Download PDF Handbook of Public Health in Natural Disasters: Nutrition, Food, Remediation and Preparation

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Only cleaned and sanitized bottles, or their equivalent, and nipples should be used in feeding.

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The bottle or container should immediately be stored in the refrigerator on arrival. Avoid bottles made of plastics containing bisphenol A BPA or phthalates, sometimes labeled with 3, 6, or 7 1.

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Use glass bottles with a silicone sleeve a silicone bottle jacket to prevent breakage or those made with safer plastics such as polypropylene or polyethylene labeled BPA-free or plastics with a recycling code of 1, 2, 4, or 5. The filled, labeled containers of human milk should be kept refrigerated. Human milk containers with significant amount of contents remaining greater than one ounce may be returned to the mother at the end of the day as long as the child has not fed directly from the bottle.

Frozen human milk may be transported and stored in single use plastic bags and placed in a freezer not a compartment within a refrigerator but either a freezer with a separate door or a standalone freezer. Human milk should be defrosted in the refrigerator if frozen, and then heated briefly in bottle warmers or under warm running water so that the temperature does not exceed If there is insufficient time to defrost the milk in the refrigerator before warming it, then it may be defrosted in a container of running cool tap water, very gently swirling the bottle periodically to evenly distribute the temperature in the milk.

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After warming, bottles should be mixed gently not shaken and the temperature of the milk tested before feeding. Some children around six months to a year of age may be developmentally ready to feed themselves and may want to drink from a cup. Two to three ounces of human milk can be placed in a clean cup and additional milk can be offered as needed. Small amounts of human milk about an ounce can be discarded.

Human milk can be stored using the following guidelines from the Academy of Breastfeeding Medicine:. Guidelines for Storage of Human Milk. Containers should be covered and kept as cool as possible; covering the container with a cool towel may keep milk cooler. Keep ice packs in contact with milk containers at all times, limit opening cooler bag. Store milk toward the back of the freezer, where temperature is most constant. Milk stored for longer durations in the ranges listed is safe, but some of the lipids in the milk undergo degradation resulting in lower quality.

Clinical protocol 8: Human milk storage information for home use for healthy full term infants, revised.

Introduction to the Public Health Preparedness Capabilities (101)

Breastfeeding Med From the Centers for Disease Control and Prevention Website: Proper handling and storage of human milk — Storage duration of fresh human milk for use with healthy full term infants. The formula should be of the same brand that is served at home and should be of ready-to-feed strength or liquid concentrate to be diluted using cold water from a source approved by the health department.

Powdered infant formula, though it is the least expensive formula, requires special handling in mixing because it cannot be sterilized. Before opening the can, hands should be washed. The can and plastic lid should be thoroughly rinsed and dried. Also, a scoop can be contaminated with a potential allergen from another type of formula.

Iron-fortified formula should be refrigerated until immediately before feeding. For bottles containing formula, any contents remaining after a feeding should be discarded. Any prepared formula must be discarded within one hour after serving to an infant. Some infants will require specialized formula because of allergy, inability to digest certain formulas, or need for extra calories.

The appropriate formula should always be available and should be fed as directed. For those infants getting supplemental calories, the formula may be prepared in a different way from the directions on the container. Formula should not be used beyond the stated shelf life period 3. The bottles must be sanitary, properly prepared and stored, and must be the same brand in the early care and education program and at home.

Avoid bottles made of plastics containing bisphenol A BPA or phthalates sometimes labeled with 3, 6, or 7. Question: I have concerns about the standards recommending glass and ceramic containers due to concerns about using plastic. I had a center that had a glass bottle drop and shatter in their infant room. Answer: BPA-free plastic bottles, those labeled 1, 2, 4, or 5, can be used to avoid the use of glass.

For those child care and early education facilities that choose to use glass bottles, a relatively new option is to use a bottle sleeve with the glass bottle to reduce the risk of shattered glass. Efficacy on this product is still being proven. Overall, glass is safer than plastic with BPA. Bottles and infant foods do not have to be warmed; they can be served cold from the refrigerator. Bottles should not be left in a pot of water to warm for more than 5 minutes. Infant foods should be stirred carefully to distribute the heat evenly.

Bisphenol A BPA -free plastic; plastic labeled 1, 2, 4, or 5, or. Bottles of human milk or infant formula that are warmed at room temperature or in warm water for an inappropriate period provide an ideal medium for bacteria to grow. Infants have received burns from hot water dripping from an infant bottle that was removed from a crock-pot or by pulling the crock-pot down on themselves by means of a dangling cord. Caution should be exercised to avoid raising the water temperature above a safe level for warming infant formula or infant food.

