Sarah Gibson1, Daniel Sahanggamu2, Dewi Fatmaningrum2, Val Curtis3, Sian White3. 1. Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. 2. Regional Centre for Food and Nutrition, Southeast Asian Ministers of Education Organization, Jakarta, Indonesia. 3. Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
Abstract
OBJECTIVES: To examine levels of bacterial contamination in formula feeding bottles in Sidoarjo, East Java, and to assess the preparation practices that may have been responsible. METHODS: A cross-sectional study was conducted among 92 randomly selected households with children under the age of two who were bottle-fed formula. In each household, we carried out video observation of mothers/caregivers preparing bottles, and examined samples of formula for coliform bacteria and Escherichia coli (E. coli). In-depth interviews were conducted with a subsample of 20 mothers. RESULTS: A total of 88% of the formula feeds were contaminated with total coliforms at a level >10 MPN/ml, and 45% contained E. coli. These feeds were defined as 'unfit for human consumption'. In the video observations, none of the mothers complied with all five WHO-recommended measures of hygienic formula feed preparation. Only two mothers washed their hands with soap prior to formula preparation. Most mothers also failed to clean or sterilise the bottle and clean the preparation area. In-depth interviews confirmed that such suboptimal hygiene practices were common. CONCLUSION: The high levels of contamination found highlight that bottles are an important faecal-oral exposure pathway resulting from poor hygiene practices during bottle preparation.
OBJECTIVES: To examine levels of bacterial contamination in formula feeding bottles in Sidoarjo, East Java, and to assess the preparation practices that may have been responsible. METHODS: A cross-sectional study was conducted among 92 randomly selected households with children under the age of two who were bottle-fed formula. In each household, we carried out video observation of mothers/caregivers preparing bottles, and examined samples of formula for coliform bacteria and Escherichia coli (E. coli). In-depth interviews were conducted with a subsample of 20 mothers. RESULTS: A total of 88% of the formula feeds were contaminated with total coliforms at a level >10 MPN/ml, and 45% contained E. coli. These feeds were defined as 'unfit for human consumption'. In the video observations, none of the mothers complied with all five WHO-recommended measures of hygienic formula feed preparation. Only two mothers washed their hands with soap prior to formula preparation. Most mothers also failed to clean or sterilise the bottle and clean the preparation area. In-depth interviews confirmed that such suboptimal hygiene practices were common. CONCLUSION: The high levels of contamination found highlight that bottles are an important faecal-oral exposure pathway resulting from poor hygiene practices during bottle preparation.
Authors: Jessica D Rothstein; Alejandra Llican Mendoza; Lilia Z Cabrera; Jessica Pachas; Maritza Calderón; Mónica J Pajuelo; Laura E Caulfield; Peter J Winch; Robert H Gilman Journal: Am J Trop Med Hyg Date: 2019-04 Impact factor: 2.345
Authors: Mackenzie Green; Alissa M Pries; Dian N Hadihardjono; Doddy Izwardy; Elizabeth Zehner; Victoria Hall Moran Journal: Matern Child Nutr Date: 2021-04-16 Impact factor: 3.092
Authors: Kevin Tsai; Sheillah Simiyu; Jane Mumma; Rose Evalyne Aseyo; Oliver Cumming; Robert Dreibelbis; Kelly K Baker Journal: Int J Environ Res Public Health Date: 2019-02-12 Impact factor: 3.390
Authors: Sarah Bick; Lauren Perieres; Lauren D'Mello-Guyett; Kelly K Baker; Joe Brown; Bacelar Muneme; Rassul Nala; Robert Dreibelbis; Oliver Cumming Journal: Matern Child Nutr Date: 2020-03-12 Impact factor: 3.092