HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 10-21
Postpartum/Maternal/Newborn: Formula Preparation __RN
PURPOSE:
To prepare formula in accurate dilutions, utilizing clean
technique.
CONSIDERATIONS:
1. Several types of milk-based and milk-free formulas
are available according to infant's special need.
2. Formula must be ordered by name of product,
calories per ounce, number of ounces per feeding,
and number of feedings per day.
3. Normal dilution is 20 calories per ounce of formula.
4. Caution should be taken when using higher calorie
formulas as osmolarity and renal solute load are
increased.
5. Most hospitals have established guidelines for
mixing formulas. Consult these guidelines.
6. If dilutions higher than 27 calories per ounce are
desired, a dietician needs to calculate formula as
other additives may be utilized, i.e., corn oil, MCT
oil, or polycose.
7. In most urban areas with safe water systems,
terminal sterilization of formula is not always
necessary.
8. Equipment should be cleansed with hot, soapy
water and rinsed well with hot water or washed in a
dishwasher.
EQUIPMENT:
Clean container
Clean or disposable bottles
Clean nipples
PROCEDURE:
1. Adhere to Universal Precautions.
2. Boil water for 3 to 5 minutes if directed by physician
or health department.
3. Cool the water to room temperature.
4. In clean container, pour the formula and cooled
water according to the calorie and type of the
formula:
20 Calories/oz Formulas
20 calories/oz Container Size Dilution Instructions
Ready-To-
Feed
32 oz. can
8 oz. can
Concentrate 13 oz. can
No Dilution required
No Dilution required
One part concentrate to one
part water
Powder 1 pound can 1 level scoop to 2 oz. water
Evap. Milk 13 oz. can
13 oz. can of milk plus 1 to
2 tablespoons of corn syrup
and 18 oz. of water
5. To dilute higher calorie formulas, it is more accurate
to make the entire day’s formula at one time. This
avoids possible mistakes of mixing and measuring
individual bottles:
24 Calories/oz Formulas
24 calories/oz Amt. Formula Amt. Water Yield
Liquid Concentrate 13 oz. can 9 oz. 22 oz.
Powder 17 scoops 28 oz. 32 oz.
27 Calories/oz Formulas
27 calories/oz Amt. Formula Amt. Water Yield
Liquid Concentrate 13 oz. can 6 oz. 19 oz.
Powder 19 scoops 28 oz. 32 oz.
6. After the mixing of formula and water in the
container, pour it into individual bottles, 2-4 ounces
per bottle according to infant’s one time
consumption.
7. Put nipple and cap on.
8. Refrigerate until ready to use.
AFTER CARE
1. Document in patient’s record:
a. Method of formula preparation and amount
prepared.
b. Instructions given to caregiver.
c. Return demonstration by caregiver of formula
preparation if greater than 20 calories per
ounce formula.
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