Sterilising Baby Bottles - Is It Necessary?

As a breastfeeding mum, I find the after-use washing and sterilising of bottles and breast pump truly tedious and bothersome. Imagine my surprise (and quiet delight) when, during my stay at the hospital after giving birth to my second baby, one of the nurses matter-of-factly told me that sterilising any feeding equipment (including dummies and nipple shields) is unnecessary. I just need to give them a good wash with hot, soapy water.

Say what…? Just to be sure I wasn’t hearing things, I confirmed this with another nurse. And she said the same thing. This was a groundbreaking discovery for me and I decided to look into the matter further because all the mums I know are faithfully sterilising everything. Turns out, this matter isn’t so black and white, and there are definitely conflicting opinions.

So, to the answer the long-debated question:

Is It Necessary to Sterilise Baby Feeding Equipment?

Let us first look at the ones who are in favour of sterilising.

NHS (UK) Says Yes

The official guidelines on NHS Choices, UK’s largest health website, recommends sterilising baby feeding equipment until 12 months old. The last review of this guideline is in October 2016, which is fairly recent and it means they are currently still in support of this stance on sterilisation.

Pregnancy Birth & Baby (Australia) Says Yes

Last reviewed in April 2016, the site is in support of sterilising for the first year of baby’s life.

Baby Centre (UK & Australia) Says Yes

Similar to the NHS, Baby Centre recommends sterilising for the first 12 months. It even goes as far as to recommend a three-step procedure to follow after EVERY FEED.

Thoroughly wash all feeding equipment in hot soapy water.
Sterilise using steam steriliser, microwave steriliser, boiling, or a sterilising solution.
Leave sterilised equipment in steriliser until next feed to maintain its sterilised state.

Here’s where their recommendations get a bit pedantic I reckon:

When you need to make a feed, clean and disinfect the work surface you’re going to use. Then wash and dry your hands. Take a sterilised bottle from the steriliser and put it on the clean surface. Use sterilised tongs to place the teat, lid, retaining ring, and cap out ready, preferably on the upturned lid of the steriliser.

Make sure you don’t leave the sterilised empty bottles out for long, as they will quickly lose their sterility. This is not usually a problem when sterilisers have built-in storage facilities and bottles can be removed when required. If you can’t do this, re-sterilise any equipment that you’ve taken out and haven’t used straight away.

(Hmm not that I know for sure, but it almost feels as if they’re purposely making it incredibly time-consuming to bottle-feed, just to deter mums from using it and exclusively breastfeed instead.)

Interesting, it seems that those who are in support of sterilising are primarily large health organisations or websites based in the UK and Australia. I know for a fact that Australia tends to follow the recommendations of those in the UK, so if the UK is strongly recommending mums to sterilise feeding equipment, it is unsurprising that Australia is taking the same stance.

However, in the United States, most people seem to have a different opinion on the matter.

The American Academy of Pediatrics Says No

According to this Q&A, the American Academy of Pediatrics merely recommends washing feeding equipment after every feed with hot water and soap. If the water is safe enough to drink, it’s safe enough for cleaning.

The U.S Food & Drug Administration (FDA) Says No

The FDA guidelines for cleaning a breast pump say that sterilisation is unnecessary to keep breast pump parts safe and sanitary. This can be done by thoroughly washing away germs and bacteria with liquid dishwashing soap and warm water.

WebMD Says No

This peer reviewed article explains that back in the days when water supplies were not reliably clean, it was necessary to sterilise bottles and teats. Nowadays, however, this is unwarranted.

‘Ask Dr Sears’ Says No

The article on transporting and storing breast milk also says that breastfeeding mums do not have to worry about sterilising pump parts and bottles. Sterilising is only important for sick or hospitalised babies.

BetterHealth (Australia) Says Yes & No

BetterHealth is a website endorsed by the Victoria State Government and they have recommended sterilising baby bottles, but says it is not necessary for pumping equipment.

Mum Forums Say No

When I did a Google search for “Is it necessary to sterilise baby bottles”, the first few mum forums that popped up quickly showed that a lot of Aussie mums aren’t actually sterilising despite widespread recommendation.

These threads on EssentialKids, BubHub and even this one on the Australia Breastfeeding Association forum date back to almost a decade ago, and even then a lot of mums were already dismissing sterilising of bottles and other feeding equipment, even toys and pacifiers. Many say that even nurses in neonatal wards do not sterilise!

The Verdict

At the end of the day, sterilising feeding equipment is just another recommendation to cover those “just in case” situations. If you want to get scientific regarding germs and our health, there is always the Hygiene Hypothesis to support skipping the sterilisation step.

The general consensus seems to be that sterilising is not a necessity if:

Baby is full term and healthy
Water is safe to drink (then it’s safe to use for cleaning)
Feeding equipment is cleaned thoroughly after each use to ensure there is no milk residue

In any other circumstances, such as a preterm or sick baby, sterilisation is a must.