PEDIATRICS Vol. 1 No. 6 June 1948, pp. 758-766
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FORMULA ROOMS FOR NEWBORN INFANTS IN LYING-IN HOSPITALS

A Preliminary Study on Supervision and Certain Technics for Preparation

HELEN M. WALLACE M.D.1, HAROLD ABRAMSON M.D.1, and MARGARET A. LOSTY R.N.1

1 The New York City Department of Health.

This report comprises a preliminary discussion of certain conditions under which formulas are prepared for newborn infants in lying-in hospitals. The general picture is one of lack of proper supervision of formula room procedures and of the unskilled personnel usually assigned to the important process of formula preparation. The conditions disclosed by this study are not peculiar to New York City alone, but merely reflect the pressing nature of the problem throughout the country.

Until recently the study of formula preparation was a neglected field of investigation. A review of the literature emphasizes the lack of attention that has been paid to the problem in the past. Investigators now state unanimously that the entire procedure of formula preparation in hospitals requires revision. But the methods by which this change should be achieved are still open to study. The general opinion is that some means of terminal steam sterilization is necessary. But opinion is, however, divided as to the type of steam sterilization that is desirable, the optimal temperature that should be employed, and the time of application required. Opinions are not always substantiated by adequate bacteriologic data.

Asking those with practical experience to answer certain questions on terminal processing of formula led to no consistent conclusion. Opinions were based mainly on clinical experience and judgment. There was general agreement that subjecting formulas to high temperatures would destroy such vitamins as thiamin and ascorbic acid, and would cause appreciable caramelization of the formulas. It was thought that such changes would not have deleterious effect on the baby. Vitamin replacement therapy could be readily introduced.

It is the responsibility of hospital administrators, pediatricians, obstetricians, nurses, dieticians, and public health workers to devise safe and practical methods for preparing infant formulas and to plan the layout of the formula room. The methods recommended should be based on sound scientific data and be sufficiently simple to be carried out effectively by any person assigned to formula room duty.

Submitted on April 1, 1948