What is the bacteria Enterobacter sakazakii and how can I protect my new baby?

Powdered Infant Formula Is Not Sterile

While this statement is not widely known by new mothers nor publicized by the formula industry, it is true nonetheless. Because it is not commercially sterile, powdered baby formula may contain a bacteria called Enterobacter sakazakii (or E. sakazakii).

Some Conditions Caused By E. Sakazakii Infection

A baby infected with E. sakazakii may develop sepsis (a serious blood stream infection), or necrotizing enterocolitis (a chronic inflammatory disease of the intestines), or meningitis (an inflammation of the membranes surrounding the brain and spinal cord).

The fatality rate among premature newborn babies infected with E. sakazakii is reported to be as high as 33%. Of those premature babies who survive infection with E. sakazakii, many are left with devastating, permanent brain injury. Such babies cannot usually walk, talk, or play. Many do not survive childhood. What can you do to prevent this potentially fatal infection from harming your premature newborn? The most obvious answer is to avoid powdered infant formula.

Most doctors and the World Health Organization agree that breastfeeding is the best way to provide healthy nutrition to infants. While powdered formula is an acceptable – but not ideal – substitute for breast milk, all infants who receive powdered formula are at risk for E. sakazakii infections.

This risk is much greater for neonates (newborn children, especially a child less than one month old), low-birth-weight, premature, and immunocompromised infants. If you must feed your baby formula, consider using pre-mixed, liquid formula. Unlike its powdered counterpart, liquid formula has been pasteurized and is sterile.

Follow FDA Recommended Precautions

When using powdered formula, take the time to familiarize yourself with FDA (Food and Drug Administration agency of the U.S. Federal government) recommendations regarding preparation and use. For example, prepare only a small amount of the powdered formula for each feeding to reduce the quantity and time that the formula is held at room temperature for consumption. This reduces the risk of infection by reducing the potential for significant microbial growth.


Discuss with your doctor or trusted health-care provider the pros and cons of powdered infant formula, liquid infant formula, and breast milk. And congratulations on your new baby!