You may need a separate formula preparation room.

To minimize formula-related microbial infections in neonates1, hospitals are shifting from bedside to centralized formula preparation, and converting from powdered formula to sterile ready-to-feed formula in the NICU. In addition, they are adopting aseptic techniques in formula preparation and implementing a control system for the storage, preparation and distribution of mother’s own milk.

The provision for a separate NICU formula preparation room with work counter, refrigerator, formula sterilizer, storage facilities and handwashing station was included in the 2010 FGI Guidelines for the Design and Construction of Hospitals and Outpatient Facilities, and is also requirement in the 2013 California building code2. The 2014 FGI Guidelines revised the recommendation for the formula preparation work area3 to provide a “flow of materials from clean to soiled to maintain aseptic preparation space.”

Implementing these changes will have an impact on NICU design in terms of square footage, layout, equipment and staffing. Specific areas for decontamination, formula prep and clean storage are being requested. Equipment to support the functions in these areas include laminar flow hoods, laboratory grade refrigerators and freezers, commercial grade washers, steam sterilizers and fluid warmers. The control system for storage and distribution of mother’s milk includes computers, bar code readers, scanners and printers.

This is just one aspect to consider when planning a NICU. Whether it’s a single department renovation or a million square foot medical center, GBA has the experience to ensure your project is successful. Give us a call to discuss.

Terry Esquibell, BS
Vice President, GBA
Direct Line: 682-587-1070

1. In a 2008 study by the American Dietetic Association, formulas prepared at bedside were found to be 24 times more likely to show contamination than those prepared in a central location and that powdered formulas were 14 times more likely to be contaminated than ready-to-feed formulas. This study suggests that centralized feeding preparation results in a significant decrease in prevalence of microbial growth. Because contamination risk increases significantly with the use of powdered formulas, sterile liquid formulas should be considered when possible to minimize risk of microbial exposure in the neonatal intensive care unit population.

2. California Building Code, Section 1224. Formula preparation room.

3. Facilities Guidelines Institute, Guidelines for the Design and Construction of Hospitals and Outpatient Facilities 2014, Section 2.2- Infant feeding preparation facilities