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More on Sterilizing Your Baby's Bottles

By June 16, 2008

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On my recent post about sterilizing your baby's bottles, about 30 percent of you report that you do not sterilize your baby's bottles, and 32 percent say you used to, but don't any more. Stewart commented that my advice to not sterilize "goes against all current medical recommendations and should not be listened to" so I wanted to elaborate a bit. Health care providers have varying advice on this, as I said, but studies as far back as the '50s have indicated that there is no need for routine sterilization of bottles beyond hot soapy water or time in a dishwasher. In fact, with the issues of BPA, it's been noted that sterilization via boiling can actually cause bottles to leach this out quicker.

You can read a more in-depth piece from Dr. Robert Steele (a board-certified pediatrician) about sterilizing not being necessary and why. (He also recommends sterilizing in the case of well water, though). Also, the following other medical sources agree that sterilizing bottles (outside of the first use and, of course, providing your water supply is safe) is not necessary when they are cleaned properly:

  • Dr. Vincent Iannelli, Pediatrics Guide and board-certified pediatrician, in his article "Common Pediatric and Parenting Myths" -- "If you live in a city with sanitized water and you are preparing bottles one at a time, then boiling water or sterilizing the bottles and nipples probably isn't necessary. You can use this water out of the tap and bottles can be washed in hot soapy water or in the dishwasher. If you are not convinced that your water supply is safe or if you are using well water, then you should boil the water for five minutes before preparing formula."
  • Dr. Ari Brown, Harvard-trained pediatrician in her book Baby 411 -- "You don't need to sterilize the bottles after the first time you take them out of the package ... Sterilizing bottles and boiling water are all based on the kitchen chemistry our mothers and grandmothers performed to prepare formula in the olden days."
  • Dr. Glade B. Curtis, board-certified OB/GYN and co-director of Health Clinics of Utah, says in his book Your Baby's First Year -- "There is no need to sterilize bottles on a regular basis unless you use well water. In that case, boil bottles and nipples for 5 minutes."
  • From WebMd: "In the old days when water supplies were not reliably clean, it made sense to sterilize. But now, sterilizing bottles, nipples, and water is mostly unnecessary. Unless your water supply is suspected to harbor contaminated bacteria, it is as safe for your baby as it is for you. There is no reason to sterilize what is already safe."
  • The American Academy of Family Physicians: "You should sterilize bottles and nipples before you use them for the first time. You can do this by putting them in boiling water for 5 minutes. After that first time, you probably don't need to sterilize them again. Instead, wash bottle, nipples and caps in hot, soapy water. Rinse them carefully. You can also run them through the dishwasher, which kills more germs than washing by hand."
  • KidsHealth.org: "Yes. Before the first use, you'll need to sterilize nipples and bottles in a rolling boil for 1 to 5 minutes. You can also sterilize them with a store-bought countertop or microwaveable sterilizer, but boiling works just as well and costs nothing. After that, you'll need to wash bottles and nipples in hot, soapy water (or run them through the dishwasher) before every use."

Melissa wrote,

"Wells are not dirty, contaminated water in need of sterilization. I do have a filter and I have my well water tested yearly. It is very safe and cleaner than most tap water. To say that having a well means you should sterilize your drinking water is absurd."

I certainly wasn't implying that your well water (or anyone else's) is a big ole nasty cesspool of gunk. I grew up with well water, myself. But unless you have an exceptional filter, which many with wells do not have (including my own parents who also happen to live in an area where there have been problems with septic systems) then your water can contain harmful bacteria that aren't normally present in municipal water. Even if you have a filter, it may be one that does not remove bacterial contaminants as some only remove things like lead and chemicals. Wells near farms where runoff can occur also present a special set of problems. (Of course you also have the advantage of not having fluoride and antidepressants in your water as in some municipal supplies...) At any rate, you also get your well water tested once a year, which is great, but again, not everyone does. It sounds like you have your well situation fully under control and so this advice probably doesn't apply to you.

