October 24, 2021

Cronobacter Is Rare But Often Deadly For Infants

A newborn boy in Missouri lost his life this week after contacting a rare bacterial infection from a  foodborne pathogen called Cronobacter sakazakii. He had been fed Enfamil Newborn powder bought at a Walmart store in Lebanon, Missouri. After learning of his death, the store, and 3,000 other Walmarts nationwide pulled the product from their shelves.

Feeding-BabyThe manufacturer of the formula, Mead Johnson Nutrition based in Glenview, Ill., said its records show that the formula in question came from a lot that tested negative for the bacterium before it was shipped. The Missouri Department of Health and Senior Services (MDHSS) the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration (FDA) are all investigating the case.

In infants, Cronobacter causes septicemia and meningitis and is deadly in 40 percent of cases.  From 1958 to 2008, 120 cases of Cronobacter infection in infants were reported to the CDC, an average of fewer than three cases per year worldwide.

Cronobacter exists throughout the environment; in soil, water, residential and commercial settings and a wide range of food including dairy products, meat, vegetables, fruits, grains, spices, dried foods, tea and herbs, according to research published in the International Journal of Microbiology.

Powdered infant formula, has repeatedly been linked through epidemiological evidence to Cronobacter infection, so much so that the World Health Organization (WHO) has issued guidelines for safer for safer preparation, handling, and storage, of the product according to the CDC.

In hospital settings, sterile liquid infant formula is often used because sterilization kills harmful bacteria.  Powdered infant formulas are manufactured according to Good Manufacturing Practices, tested to meet FDA standards and are heat-treated but are not sterile.

The International Formula Council, an association of manufacturers and marketers of infant formulas and adult nutritionals, whose members include Mead Johnson, Abbott Nutrition; Nestle Infant Nutrition; PBM Products, LLC, A Perrigo Company; and Pfizer Nutrition released a statement today saying:

“The International Formula Council (IFC) wants to reassure parents and caregivers that powdered infant formula is safe.  Because Cronobacter  spp. has been detected in many substances, careful preparation and handling of powdered infant formula is strongly recommended to avoid possible contamination.”

Those recommendations are:

  • Boil new bottles and nipples for five minutes before using them the first time.   Also, wash them for one minute in hot, soapy water after each use.
  • Wash hands before preparing formula and before feeding the baby to avoid contamination
  • When opening a can of formula, clean the lid and the can opener of dust or soil.
  • Follow preparation instructions on the product label to ensure the formula is prepared properly. Discard previously chilled bottles of formula if left out of a cooler or refrigerator for more than an hour.
  • Discard any excess liquid in baby bottles to help avoid the growth of bacteria found in baby saliva.
  • Never feed infant formula that has expired or formula from a dented container. 
  • Never heat infant formula or bottled breast milk in the microwave. Buy formula only from reputable retailers and not from on-line auctions or flea markets.
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