Sterilising Infant Feeding Equipment: Updated Guidance for Pharmacy Teams
Written by Katie Mugan RGN RCN RPHN IBCLC
Source: Irish Pharmacy News, June 2026, page 40.
Pharmacy teams are frequently asked for advice on sterilising infant feeding equipment, particularly during the early postpartum period when parents are often overwhelmed by conflicting information online and evolving product guidance. Recent updates surrounding cold water sterilising recommendations have added further confusion for many families.
Pharmacists and pharmacy staff are therefore well placed to provide clear, practical and evidence-based advice that aligns with current HSE, NHS and CDC guidance.
Current Recommendations for Bottle Feeding Equipment
The HSE and NHS recommend that all bottle-feeding equipment used for infants under 12 months should be washed and sterilised after every use. This includes bottles, teats, bottle collars, lids and formula preparation equipment.
Formula milk is considered a food product and can provide an ideal environment for bacterial growth if feeding equipment is not cleaned correctly. Organisms can multiply rapidly in residual milk.
Parents should first wash all feeding equipment thoroughly in hot soapy water using a dedicated bottle brush before sterilising.
Recommended sterilisation methods include:
- Cold water sterilisation systems
- Electric or microwave steam sterilisers
- Boiling
Cold water sterilising solutions should be changed every 24 hours, and equipment must remain submerged for the recommended contact time.
Updated Milton Guidance
Milton recently updated its guidance following revised regulatory requirements relating to rinsing after cold water sterilisation.
Historically, parents were commonly advised that equipment sterilised using the Milton method could simply be shaken dry and used immediately. However, updated regulations now recommend an additional rinsing step.
Initially, Milton advised rinsing with drinking water, but to align with NHS guidance and reduce parental confusion, the recommendation has now changed to rinsing with cooled boiled water where rinsing is undertaken.
It is important to reassure parents that:
- The Milton sterilising solution itself has not changed
- There are no new safety concerns regarding the product and this change is to comply with the stricter regulations
- The update reflects revised regulatory wording rather than concerns about product safety or effectiveness
Breastfeeding Equipment: Different Guidance Applies
Guidance for breast pump equipment and expressed breast milk collection differs from formula feeding equipment and is an important distinction for pharmacy teams to understand.
Unlike formula milk, breast milk is a living biological substance containing antibodies, leukocytes and antimicrobial properties which reduce the likelihood of harmful bacterial growth.
For healthy, full-term infants under two months of age with no underlying medical concerns:
- Breast pump parts and milk collection equipment should be washed thoroughly in hot soapy water after every use
- Equipment should then be rinsed and allowed to air dry completely
- Sterilisation is recommended once every 24 hours rather than after every use
For healthy infants over two months of age:
- Routine sterilisation of breast pump equipment is generally not required
- Thorough washing and air drying after use is considered sufficient
However, more stringent hygiene measures may be needed for premature infants, immunocompromised babies or infants with underlying medical conditions. In these cases, sterilisation after every use may be recommended.
Parents should also be advised to fully dismantle pump parts before cleaning, paying particular attention to valves, membranes and collection containers where milk residue may accumulate.
Soothers and Teething Items
Items that babies regularly place in their mouths, including soothers and teething toys, should be cleaned frequently and sterilised where appropriate, particularly for younger infants.
Parents should inspect soothers regularly for signs of wear or cracking, as damaged surfaces may harbour bacteria.
Common Misunderstandings Encountered in Practice
Pharmacy teams commonly encounter misconceptions around sterilising and storage practices. These include:
- Assuming dishwashers alone sterilise equipment
- Confusion between guidance for formula feeding and breast milk equipment
- Inadequate cleaning prior to sterilisation
- Reusing partially consumed formula feeds
- Improper storage of sterilised equipment
One particularly common issue involves the storage of bottles after sterilisation. Parents may appropriately wash and sterilise bottles and teats but then remove the separate components from the steriliser and leave them exposed on countertops or drying racks until needed. Once exposed to the environment, they can no longer be considered sterile.
Parents should instead be advised to either:
- Leave bottles inside the closed steriliser until required, or
- Immediately assemble the bottle using clean hands, attaching the teat, collar and lid to create a sealed sterile environment
When left inside a closed steriliser or fully assembled after sterilisation, bottles are generally considered sterile for up to 24 hours, depending on manufacturer guidance.
It is also important to reinforce that cleaning and sterilisation are separate processes. Sterilisation is ineffective if visible milk residue remains on equipment beforehand.
When to Refer for Further Support
Parents should be referred to a Public Health Nurse (PHN), GP, paediatrician or IBCLC if:
- An infant has recurrent vomiting or diarrhoea
- There are concerns regarding poor weight gain
- Persistent feeding difficulties are present
- The infant is premature or medically vulnerable
- Parents require additional support with expressing or combination feeding
Pharmacy professionals play an important role in reducing parental anxiety by providing consistent, evidence-based guidance. While sterilisation recommendations may evolve over time, the core principles remain unchanged: appropriate cleaning, safe storage and tailored advice based on the infant’s age, feeding method and clinical vulnerability.
