicals to your water. Follow the manufacturer’s instructions.

2. Private well water:

• Have your well water tested at least twice a year for bacteria and nitrates. Boiling waterdoes not remove nitrates.

• Call the Health Unit to learn about how to have your well water tested for bacteria and nitrates.

3. Bottled water:

• Choose plain bottled water with low levels of minerals.• Commercial baby water can be used but it costs more and is not needed.• Do not use mineral, carbonated, seltzer, soda, tonic, flavoured, or vitamin enriched water

to mix formula.

4. If you have lead pipes, follow these instructions:

• Use a water filter that is certified to remove lead.• Use only water from the cold water tap to prepare formula. Water from the hot water tap

may contain more lead and other minerals.• Run the cold water tap for at least 5 minutes to get rid of any standing water in the water system.

11

01 Sterilizing & Storing Water

STERILIZING WATER

• Boiling water makes it sterile and safe to use to mix formula.• Use water from the cold water tap. Let the water run for 2 minutes before using.• Heat at least 1 litre (4 cups) of water in a pot and bring it to a rolling boil. Let the water

boil for at least 2 minutes.• Do not use a kettle or microwave to boil water to make formula. It is too hard to time how

long the water boils.

STORING WATER

You can store boiled water in a tightly sealed, sterilized container:

• for up to three days (72 hours) in the fridge• for one day (24 hours) at room temperature

USING PREVIOUSLY BOILED WATER

If you are using water that has been boiled and stored to make powdered infant formula, you should always make one bottle at a time and serve it to your baby right away. Do not store formula that has been made this way in the fridge because bacteria can grow and it can make your baby sick.

If your baby is premature or has a low birth weight and is under two months of age or has a weakened immune system, do not prepare powdered formula this way. Use water that has been boiled and cooled to 70°C, (see page 14) or use liquid concentrate formula/ready-to-feed formula.

02Sterilizing Supplies & Preparing Formula

• Getting Ready to Sterilize• Steps to Sterilizing Supplies• Preparing Liquid • Concentrate Formula• Preparing Powdered Formula• Preparing Ready-to-feed Formula

14

02 Sterilizing Supplies:Getting Ready to Sterilize

Sterilize feeding supplies before using them to make all types of formula. Sterilizing kills germs that can make your baby sick. Continue to do so for as long as formula is being fed to your baby. If using a steam sterilizer, follow the manufacturer’s instructions.

• Wash your hands with soap and warm water for at least 15 seconds.

• Clean and sanitize* the counter top.

Gather the following:• 1 large pot with lid• bottle brush and nipple brush• tongs• knife• fork• can opener• glass measuring cup container with tight-fitting lid (to store

boiled water)• glass bottles or BPA-free plastic bottles • nipples, rims and caps

If using disposable bottles, the liners are sterile so you need to sterilize only the nipples, rims, and caps. Throw out the plastic disposable liners after one use.

Throw out nipples when they become cracked, sticky, or worn.

*Mix 5 mL (1 tsp) household bleach per 750 mL (3 cups) of water. Put the mixture into a spray bottle and label it. Use it to wipe down countertops with a clean towel. Make a fresh solution often. 13

15


• Clean and sanitize* the countertop.

• Wash all items in warm soapy water.• Use bottle or nipple brushes to clean the hard-to-reach areas.

• Make sure that the holes in the nipples are not clogged. If nipples are sticky or worn, throw them out.

• Rinse well.

• Put clean supplies in a pot. Cover with water.

• Heat at a rolling boil for at least 2 minutes. • Remove items with sterile tongs.

• Set supplies on a clean paper towel to air-dry and cool to room temperature before using.


02 Sterilizing Supplies:Steps to Sterilizing Supplies

16

• Wash your hands with soap and warm water for atleast 15 seconds.

• Clean and sanitize* the countertop.• Have the sterile supplies ready on a clean paper towel.

• Run the cold water tap for 2 minutes.• Bring a pot of water to a rolling boil on the stovetop.• Let the water boil for at least 2 minutes.• Let the water cool to room or body temperature (37°C).

• Read the can’s label to make sure it is not “ready-to-feed”formula.

