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Am. J. Trop. Med. Hyg., 81(1), 2009, pp. 132-139
Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

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Efficacy of Protocols for Cleaning and Disinfecting Infant Feeding Bottles in Less Developed Communities

Li Ma, Guodong Zhang, Balasubr Swaminathan, Michael Doyle, AND Anna Bowen*
Center for Food Safety, University of Georgia, Griffin, Georgia; Division of Foodborne, Bacterial, and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

Although breastfeeding is the best choice for most infants, infant formula is used widely, commonly introduced during the neonatal period, and usually given to infants in bottles that can be difficult to clean. We artificially contaminated infant feeding bottles with low and high inocula of bacterial enteric pathogens and evaluated the efficacy of several cleaning and chlorine disinfection protocols. Rinsing with soapy water followed by tap water was the most effective cleaning method and reduced pathogen load by 3.7 and 3.1 log10s at the low and high inoculum levels, respectively. Submersion in 50 ppm hypochlorite solution for 30 minutes produced a 3.7-log10 reduction in pathogens, resulting in no identifiable pathogens among bottles. This result was comparable to boiling. When combined with handwashing, use of safe water, and appropriate storage of prepared infant formula, these simple, inexpensive practices could improve the microbiological safety of infant formula feeding in less developed settings.

Received December 15, 2008. Accepted for publication February 26, 2009.

Acknowledgments: The authors thank Jill Blalock, Lori Harrison, Bobby Goss, Vijaya Mantripragada, and Jill Smith for technical assistance and Tracy Creek for procuring feeding equipment.

Financial support: This study was funded by the CDC and Center for Food Safety.

* Address correspondence to Anna Bowen, CDC, 1600 Clifton Road NE, MS A-38, Atlanta, GA 30333. E-mail: abowen{at}cdc.gov

Authors’ addresses: Li Ma, Center for Food Safety University of Georgia, 1109 Experiment Street, Griffin, GA 30223, Tel: 770-228-7283 ext. 144, Fax: 770-229-3216, E-mail: lima{at}uga.edu. Guodong Zhang, Center for Food Safety University of Georgia, 1109 Experiment Street, Griffin, GA 30223, Tel: 770-228-7283 ext. 144, Fax: 770-229-3216, E-mail: guodongzhang63{at}hotmail.com. Balasubr Swaminathan, CDC, 1600 Clifton Road NE, MS C-03, Atlanta, GA 30333, Tel: 770-458-5945, E-mail: balas7780{at}gmail.com. Michael Doyle, Center for Food Safety University of Georgia, 1109 Experiment Street, Griffin, GA 30223, Tel: 770-228-7284, Fax: 770-229-3216, E-mail: mdoyle{at}uga.edu. Anna Bowen, CDC, 1600 Clifton Road NE, MS A-38, Atlanta, GA 30333, Tel: 404-639-2206, Fax: 404-639-2205, E-mail: abowen{at}cdc.gov.






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