RN Nursing · Newborn Care and Parent Teaching · Practice question
A nurse is teaching about safe handling of formula to a client who is postpartum and chooses to bottle feed her newborn. Which of the following statements by the client indicates an understanding of the teaching?
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"l can dilute the ready-to-feed formula with water when my baby wants more than 4 ounces at a feeding."
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✓
"l should boil tap water for 2 minutes and cool it before I mix it with the powdered formula."
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"l can keep a can of concentrated formula in the refrigerator for 3 days after I open it."
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"l will be sure that all of my bottles contain BPA"
Answer & explanation
Correct: "l should boil tap water for 2 minutes and cool it before I mix it with the powdered formula."
The statement indicating correct understanding is that the client should boil tap water for at least one to two minutes and allow it to cool before mixing it with powdered formula. This practice eliminates pathogens such as Cronobacter sakazakii that can contaminate powdered formula or tap water and cause serious illness in newborns whose immune systems are immature. Ready-to-feed formula should never be diluted with water; it is already prepared at the correct concentration, and dilution alters caloric density and electrolyte balance, putting the infant at risk for hyponatremia and inadequate nutrition. Concentrated liquid formula may be kept in the refrigerator for up to 48 hours — not 72 hours — after opening, so the three-day statement is incorrect. Regarding BPA (bisphenol A), parents should ensure bottles are BPA-free, not that they contain BPA, because BPA is a chemical that can leach into formula and has potential endocrine-disrupting effects. The statement about boiling water is the only one that reflects safe, evidence-based formula preparation practice.
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