• Check the “Use By” date on the can.• Throw out expired or dented cans.

• Wash the top of the can with soap and warm water.• Shake the can for about 10 seconds.• Open the can with a sterile can opener.• Read the label for how much formula and water to mix.

• Pour the cooled water into an empty sterilized glassmeasuring cup.

• Add an equal amount of liquid concentrate formula to theboiled water.

• Make only the amount you need for one feeding or one day.

*Mix 5 mL (1 tsp) household bleach per 750 mL (3 cups) of water. Put the mixtureinto a spray bottle and label it. Use it to wipe down countertops with a clean towel.Make a fresh solution often. 13

02 Preparing Liquid ConcentrateFormula: Part 1 of 2

17

• Measure carefully. Make sure that you have added thecorrect amount of water and formula.

• Caution: measurements on drop-in liners and on babybottles may not be accurate.

• Mix well with sterilized fork or spoon.

• Pour enough formula for one feeding into each bottle.• Use glass bottles or BPA-free plastic bottles.

• Pick up the sterile nipple, rim, and cap with sterile tongs andput them on the bottles.

• Tighten with your hands.

• If feeding right away, serve the formula slightly warm, nothot. Check the temperature by shaking a few drops of formulaon the inside of your wrist.

• Place the tightly sealed bottles in the fridge right away.• Do not store the formula in the door of the fridge because

temperatures are often warmer there.• Check that your fridge is 4°C or lower.• Use or throw out the prepared formula within 24 hours.

• If there is liquid concentrate formula left in the can, tightlycover it and store it in the fridge.

• Use within 48 hours.

02 Preparing Liquid ConcentrateFormula: Part 2 of 2

Adding too much or too little water could

harm your baby.

18

Powdered infant formula is not sterile and may contain harmful bacteria that can make your baby sick. To avoid problems, always use boiled water and sterilize all supplies. If your baby is premature or low birth weight and under two months of age or has a weakened immune system, it is safer to use liquid concentrate or ready to feed formula. If you have to use powdered infant formula, it is important to follow these instructions carefully.



• Run the cold water tap for 2 minutes.• Bring a pot of water to a rolling boil on the stovetop. • Let the water boil for at least 2 minutes.

• Check the “Use By” date on the can. • Throw out expired or dented cans.

• Wash the top of the can with soap and warm water. • Open the can.• Read the label on the can for how much water and powder to mix.

• Cool the boiled water for about 30 minutes. • The powder must be mixed with water that is at least 70°C. • Pour the boiled water into an empty sterile glass measuring cup.

• Fill the scoop provided with the can. • Level with a sterilized knife.• Add the required number of scoops of powder to the water.


02 Preparing PowderedFormula: Part 1 of 2

19

• Make sure that the temperature of the water does not go below 70°C before you mix it with the powder. You can use a clean, sterile food thermometer to check the water temperature.

• Measure carefully. Make sure you have added the correct amount of water and powdered formula.

• Caution: measurements on drop-in liners and on baby bottles may not be accurate.

• Mix well with a sterilized fork until no lumps of powder are left.• Pour enough prepared formula for one feeding into the bottle.• Use glass bottles or BPA-free plastic bottles.

• Pick up the sterile nipple, rim, and cap with sterile tongs and put on the bottles. Tighten with your hands.

• Cool the bottle quickly by placing it in cold water or under cold running water.

• Keep the running water below the rim of the bottle, away from the nipple.

• Check the temperature of the formula by shaking a few drops on the inside of your wrist. Serve the formula slighty warm, not hot.

• Feed your baby prepared powdered infant formula right away. Serve it slightly warm.

• If the formula is mixed with water that is at least 70°C, you can store it in the fridge for up to 24 hours.

• Do not store the formula in the door of the fridge because temperatures are often warmer there.

• Use or throw out prepared formula within 24 hours.

• Tightly cover the open can with the plastic lid.• Store the can in a cool, dark place at room temperature for up to

30 days.

02 Preparing PowderedFormula: Part 2 of 2

Adding too much or too little water could

harm your baby.

20

• Wash your hands with soap and warm water for atleast 15 seconds.