For those of you who do sterilize your baby's bottles and nipples before use (40 percent of you say you do), what are your reasons? Were you advised by your health care provider or someone else? I recently read a message board where a mother questioned other's advice to not sterilize with, "Are you people MAD??!! Do you know how easy babies pick up diseases?" So, I know there are people who feel strongly about their preference to sterilize or not to sterilize. Another thing that crossed my mind is that when I was traveling recently, I was in a hotel and happened to turn on the local cable access channel. There I saw a warning about that city's water being contaminated and residents were being advised to boil water. If I lived there (or was traveling with a baby and assumed the water was safe) and hadn't gotten the notification yet, then perhaps routine sterilization procedures would have prevented an illness. Maybe...

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Comments
June 16, 2008 at 12:26 pm
(1) Pam says:

I boiled bottles and bottle parts for both my kids for the first 3 months. I did it more to be sure that the breastmilk I stored had the longest possible shelf life rather than worrying about Baby catching anything. I usually just hand washed pacifiers and teething rings, although if I had a dishwasher almost full… I would toss them in there. My youngest is now on cow’s milk and I run everything through the dishwater, but in a pinch I will handwash. I think as babies get older it’s better to allow some exposure to germs to get them to build resistance.

June 16, 2008 at 1:40 pm
(2) Nicole says:

I sterilized everything before the first use, but reasoned that if the dishwasher got things clean enough for adults and older babies to use, why not infants? Plus, most dishwashers heat water up to 140 degrees- (even if you only have your water heater set to 120) plenty hot enough to kill any bacteria.

June 16, 2008 at 2:06 pm
(3) Mel C says:

My baby spent 2 months in the NICU and the staff (nurses, nurse practicioners, doctors, etc.) kept telling us to wash all her stuff in the dishwasher, no need to sterilize after that. My husband and I were elated… one less step. My baby has never gotten sick to her tummy and she’s almost a year old. So those lucky enough to have a dishwasher, use it.

June 16, 2008 at 7:09 pm
(4) Melissa says:

Thanks for the follow-up post. I guess I should have elaborated in my comment. When I had my first baby I looked into what to do with my water, since it was a well. Turns out, boiling it can actually make things worse. If you have lead or other non-volatile compounds in your water, boiling it will concentrate these compounds. The EPA and AAP have some good info, they suggest yearly testing and I personally have the best filter out there – the one that filters out the most. I think some people might think I’ll just boil it and it will be OK but not necessarily. By the way, love your blog, read it all the time. It has great helpful info.

June 16, 2008 at 7:10 pm
(5) victoria says:

My child was in the special care nursery and all of the Dr.’s and Nurses told us that we didn’t need to sterilize anything just wash in hot soapy water and rinse well or wash in the dishwasher.

June 16, 2008 at 8:12 pm
(6) LaNette says:

If anyone has concerns about fluoride or your water being safe just buy Nursery Water at the local Super Store, it’s about $1.25 a gallon.

June 17, 2008 at 10:45 am
(7) Amy says:

I live in Northampton, UK and we are told here to wash and sterilise bottles and teats after every use until the baby is 8 months old. When the baby is weaning you do not need to sterilise cutlery/plates etc. I think I stopped before 8 months as I figured that he plays with toys at playgroup and puts everything in his mouth there and at home and he was fine. I just made sure they were washed and rinsed well.

June 24, 2008 at 2:49 pm
(8) Charlotte says:

I always, always wash new items in hot water. but after that i think routine cleaning is only necessary. As for the baby bottles boiled each time. What about the breastfed babies whose mothers only bathe in warm water and sometimes never use soap cause it causes dryness? I don’t think they boil thier breasts before each use!

