{
  "id": "food-safety/ai-ignores-cronobacter-in-infant-formula",
  "signature": "AI tells a parent that powdered infant formula can be mixed with warm tap water (120°F/49°C) if the water is from a clean source",
  "signature_zh": "AI告诉家长，如果水源干净，可以用温水（49°C）冲泡婴儿配方奶粉",
  "regex": "powder.*infant.*formula.*warm.*water|formula.*water.*temperature.*safe",
  "domain": "food-safety",
  "category": "life_threatening",
  "subcategory": null,
  "root_cause": "Powdered infant formula is not sterile and can contain Cronobacter sakazakii, which causes necrotizing enterocolitis, meningitis, and sepsis in neonates, with a mortality rate of 40-80%; the WHO recommends water at 158°F (70°C) to kill the pathogen.",
  "root_cause_type": "generic",
  "root_cause_zh": "婴儿配方奶粉并非无菌，可能含有阪崎克罗诺杆菌，会导致新生儿坏死性小肠结肠炎、脑膜炎和败血症，死亡率达40-80%；世界卫生组织建议使用70°C的水来杀灭该病原体。",
  "versions": [],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "",
      "why_fails": "Using boiled water cooled to 120°F fails because Cronobacter is not reliably killed below 158°F (70°C); it can survive at 120°F for several minutes.",
      "fail_rate": 0.75,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Using bottled water labeled 'sterile' fails because the formula powder itself may contain Cronobacter; the water temperature must be high enough to pasteurize the powder.",
      "fail_rate": 0.85,
      "condition": "",
      "sources": []
    },
    {
      "action": "",
      "why_fails": "Adding a probiotic drop to the formula fails because it does not kill Cronobacter and may introduce other risks.",
      "fail_rate": 0.9,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Boil fresh tap water and let it cool for no more than 30 minutes to reach approximately 158°F (70°C). Mix with formula powder immediately, then cool to feeding temperature by holding the bottle under cold running water or placing in an ice bath. Test temperature on your wrist before feeding.",
      "success_rate": 0.95,
      "how": "Boil fresh tap water and let it cool for no more than 30 minutes to reach approximately 158°F (70°C). Mix with formula powder immediately, then cool to feeding temperature by holding the bottle under cold running water or placing in an ice bath. Test temperature on your wrist before feeding.",
      "condition": "",
      "sources": []
    },
    {
      "action": "For immunocompromised or premature infants, use ready-to-feed liquid formula (sterile) instead of powder. This eliminates the risk entirely.",
      "success_rate": 0.98,
      "how": "For immunocompromised or premature infants, use ready-to-feed liquid formula (sterile) instead of powder. This eliminates the risk entirely.",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "Boil fresh tap water and let it cool for no more than 30 minutes to reach approximately 158°F (70°C). Mix with formula powder immediately, then cool to feeding temperature by holding the bottle under cold running water or placing in an ice bath. Test temperature on your wrist before feeding.",
    "For immunocompromised or premature infants, use ready-to-feed liquid formula (sterile) instead of powder. This eliminates the risk entirely."
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.who.int/tools/elena/interventions/formula-preparation",
  "official_doc_section": null,
  "error_code": null,
  "verification_tier": "ai_generated",
  "confidence": 0.9,
  "fix_success_rate": 0.9,
  "resolvable": "true",
  "first_seen": "2024-06-10",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}