• Read the label to make sure that the can is not“liquid concentrate”.

• Check the “Use By” date.• Throw out expired or dented cans.

• Wash the top of the can with soap and warm water.

• Shake the can for about 10 seconds.• Open the can with the sterilized can opener.

• Pour enough formula for one feeding into eachsterilized bottle.

• Make only the amount you need for one feeding or one day.• Do not add water!• Use glass bottles or BPA-free plastic bottles.

• Pick up the sterile nipple, rim, and cap with sterile tongs andput them on the bottles.

• Tighten with your hands.

*Mix 5 mL (1 tsp) household bleach per 750 mL (3 cups) of water. Put the mixtureinto a spray bottle and label it. Use it to wipe down countertops with a clean towel.Make a fresh solution often. 13

02 Preparing Ready-to-feedFormula: Part 1 of 2

21

• Place the tightly sealed bottles in the fridge right away.• Do not store the formula in the door of the fridge because

temperatures are often warmer there.• Check that your fridge is 4°C or lower.• Use or throw out prepared formula within 24 hours.

• If there is formula left, tightly cover the open can and store it inthe fridge.

• Use within 48 hours.

02 Preparing Ready-to-feedFormula: Part 2 of 2

03Feeding Your Baby

• Feeding Your Baby Formula• Knowing When it is Feeding Time• Getting Ready to Feed• Keeping Your Baby Close• Giving Your Baby a Bottle• Finishing a Feeding• After Feeding Your Baby• Cleaning Gums & Teeth

24

03 Feeding Your Baby Formula

Every baby is different. Follow your baby’s cues and let your baby decide how much formula to drink and how often to feed.

Your baby may be hungrier and need to drink more formula during growth spurts. Growth spurts are common at 2 to 3 weeks, 6 weeks, 3 months, and 6 months. Other days your baby may be less hungry. Your baby is getting enough to eat if they are satisfied after a feeding and growing well.

Knowing When it is Feeding Time

Learning to read your baby’s early hunger cues will help to make feeding a happy time for you and your baby. Your baby will tell you when he or she is ready to feed. Some signs that your baby is hungry are:

• Stirring, or more body movements.• Sucking on her fingers or fist.• Looking around.• Licking or smacking her lips.• Searching with an open mouth.• Rubbing or scratching face.• Crying may be one of the last signs they show to tell you they are hungry.

25

03 Getting Ready to Feed

Most babies enjoy their bottles slightly warmed. Warm the bottle by placing it in a pot of hot water. Throw out any formula that is warmed for more than 15 minutes. Do not warm the formula more than once. Shake the bottle to mix it.

Never heat your baby’s bottle in a microwave. A microwave may heat the water unevenly. It can make hot spots that can burn your baby’s mouth or throat.

Always check the temperature of the formula before feeding. Shake a few drops of formula on the inside of your wrist. It should feel slightly warm, not hot. Throw out any leftovers.

Choose nipples that are right for your baby’s age. For the first 3 months, use a “slow flow” nipple. It has one hole that lets formula come out at a rate of about one drop per second. Do not make the hole bigger.

26

03 Keeping Your Baby Close

Feeding is a special time to get close to your baby. It is the perfect time for you and your baby to get to know one another. Choose a quiet place where you and your baby can feel relaxed. Get into a comfortable position.

Hold your baby skin-to-skin during a feeding. This is an enjoyable position for both you and your baby. To hold your baby skin-to-skin:

• Have your baby in his or her diaper and hold them against your bare chest or stomach.

• If you want, drape a light blanket across the both of you.

When babies are held skin-to-skin, they can hear your heartbeat, feel you breathing and can smell and feel your skin. This is very comforting to your baby.

Sharing a room with your baby (rooming-in) and being together often will help you know when your baby is hungry. It can also help you adjust to your new role as a parent and increase the attachment and bonding you feel with your baby.

27

03 Giving Your Baby a Bottle

Paced bottled feeding allows your baby to drink at a comfortable pace and can prevent overfeeding. It can also help you watch and respond to your baby’s cues. Follow these steps:

• Hold your baby in an upright position, supporting the head and neck. Keep your baby’s chin off of the chest.

