Guidelines for the safe preparation, storage and handling of powdered infant formula

Powdered infant formula (PIF) has been associated with serious illness and death in infants due to infections with Enterobacter sakazakii. During production, PIF can become contaminated with harmful bacteria, such as Enterobacter sakazakii and Salmonella enterica. This is because, using current manufacturing technology, it is not feasible to produce sterile PIF. During the preparation of PIF, inappropriate handling practices can exacerbate the problem.

Recognizing the need to address such hazards in PIF, Codex Alimentarius decided to revise the Recommended International Code of Hygienic Practice for Foods for Infants and Children. In doing so it requested specific scientific advice from the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO). FAO and WHO have provided this advice in the reports of two expert meetings held in 2004 and 2006 on Enterobacter sakazakii and other microorganisms in PIF. Part of this advice included a recommendation to develop guidelines for the preparation, use and handling of PIF.

In 2005 the World Health Assembly (WHA) of WHO requested the Organization to develop such guidelines in order to minimize the risk to infants.

These present guidelines are considered to be a generic document that will provide guidance and support for countries and governments. When adapted at the country level, conditions (i.e. climatic and socioeconomic differences, etc.) within the country should be reflected. Individual countries should outline minimum training requirements for parents, caregivers, and staff in hospitals and day-care centres.

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