Finding the right formula: Establishing the feasibility of doing science in the home to assess the safety of Powdered Infant Formula preparation

问题出在哪里？婴儿配方奶粉是喂给婴儿的母乳的替代形式，当母亲无法或不想母乳喂养时，婴儿配方奶粉就会被用来代替母亲的母乳喂养。在英国，支持母乳喂养的服务不足，因此大多数婴儿使用婴儿配方奶粉喂养，近四分之三的婴儿在出生后六周内服用婴儿配方奶粉。在生命的最初几周，婴儿的免疫系统不发达，这意味着他们非常容易受到细菌感染。因此，任何婴儿配方奶粉都必须不含有害细菌(无菌)。要用婴儿配方奶粉制作无菌牛奶，必须使用煮开并冷却到70摄氏度的水。原因是婴儿配方奶粉在生产过程中不是无菌的，也不可能是无菌的。这意味着，根据法律，它可以含有少量的沙门氏菌和慢杆菌，这些细菌在配制配方奶粉的水不够热的情况下会存活下来。在英国，每年有3000多名婴儿因这些感染而住院，另有1万名婴儿接受社区医生的检查。可悲的是，这些感染可能会导致脑膜炎、败血症，甚至很少会死亡。我们调查了300多名使用婴儿配方奶粉的父母；其中三分之一的人表示对安全制备婴儿配方奶粉缺乏信心，每12人中就有一人表示他们并不总是遵循说明；例如，开水，在冰箱中冷却，然后用冷水配制婴儿配方粉。这可能是与婴儿配方奶粉喂养的婴儿相关的细菌感染有关的因素。志愿者科学家可以帮助理解这个问题吗？“寻找正确的配方奶粉”是父母和研究人员共同开发的一个社区科学项目(“参与性行动研究”)，通过测试在家中准备的婴儿配方奶粉的温度来测试其安全性。如今，护理人员可能会使用各种方法来加热他们用来制作婴儿配方奶粉的水，包括即时热水龙头和专门为制备婴儿配方奶粉而设计的机器。然而，NHS不推荐这些机器，因为在实验室条件下的少量研究引发了人们对它们安全性的担忧，但当照顾者在家中制作配方奶粉时，这一点还没有得到测试。200名参与者将有机会像往常一样，在家中使用温度计测试他们用来准备婴儿配方奶粉的水样本的温度。他们将在在线研究日记中记录水温，以及他们如何准备配方的信息。匿名数据将提供给在线社区，以获得关于照顾者如何组成婴儿配方奶粉的各种观点。参与者将有机会了解更多关于研究的知识，以及他们如何在总体上为研究做出贡献，使他们对未来参与研究更有信心。参与者将得到一小笔感谢金。研究结果将如何处理？主持这项研究的学者和参与者将共同努力，通过制作视频和书面内容与公众、卫生专业人员和政策制定者分享结果。如果在线社区想要扩大这项研究，我们将寻求资金，在更多的人中重复该项目。此外，我们还将对人们参与研究的能力进行评估(过程评估)。这将使我们了解消费者如何在家里进行食品安全研究，这可能对其他研究有价值，特别是在食品温度对杀灭可能使我们身体不适的细菌非常重要的情况下。

WHAT IS THE ISSUE?Infant Formula is a substitute form of breastmilk fed to babies, which is used instead of mothers' breastfeeding when mums are unable, or do not want, to breastfeed. In the UK, services to support breastfeeding are inadequate, so the majority of babies are fed Infant Formula, with almost three-quarters receiving Infant Formula in their first six weeks. In the early weeks of life, babies have an underdeveloped immune system and this means that they are very vulnerable to bacterial infections. For this reason, any Infant Formula they are fed must be made to be free from harmful bacteria (sterile). To create sterile milk from Powdered Infant Formula, it is essential to use water that has been boiled and cooled to 70 degrees centigrade. The reason for this is that Powdered Infant Formula is not - and cannot be made to be - sterile during manufacturing. This means that by law it is allowed to contain small amounts of Salmonella and Cronobacter, bacteria which survive if the water used to prepare the formula is not hot enough. Over 3,000 babies end up in hospital in the UK each year because of these infections and another 10,000 are reviewed by a doctor in the community. Sadly, these infections can result in meningitis, sepsis and rarely even death. We surveyed over 300 parents who use Powdered Infant Formula; one third of them reported lacking confidence in safely preparing Powdered Infant Formula, and one in 12 said that they do not always follow instructions; instead for example, boiling water, cooling it in the fridge and later making up Powdered Infant Formula with the cold water. This may be something that contributes to the bacterial infections associated with babies who are fed Powdered Infant Formula.HOW CAN VOLUNTEER SCIENTISTS HELP UNDERSTAND THIS ISSUE?"Finding the right formula" is a collaborative community science project developed between parents and researchers ("Participatory Action Research") to test the safety of Powdered Infant Formula prepared at home, by testing its temperature. These days, caregivers may use a variety of ways to heat up the water that they use to make Powdered Infant Formula, including instant hot water taps and machines designed specifically to prepare Powdered Infant Formula. However, these machines are not recommended by the NHS because a small amount of research in laboratory conditions raised concerns about their safety, but this has not yet been tested when caregivers make formula at home.200 participants will be given the opportunity to use a thermometer to test the temperature of a sample of the water they used to prepare Powdered Infant Formula at home, in the way that they usually do. They will record in an online research diary the temperature of the water, and information about how they prepared the formula. Anonymized data will be available to the online community, to gain a variety of perspectives about how caregivers make up Powdered Infant Formula. Participants will be offered the chance to learn more about research and how they can contribute to it generally, to enable them to feel more confident to participate in research in the future. Small thank you payments will be provided to participants.WHAT WILL BE DONE WITH THE FINDINGS?The academics running the study and the participants will work together to share the results with the public, health professionals and policymakers by creating video and written content. If the online community would like to grow the study, we will seek funding to repeat the project with a larger group of people.As well as this, we will undertake an evaluation of how people have been able to engage with the research study (a "process evaluation"). This will allow us to learn about how food safety research can be conducted in the home by consumers, which may be valuable in other research studies, particularly where the temperature of a food is important to killing bacteria that can make us unwell.