• Gently touch the nipple to your baby’s lips. As your baby opens her mouth, gently put the nipple in. Do not force the nipple into your baby’s mouth.

• Tip the bottle just enough so there is some milk in the nipple. At the beginning of a feeding, the bottle will be horizontal. It will gradually become more angled throughout the feeding.

• Watch your baby’s sucks, swallows and breathing. It is normal for your baby to take a break and stop sucking for a few moments. You can also pause the feeding about every 3 swallows to make it feel more natural for your baby.

• Gently take the bottle out of his or her mouth if your baby is resting, if you have paused a feeding or if your baby is showing any of the following signs:

• Swallowing quickly without taking a breath after each swallow.• Milk spilling from her mouth.• Opening eyes widely.• Stiffening of arms and legs.• Flaring nostrils.• Grimacing.• Lips turning blue.

• A feeding usually takes less than 30 minutes. • Never prop up your baby’s bottle or leave your baby alone during a feeding. • Never put your baby to bed with a bottle. This can cause cavities.

28

03 Finishing a Feeding

Babies know how much they need to eat and when they have had enough. If you see signs that your baby is full, stop feeding. Never force your baby to finish a bottle. Some signs that your baby has had enough to drink are:

• Sucking slows or stops.• Baby looks content and sleepy.• Lets go of the bottle and turns head away.• Seals her lips and does not want to start again.

After Feeding Your Baby

• After feeding your baby, throw out any formula that is left in the bottle. Never reuse or reheat formula.

• Throw out formula that has been sitting at room temperature for more than 2 hours. • Never return the bottle to the fridge or reuse reheated formula.• Rinse the bottle and nipple right away.

Cleaning Gums & Teeth

After each feeding wipe your baby’s gums with a clean, damp cloth. This will help prevent childhood tooth decay. As your baby grows teeth, wipe the gums and brush his teeth with a toothbrush that has soft bristles.

04Additional Information

• When You Are Travelling• During an Emergency• Formula Recalls & Safety• Questions?

30

04 When You Are Traveling

Take prepared, cool bottles of formula from the fridge and put them in a cooler bag with an ice pack. Use the formula within 2 hours.

If you can, put the cool bottles in a fridge when you get to where you are going. If the bottles are warm, throw out the formula. Do not feed it to your baby. Consider using a ready-to-feed infant formula or bottled water if you are unsure of the safety of the water where you will be visiting.

During an Emergency

During an emergency (i.e. power failure or unsafe water) you will still need to prepare formula according to the recommendations in this booklet. It may be easier to offer your baby ready-to-feed formula during this time because you do not have to add water or store prepared formula. There are two key issues to keep in mind during an emergency:

KEEPING PREPARED FORMULA COOL

You will need to follow the storage guidelines as outlined in this booklet. It may be safest to prepare formula one bottle at a time and feed it to your baby right away. If you already have prepared formula in your fridge, keep the fridge door closed to maintain the temperature inside. Without power, the refrigerator section will keep foods cool for 4-6 hours if the door is kept closed.

A SAFE WATER SUPPLY

You may need to find alternative ways to boil your water. You can consider using a gas barbeque, outdoors only, to boil water. If your water supply is unsafe, use commercial plain bottled water to prepare infant formula. You will still need to boil bottled water to prepare formula.

31

04 Formula Recalls & Safety

From time to time some brands and types of formula are recalled. For information about recalls, advisories and safety alerts, check out Health Canada’s database at: healthycanadians.gc.ca.

Questions?

If you think your baby is having problems with the formula you are feeding, check with your health care provider before changing formulas or feeding your baby anything else.

If you have questions about feeding your baby call the Northwestern Health Unit at 1-800-465-4377 to speak with a public health nurse.

You can also speak with a registered dietitian by calling EatRight Ontario toll-free at 1-877-510-5102 Monday to Friday from 9 a.m. to 5 p.m., until 9 p.m. on Tuesday and Thursday, or visit eatrightontario.ca.

05Glossary & References

34

Food Thermometer: A thermometer that is placed into food to make sure it reaches a safe internal temperature. This helps to avoid food poisoning or food-borne illness. When making powdered infant formula, a food thermometer should be used to make sure that the boiled water is at least 70°C when you mix it with the powder. The higher temperature helps to kill any harmful bacteria that could make your baby sick.