Food safety for moms to be: once baby arrives. Updated November 8, Pediatric oral burns: a ten-year review of patient characteristics, etiologies and treatment outcomes. Int J Pediatr Otorhinolaryngol. Environmental Working Group. Guide to baby-safe bottles and formula. Updated October, Tableware and feeding utensils should meet the following requirements:. Food should not be put directly on the table surface for two reasons. First, even washed and sanitized tables are more likely to be contaminated than disposable plates or washed and sanitized dishes. Second, eating from plates reduces contamination of the table surface when children put down their partially eaten food while they are eating.

Although highchair trays can be considered tables, they function as plates for seated children.

The tray should be washed and sanitized before and after use 4. The use of disposable items eliminates the spread of contamination and disease and fosters safety and injury prevention. Single-service items are usually porous and should not be washed and reused. Items intended for reuse must be capable of being washed, rinsed, and sanitized.

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Medium-weight plastic should be chosen because lighter-weight plastic utensils are more likely to have sharp edges and break off small pieces easily. Older children can cut their mouth tissues in the same way. Foam can break into pieces that can become choking hazards for young children. Imported dishware may be improperly fired and may release toxic levels of lead into food.

There is no safe level of lead in dishware. If there is a question about whether tableware is safe and sanitary, consult the regulatory health authority or local health department.

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In centers using commercial cooking equipment to prepare meals, ventilation should be equipped with an exhaust system in compliance with the applicable building, mechanical, and fire codes. These codes may vary slightly with each locale, and centers are responsible to ensure their facilities meet the requirements of these codes All gas ranges in centers should be mechanically vented and fumes filtered prior to discharge to the outside. All vents and filters should be maintained free of grease build-up and food spatters, and in good repair. An exhaust system must collect fumes and grease-laden vapors properly at their source.

Proper construction of the exhaust system duct-work assures that grease and other build-up can be easily accessed and cleaned. If the odor of gas is present when the pilot lights are on, turn off gas and immediately call a qualified gas technician, commercial gas provider, or local gas, electric or utility provider.

Never use an open flame to locate a gas leak. Microwave ovens should be inaccessible to all children, with the exception of school-age children under close adult supervision. Any microwave oven in use in a child care facility should be manufactured after October and should be in good condition.

While the microwave is being used, it should not be left unattended. Question: I am hoping to get some clarification on the amount of bleach to use when washing dishes in a three compartment sink. Answer: The sanitizing solution referenced in Standard 4. If the facility does not use a dishwasher, reusable food service equipment and eating utensils should be first scraped to remove any leftover food, washed thoroughly in hot water containing a detergent solution, rinsed, and then sanitized by one of the following methods:. Often, sponges are used in private homes when washing dishes.

The structure of natural and artificial sponges provides an environment in which microorganisms thrive. This may contribute to the microbial load in the wash water. Nevertheless, the rinsing and sanitizing process should eliminate any pathogens contributed by a sponge. When possible, a cloth that can be laundered should be used instead of a sponge. The concentration of bleach used for sanitizing dishes is much more diluted than the concentration recommended for disinfecting surfaces elsewhere in the facility.

After washing and rinsing the dishes, the amount of infectious material on the dishes should be small enough so that the two minutes of immersion in the bleach solution or treatment with an EPA-registered sanitizer combined with air-drying will reduce the number of microorganisms to safe levels. Air-drying of surfaces that have been sanitized using bleach leaves no residue, since chlorine evaporates when the solution dries. However, other sanitizers may need to be rinsed off to remove retained chemical from surfaces.

Newly constructed, renovated, remodeled, or altered buildings should be inspected by a public inspector to assure compliance with applicable building and fire codes before the building can be made accessible to children 1. Somers, T. Public Health Reports Suppl 1 : 34— Question: Has the recommendation for minimum distance between a playground site and hazards, such as electrical transformers and high voltage power lines changed since the CFOC, 2 nd Ed.

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Answer: Yes, specific distances are no longer recommended as distances may differ according to local municipalities and states. Please consult your local ordinance for appropriate information. The environmental audit should include assessments of:. A written environmental audit report that includes any remedial action taken should be kept on file, along with appropriate follow-up assessment measures of noise, air, water and soil quality, and post-remediation to show compliance with local and federal environmental health standards.