This requirement in the UK came about due to the work of Baby Milk Action and the Baby Feeding Law Group (BFLG), a coalition of UK health worker and mother support groups.
The issue of powdered formula not being sterile was one of the issues we said should be addressed when our Infant Formula and Follow-on Formula Regulations were updated in 2007. The requirement did not make it into the law, but was included in Guidance Notes on how to interpret the regulations produced by the Food Standards Agency. These have come under the Department of Health since 2010 when there was a change in government.
The labels in the UK give instructions to use boiled water that has not cooled for more than 30 minutes (which the Food Standards Agency found was more readily understandable than saying above 70 deg.C).
Much that is included in the Guidance Notes is ignored by the companies and not enforced, but the instructions have been changed. We have campaigned on this over the years, highlighting labels that had not changed, for example.
The Guidance Notes can be found here:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/204314/Infant_formula_guidance_2013_-_final_6_March.pdf
The specific section is this:
----
Labelling relating to the preparation, storage and disposal of infant formula and follow-on formula
24. Regulation 17 (1)(d) and 18(1)(d) require that instructions are provided for appropriate preparation, storage and disposal of the product. The Department recommends that these instructions should include information noting that:
Powdered infant formulae and follow-on formulae are not sterile, and as such can contain harmful bacteria. It is therefore important to be very careful when preparing formula to reduce the risks. Boiled tap water (not bottled water) cooled for no more than 30 minutes should be used to prepare infant feeds.
All equipment used for feeding and preparing feed must be thoroughly cleaned and sterilised before use, and bottles should be made up fresh for each feed, as storing made- up formula milk may increase the chance of a baby becoming ill.
—
In our submission during the consultation, we highlighted that labels and information from companies were undermining the public health advice on reconstituting formula from WHO and the Food Standards Agency. You can find the full submission here (search the document for “sterile” for this specific information):
http://archive.babymilkaction.org/pdfs/bflgweb1007.pdf
There are other countries that have also taken action to implement the requirement. The Philippines is an example and we campaigned with IBFAN partners in the Philippines to stop Nestlé overturning the regulations. There is an image of the Philippines label on the campaign page here. The label warns “There is a likelihood that pathogenic microorganisms will be in this product if it is prepared and used inappropriately”:
http://www.babymilkaction.org/philippines2013
We have a sheet of Nestlé labels from around the world that does not look at the instructions, but the health claims used. This may be useful as it shows how Nestlé gets away with as much as it can where regulations are not implemented or enforced. See:
http://archive.babymilkaction.org/pdfs/nestlelabels13.pdf
Nestlé’s claims to the public regarding labelling are analysed in this response from the company:
http://www.babymilkaction.org/nestle-response-2014