title: Cleaning and sterilisation of infant feeding equipment: a systematic review.
abstract: OBJECTIVE
  To assess the clinical and cost-effectiveness of different methods of cleaning and sterilisation of infant feeding equipment used in the home.
  
  
  METHODS
  Systematic review of studies from developed countries on the effectiveness of methods of cleaning and sterilisation of infant feeding equipment used in the home. A brief telephone survey of UK-based manufacturers of infant feeding equipment and formula to ascertain the evidence base used for their recommendations, and a comparison of current relevant guidelines in developed countries, informed the work.
  
  
  RESULTS
  National guidelines from six countries demonstrated variation and lack of evidence to support current guidance. Manufacturers did not report evidence of effectiveness to support their recommendations. Nine studies were identified; eight conducted between 1962 and 1985 and one in 1997. All had methodological weaknesses. Hand-washing was identified as fundamentally important. Health professionals were reported as not providing appropriate education on the importance and methods of cleaning and sterilisation. Mothers of subsequent babies and women from lower socio-economic groups were less likely to follow recommended procedures.
  
  
  CONCLUSIONS
  There is a lack of good-quality evidence on effective ways of cleaning and sterilising infant feeding equipment in the home. The evidence base does not answer the question about which of the methods in common use is most effective or most likely to be used by parents. Hand-washing before handling feeding equipment remains important. Further research on the range of methods used in the home environment, including assessment of the views of parents and carers, is required.
authors.affiliation: Mother and Infant Research Unit, Department of Health Sciences, Area 4, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK. mjr505@york.ac.uk
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Renfrew
authors.forename: Marie
authors.initials: M
authors.lastname: McLoughlin
authors.forename: Alison
authors.initials: A
authors.lastname: McFadden
mesh_terms: D017028:Caregivers / Q000523:psychology*; D004866:Equipment Contamination / Q000517:prevention & control*; D006235:Hand Disinfection; D006801:Humans; D006920:Hygiene; D007223:Infant; D015370:Infant Equipment / Q000592:standards*; D007225:Infant Food / Q000592:standards*; D007231:Infant, Newborn; D012959:Socioeconomic Factors