Liquid Concentrate Infant Formula: You have to add an equal amount of water to this formula before it can be served to your baby. Follow the instructions in your booklet on how to prepare liquid concentrate formula. Tightly cover any leftover formula in the open can, and store it in the fridge. Use within 48 hours.

Liquid Infant Formula: Both liquid concentrate and ready-to-serve infant formulas are considered liquid formulas. Always check the label because both types of formula look alike, and you never add water to ready-to-serve infant formula. If you make a mistake with the amount of water you add to infant formula, it could harm your baby.

Powdered Infant Formula: This formula is not sterile. This means there can be harmful bacteria in the powder that will make your baby sick. Take extra care when you make and store powdered infant formula. Store the can in a cool dark place at room temperature for up to 30 days.

Ready-to-feed Infant Formula: This is the most expensive and most convenient type of infant formula that you can buy. It is ready-to-use so you never add water to it. Pour ready-to-feed infant formula into sterilized bottle(s) as directed in your booklet. Tightly cover any leftover formula in the open can and store it in the fridge. Use within 48 hours.

Clean: The removal of oil, grease, dirt and debris using soap, water and friction.

Sanitize: To greatly reduce the number of germs or harmful bacteria on a surface or object. Cleaning should be done before sanitizing. To sanitize a countertop, mix 5 mL (1 tsp) household bleach per 750 mL (3 cups) of water. Put the mixture into a spray bottle and label it. Use this to wipe down countertops with a clean towel. Make a fresh solution often.

Sterilize: To kill any germs or harmful bacteria that can make your baby sick. To keep your baby safe, rinse dirty equipment right away. Wash all equipment with warm soapy water, rinse and place in a pot of water. Heat to a rolling boil for at least 2 minutes.

05 Glossary

35

1. Health Canada. Nutrition for Healthy Term Infants: Recommendations from Birth to Six Months (2012). Health Canada Document. Retrieved at www.hc-sc.gc.ca/fn-an/nutrition/infant-nourisson/recom/index-eng.php. Last update: May 27, 2014.

2. Best Start Resource Centre & Baby-Friendly Initiative Ontario (2013). The Baby-Friendly Initiative: Evidence-informed key messages and resources. Toronto, Ontario, Canada: authors. Retrieved at http://www.beststart.org/resources/breastfeeding/Baby_Friendly_Resource_linked_final.pdf.

3. Health Canada. Food and Nutrition. Recommendations for the Preparation and Handling of Powdered Infant Formula (PIF). Retrieved at www.hc-sc.gc.ca/fn-an/nutrition/infant-nourisson/pif-ppn-recommandations-eng.php. Last update: February 9, 2010.

4. World Health Organization (WHO). Safe preparation, storage and handling of powdered infant formula guidelines (2007). Retrieved at http://www.who.int/foodsafety/publications/micro/pif_guidelines.pdf.

5. Government of Canada. Preparing and handling powdered infant formula. Retrieved at http://healthycanadians.gc.ca/eating-nutrition/safety-salubrite/formula-nourrisson-eng.php. Last Update: April 12, 2011.

6. Dietitians of Canada, Practice-based Evidence in Nutrition (PEN). Infant Formula – Microbiological Issues Background. Retrieved at www.pennutrition.com. Last update: June 13, 2011. Access only by subscription.

7. Dietitians of Canada (PEN approved). How to Prepare and Feed Powdered Infant Formula. Retrieved at www.Ontario.ca/EatRight. Last update July 2, 2014.

8. Dietitians of Canada (PEN approved). How to Prepare and Feed Liquid Concentrate Infant Formula. Retrieved at www.Ontario.ca/EatRight. Last update July 2, 2014.

9. Health Canada, It’s Your Health. The Safety of Bottled Water (2009). Retrieved at www.hc-sc.gc.ca/hl-vs/iyh-vsv/food-aliment/bottled-embouteillee-eng.php. Last update: November 4, 2010.

