title: A survey on knowledge and self-reported formula handling practices of parents and child care workers in Palermo, Italy.
abstract: BACKGROUND
  Powdered infant formula (PIF) is not a sterile product, but this information appears to be poorly diffused among child caregivers. Parents and child care workers may behave in an unsafe manner when handling PIF.
  
  
  METHODS
  This study involved parents and child care workers in the 24 municipal child care centres of Palermo. Knowledge and self-reported practices about PIF handling were investigated by a structured questionnaire. A Likert scale was used to measure the strength of the respondent's feelings. Association of knowledge and self-reported practices with demographic variables was also evaluated.
  
  
  RESULTS
  42.4% of parents and 71.0% of child care workers filled in the questionnaire. Significant differences were found between parents and child care workers for age and education. 73.2% of parents and 84.4% of child care workers were confident in sterility of PIF. Generally, adherence to safe procedures when reconstituting and handling PIF was more frequently reported by child care workers who, according to the existing legislation, are regularly subjected to a periodic training on food safety principles and practices. Age and education significantly influenced the answers to the questionnaire of both parents and child care workers.
  
  
  CONCLUSIONS
  The results of the study reveal that parents and child care workers are generally unaware that powdered formulas may contain viable microorganisms. However, child care workers consistently chose safer options than parents when answering the questions about adherence to hygienic practices.At present it seems unfeasible to produce sterile PIF, but the risk of growth of hazardous organisms in formula at the time of administration should be minimized by promoting safer behaviours among caregivers to infants in both institutional settings and home.
authors.affiliation: Department of Sciences for Health Promotion G D'Alessandro, Section of Hygiene, University, Via del Vespro 133, I-90127 Palermo, Italy. gcalamusa@unipa.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Calamusa
authors.forename: Rosalia Maria
authors.initials: RM
authors.lastname: Valenti
authors.forename: Ivana
authors.initials: I
authors.lastname: Guida
authors.forename: Caterina
authors.initials: C
authors.lastname: Mammina
mesh_terms: D000328:Adult; D017028:Caregivers / Q000193:education*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D007223:Infant; D007224:Infant Care / Q000379:methods*; D041943:Infant Formula / Q000592:standards*; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods*; D007239:Infections / Q000453:epidemiology / Q000209:etiology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000193:education*; D011208:Powders; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
chemical_list: D011208:Powders