Mix formula with boiling water?

Question

Second time mom, but new to formula feeding. Everything I see online says you should mix powdered formula with boiling water to kill the bacteria in the formula, but on all of my formula cans it says to mix it with room temperature water that was previously boiled, and cooled. Which way is the right way? And how do you mix formula up on the go? This is so confusing lol. Please help a momma out.

Answer

I have never boiled my water, I have used filtered water.

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I used filtered tap water without boiling. I asked the pediatrician and they said our public water didn’t need to be boiled with a healthy infant.

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I’ve always mixed in with cold or hot. Never had an issue and my daughter is 11 mos (been on formula since birth). We also make her total daily amount in a Dr. Brown’s pitcher and keep it in the fridge. It’s such a time saver and a life saver! She likes her formula cold. 🤷🏻‍♀️

Answer

The WHO recommends boiling the water and mixing it while hot because the powder is not sterile, not because the water isn’t safe.
Formula cans in Canada include boiling the water and mixing while hot on the instructions. 
Liquid formula sold in bottles is sterile, but not powder.

Answer

OK, just to make this crystal clear, it doesn't matter if you use water that is taken from the tears of fairy princesses riding unicorns... The issue is with formula itself.
If you read the World Health Orgsnisation's guide to safe infant formula preparation, or look at this site:
 https://www.ibfan.org/contaminants-in-baby-foods/
You will see that not once, not twice but on hundreds of occasions  infant formula powder has be found to be contaminated with bacteria such as E. Coli and Salmonella (and many other contaminates).
If you use boiling water, it kills this bacteria. If you don't use boiling water, the bacteria is present, and can grow and sometimes go on to cause illnesses and even death. In the UK all mothers receive free antenatal classes where this is taught.
The World Health Organisation states:
 "“Powdered infant formula (PIF) has been associated with serious illness and death in infants due to infections with Enterobactersakazakii. During production, powdered infant formula can become contaminated with harmful bacteria such as Enterobactersakazakii and Salmonella enterica. This is because, using current manufacturing technology, it is not feasible to produce sterile PIF.” In these Guidelines, WHO insists that “Users of PIF are made aware that powdered infant formula is not a sterile product and maybe contaminated with pathogens that can cause serious illness. Correct preparation and handling reduces the risk of illness.” (2).
Also:
" Are the bacteria in powdered formulas friendly or unfriendly?
Unfounded claims for beneficial bacteria Baby food companies manufacture and market powdered milk formulas and cereal products for infants and young children. These companiesmake unfounded claims on product labels, stating that their product contains special ingredients which are alleged to improve growth, make digestion easier or protect against infections. Such additives include probiotics, the so-called ‘friendly bacteria’ which are claimed to improve infant health and make the formula ‘even closer to breastmilk’. The heavy promotion of products claiming such benefits for these added probiotics gives some companies a competitive edge over others.Yet these claims are unsubstantiated by scientific evidence, meaning that parents, care-givers and health professionals are misled (1).
Failure to warn about harmful bacteria At the same time, the baby food companies fail to state on product labels that powdered infant formulas and cereals may also contain harmful bacteria – the definitely ‘unfriendly bacteria’. These companies do not inform parents and health professionals that powdered formulas are not sterile and can also contain pathogenic bacteria, such as Salmonella species or Cronobacter/Enterobacter sakazakii. These bacteria can be introduced during the manufacturing process and may cause severe invasive infections which can be fatal or cause life-long disability. All those responsible for the care and healthy development of infants and young children must be warned of this risk.
World Health Organization guidance informs – and warns For this reason, in 2007 the World Health Organization, WHO, producedGuidelines for the safe preparation, storage and handling of powdered infant formula. These Guidelines state in the very first sentence “Powdered infant formula (PIF) has been associated with serious illness and death in infants due to infections with Enterobactersakazakii. During production, powdered infant formula can become contaminated with harmful bacteria such as Enterobactersakazakii and Salmonella enterica. This is because, using current manufacturing technology, it is not feasible to produce sterile PIF.” In these Guidelines, WHO insists that “Users of PIF are made aware that powdered infant formula is not a sterile product and maybe contaminated with pathogens that can cause serious illness. Correct preparation and handling reduces the risk of illness.” (2).This risk of contamination can thus have serious consequences for the survival and health of infants and young children.
WHO’s “New Safety Advice”, also issued in 2007, carries the clear and direct message:
“Powdered infant formula is not sterile.  It may contain bacteria that can cause serious illness in infants. By preparing and storing powdered infant formula correctly, you can reduce the risk of illness.”
Steps to reduce a risk that cannot be eliminated There is no such thing as safe formula feeding, as evidenced by the repeated withdrawals and recalls of potentially contaminated infant and follow-on formulas, as well as baby cereals. Theseofficial withdrawals are regularly documented since 2002 by the International Code Documentation Centre in their Product Recall lists:https://www.ibfan-icdc.org/wp-content/uploads/Product-Recall-List-2014-2019.pdf and https://www.ibfan.org/fact-contaminants-reports-recall/The WHO Safety Advice “How to Prepare Formula for Bottle-feeding at Home” explains the careful preparation that is needed to reduce risks:“This leaflet contains new information to help you prepare bottle feeds from powdered infant formula as safely as possible.” http://www.who.int/foodsafety/document_centre/PIF_Bottle_en.pdf
The decontamination step Instructions for careful preparation include the decontamination step, also called the lethal or ‘kill’ step. This step is recommended by the WHO Guidelines to inactivate any harmful bacteria which might be present, even in unopened tins of powdered formula.This is a sensible but stringent precaution for all users of PIF. Species of pathogenic bacteria such as Salmonella and Cronobacter/Enterobacter thrive and multiply in the warm milk when the powdered formula is made up with lukewarm water. However, such bacteria are heat resistant and so the water needs to be very hot to kill them and thus prevent rapid multiplication. Reconstitution with water first boiled and then cooled to no less than 70°C is the lethal step required for inactivation. Prepared formula should be fed to the baby promptly and then any leftovers must be discarded and not re-used. Several governments have issued guidance and policies to implement the WHO Guidelines, including the decontamination step. However, there is evidence that the companies are actively opposing the WHO Guidelines so as to protect their market for formulas with ‘added probiotics’.  This is because the added probiotics, on which all the company claims are based, are heat-sensitive bacteria: they are killed off by reconstitution with water first boiled and then cooled to no less than 70°C. Therefore the claims made by the companies that their formulas are ‘modelled on breastmilk’ or ‘patterned after breastmilk’ are invalidated. It is only the living fluid, breastmilk, which provides the baby with live anti-infective agents and helps boost the development of its still immature immunesystem."
It doesn't matter how filtered your water is, the formula itself is the issue, it is not sterile, and so you are meant to sterilise it with boiling water, and then after one hour, it should not be used again. This isn't even just UK guidelines, this is the WHO, and it has been their firm policy since 2007.

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We just used (cold) filtered water from our fridge and when we were traveling we used bottled water. She’s 3.5 now and totally healthy. Of course if your area does not have safe water the guidance may be different.

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I just used tap water for the few formula bottles she had. We have a filter.

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I just used filtered water, then put the bottle in a bottle warmer

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I splurge and buy nursery water. I’m sure it’s excessive, but we might have lead lined pipes and it’s not worth risking it for me

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Yes. Boiled hot water is important.
I figured out the measurements to make formula that is ready to drink instantly eather than cooling it down:
Boiled hot water mixed with cold ( from the fridge) pre-measured preciously boiled cold water
And formula is ready within 1 minute

Mix formula with boiling water?

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