10. Health Canada. Frequently Asked Questions about Bottled Water. Retrieved at www.hc-sc.gc.ca/fn-an/securit/facts-faits/faqs_bottle_water-eau_embouteillee-eng.php. Last update: December 5, 2013.

11. Government of Canada. Bisphenol A (BPA). Retrieved at http://healthycanadians.gc.ca/healthy-living-vie-saine/environment-environnement/home-maison/bisphenol_a-eng.php. Last update: April 16, 2013.

12. Sudbury & District Health Unit, Environmental Health. Lead in Drinking Water. Fact Sheet. Last update: April 2008.

13. Government of Ontario. Handle Food Safely Reduce the Risk of Foodborne Illnesses. Catalogue No. 016791 Queen’s Printer for Ontario. Retrieved at: http://www.health.gov.on.ca/en/public/programs/publichealth/foodsafety/docs/fs_handle_food_foodsafety_20111205.pdf. Last update: November 2011.

14. Toronto Public Health (2013). Breastfeeding Protocols for Health Care Providers. Retrieved at: http://www1.toronto.ca/City%20Of%20Toronto/Toronto%20Public%20Health/Health%20Professionals/Child/Files/239%20-%20FP_BFP_Manual_2013_Protocol-accessibility_FINAL-s_2.pdf

15. Peel Public Health (2009). Paced Bottle Feeding Factsheet. Retrieved at: https://www.peelregion.ca/health/family-health/breastfeeding/pdf/paced-bottle-feeding.pdf

16. Wilson-Clay, B., & Hoover, K. (2008). The Breastfeeding Atlas. (4th ed.). Manchaca, TX: LactNews Press.

17. Government of Ontario. Food Safety: Preparing Baby Formula During A Power Failure. Retrieved on November 13, 2014 at http://www.lambtononline.ca/home/residents/EmergencyManagement/Power%20Failure%20Documents/How%20to%20Prepare%20Baby%20Formula%20During%20a%20Power%20Outage.pdf

18. Government of Ontario. Food Safety Frequently Asked Questions. Retrieved at http://www.health.gov.on.ca/en/public/programs/publichealth/foodsafety/faq.aspx. Last updated December 8, 2011.

05 References

Atikokan115 Main StreetP0T 1C0Tel. (807) 597-6871Fax (807) 597-52178:30 to 4:30, Monday to Friday Dryden75D Van Horne AvenueP8N 2B2Tel. (807) 223-3301 or 1-888-404-4231Fax (807) 223-57548:30 to 4:30, Monday to Friday Ear Falls25 Spruce StreetP0V 1T0Tel. (807) 222-3098Fax (807) 222-33248:30 to 4:30, Monday to Friday Emo76 Front StreetP0W 1E0Tel. (807) 482-2211Fax (807) 482-16788:30 to 4:30, Monday to Friday Fort Frances396 Scott StreetP9A 1G9Tel. (807) 274-9827 or 1-800-461-3348Fax (807) 274-07798:30 to 4:30, Monday to Friday IgnaceCorner of Highway 17 & Highway 599P0T 1T0Tel. (807) 934-2236Fax (807) 934-28288:30 to 4:30, Monday to Friday Kenora - City View210 First Street NorthP9N 2K4Tel. (807) 468-3147 or 1-800-830-5978Fax (807) 468-49708:30 to 4:30, Monday to Friday

Machin84B Spruce StreetP0V 2V0Tel: (807) 227 2088Fax: (807) 227-3418 Pickle Lake 3 Anne StreetP0V 3A0Tel. (807) 928-2234By appointment only Rainy River210 Atwood AvenueP0W 1L0Tel. (807) 852-3268Fax (807) 852-30158:30 to 4:30, Monday to Friday Red Lake234 Howey StreetP0V 2M0Tel. (807) 727-2626Fax (807) 727-30018:30 to 4:30, Monday to Friday Sioux Lookout47B Front StreetP8T 1A3Tel. (807) 737-2292Fax (807) 737-37118:30 to 4:30, Monday to Friday Sioux Narrows-Nestor Falls5736 Highway 71, P.O. Box 246P0X 1N0Tel. (807) 226-9626Fax (807) 226-9626