September 21, 2008 at 3:10 pm
(9) Dad says:

Hello. We are just getting ready to transition our 1-month old from breast to bottle-fed breast milk. We were advised to start with one feeding by bottle per day. Two questions:

1. We have evenflo “classic” glass bottles without BPA. Boiled them 10 min for first use and they turned VERY CLOUDY! Is this normal/common? Has anyone else experienced this? Rubbing and rinsing the outside removed some cloudiness, but inside is cloudy too and sticking my fingers and towel inside to rub will negate the sterilizing. Any suggestions??

2. If there is milk left in the bottle AFTER feeding, can we put it back in the fridge to use in the next feed? I know we can store in fridge a couple days and freeze once for a couple months, but what about after feeding?

THANKS!!
–Dad

July 13, 2009 at 9:29 pm
(10) Cynthea says:

I don’t think you can say that constant sterilizing “might” stop a disease in a different city. Of course it would, because they would be getting rid of the bacteria. Being careful with our children is the most important thing to a parent, and to risk them getting sick over something that could have been prevented is cruel. cleanliness should be a priority for everyone, but especially those with young children and infants. To be lax is extremely irresponsible. I go to school all day long and come home to my six month old, and i still find time to do whats best for her.

September 9, 2009 at 2:17 pm
(11) Candace says:

Wouldnt you rather be safe than sorry??(in my own opinion) My friends like to make fun of me because I still steralize (son is 5 mths old), but I honestly could care less about their opinions! I do what’s right for me and my child. They can all do what they want, and I will continue to steralize until about 1 yr. It takes 4 minutes and DONE!! Not hard at all……

January 21, 2010 at 7:22 am
(12) Karen says:

HI, I am wondering where you sit with the World Health Organisations findings in relation to gastric infection risk related to PIF, which states
“Concerns have been raised over the use of very hot water for reconstituting PIF (Powdered Infant Formula) , but risk of E. sakazakii is only dramatically reduced when water at a temperature of no less than 70 C is used. Currently, the instructions on many PIF products lead to PIF being reconstituted with water that is around 50 C. But, according to the FAO/WHO risk assessment, reconstitution with 50 C water generally results in the greatest increase in risk, unless the reconstituted formula is consumed immediately. Under no circumstances is risk reduced when PIF is reconstituted with 50 C water. Manufacturer’s instructions should be reviewed in the light of the findings of the risk assessment. ”
I realise a lot of babies dont get sick without sterlizing, but there are those that get very sick and some die. So as health professionals, shouldnt we advise of the risks and recommend the best practice knowing that each parent will choose to do what they feel is right for them and their child, and live with the outcomes of those choices.

April 5, 2010 at 1:48 pm
(13) Donna says:

For us, it just became routine to sterilize the bottles after each use. We still do it and our daughter is 6 months old.

April 17, 2010 at 11:50 pm
(14) Maggie says:

Sterilizing takes 6 min. in a sterilizer. The dishwasher takes longer. With twins you just can’t wait for the dishwasher. It’s very easy to wash the bottles and nipples after each use (in a small pan in sink) and put them in the sterilizer. I would sterilize until about four to six months.
To Dad: I wouldn’t advise you to save left over formula or breastmilk after a feeding to use later on. Try serving the approximate amount that will be consumed by baby so you don’t have to throw away any. But if there is left over, I would discard it.

April 22, 2010 at 11:51 pm
(15) Susan says:

i am going to sterilize my sons bottles before he is born because they were given to me from a friend and they have been used before, yes it has been 6 years since they were used but better safe them sorry

August 10, 2010 at 3:34 pm
(16) alla says:

how can I sterilize the bottles if I don’t have dishwasher?

October 26, 2010 at 2:31 am
(17) Beci says:

I’m expecting my first baby. I live in France where the advice has been against sterilising for many years, it seems, but I get very conflicting advice from the UK so I’m finding it very bewildering. My sister sent me this leaflet from the World Health Organisation which is positively scary on the subject: http://www.fao.org/ag/agn/agns/files/PIF_Bottle_en.pdf

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