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Is there a risk for Cronobacter sp. infection in day-care centers ?

It is recommended by the WHO that caregivers to infants, particularly those at high risk (children less than 1 year old), should be regularly alerted to the fact that powdered infant formula is not a sterile product. In situations where the mother cannot breastfeed, or chooses not to breastfeed for any reason, caregivers should use, whenever possible and feasible, commercially sterile liquid formula or include a decontamination step in the preparation of powdered infant formula (such as reconstituting with boiling water or heating reconstituted formula) .

A preliminary risk assessment further indicated that reduced holding (time between rehydration of the formula and consumption) and feeding times for the reconstituted formula decrease the risk of infecting infants. A combination of control measures would have the greatest impact on reducing the risk. With current technology it seems not to be possible to produce sterile powdered infant formula. However, recommendations are being made to the industry by for example the WHO on how they can improve the safety of powdered infant formula.