追加：第 20 节第 5 条（冲奶粉用 70 ℃ 以上的水）补争议和热水的营养代价 · 核实记录（2026-10-12）
任务来源：issue #120。读者说很多品牌奶粉罐上写的水温和 70 ℃ 不一致，水温高可能损失营养，建议补争议。读者给的依据是《消费指南》2013 年的记者稿（m.cqn.com.cn），属于二手转述，没有引，改为逐一找它提到的原始文件。
落点：改第 20 节第 5 条本身，标题、条号、成本标签都不动。收益栏补「热水的代价」一段，说人话补一句，备注开头加「争议」，来源栏加四份。
文献
| 来源 | 复核 | 关键数字原文 |
|---|---|---|
| WHO & FAO (2007). Safe preparation, storage and handling of powdered infant formula: guidelines（条目原有来源）。IRIS PDF，pdftotext 抽文本 | 是 | 「Data presented at the meeting on the reduction in vitamin levels on reconstitution with boiling water showed that vitamin C is the only vitamin that is significantly affected (reduction ranging from 5.6 to 65.6% in the four powders tested). However, to offset the loss of vitamins during the shelf-life of the product, all dry formulas actually contained higher levels of vitamin C than was labelled. After reconstituting with boiling water, three of the four formulas still contained higher levels than labelled. The fourth, after a vitamin C reduction of 65.6%, contained 9.0 mg/100 calories. This level is still greater than the minimum level of vitamin C (8 mg/100 calories) required by the Codex Standard for Infant Formula」；「as the results of only one study were discussed, the meeting did not agree to make any specific recommendations on this issue」；「The ESPGHAN Committee on Nutrition disagreed with the use of boiling water ... because of the possible adverse effects on nutrients such as vitamins (Agostoni et al., 2004)」 |
| BfR (2022). Updated BfR Opinion No. 009/2022 of 29 March 2022。https://doi.org/10.17590/20220510-104706 | 是（官网 PDF，pdftotext 抽文本） | 「water temperatures ranging from roughly 20 °C to 50 °C are appropriate for full-term, healthy infants」；「most manufacturers recommend reconstitution of the formula at a temperature between 40 °C and 50 °C (BVL, 2011)」；「In practice, the originally 70 °C water cools down too rapidly to effectively kill off Cronobacter bacteria (Losio et al., 2018). Preparation with water of at least 70 °C also involves other health risks, such as the loss of nutrients due to heat or the risk of an infant being scalded during consumption.」；「For full-term, healthy infants with a normal birth weight, the risk of contracting an infection with Cronobacter is considered to be extremely low if minimally contaminated formula is prepared and fed directly.」；低体重（under 2,500 g）和免疫力低下的孩子「the decision must be made on a case-by-case basis」 |
| Agostoni C, et al. (2004). JPGN 39(4):320-322。https://doi.org/10.1097/00005176-200410000-00002 | 摘要（Europe PMC） | 摘要没有写维生素。「担心破坏维生素」按 WHO 2007 指南对它的转述写 |
| Silano M, Paganin P, Davanzo R (2016). Ital J Pediatr 42:17。https://doi.org/10.1186/s13052-016-0228-9 | 是（Europe PMC 全文） | 「the main concern of the ESPGHAN experts is that the hot water may inactivate the vitamins and kill the probiotic strains contained in the formula」；结论「it is advisable the use of "70 °C" warm water for the dilution of PIF, especially for feeding preterm and low birth weight infants」 |
| Losio MN, et al. (2018). JPGN 67(4):543-546。https://doi.org/10.1097/MPG.0000000000002100 | 是（Europe PMC 全文） | 摘要「In these conditions we observed a survival of both pathogens, indicating that the suggested recommendations may be not enough」；「even if starting from water at 70°C a rapid cooling may occur」 |
定级与取舍
- 证据等级仍是 A，加「争议」：70 ℃ 能杀菌的实验数字没被推翻。分歧在于足月健康的孩子值不值得为一个极低的风险用热水，以及家里冲的时候实际能不能保住 70 ℃。
- 「凉得快」和条目里的 73.8 ℃ 做法不矛盾：Losio 测的是直接用 70 ℃ 的水，凉下来后杀菌不够；条目按 Beary 2025 让水降到约 73.8 ℃ 就放奶粉，奶液还在 70 ℃ 以上。备注照写德国的理由，没有拿它反驳条目的做法。
- 维生素损失的数字是开水冲的，比 70 ℃ 更狠，所以写成「测过的奶粉仍够标准」不算夸大。只有一项研究，收益栏照 WHO 原文写了「没有就此下结论」。
- 益生菌的担心只有 Silano 对 ESPGHAN 的转述，没有量化数字，只在备注里提一句。
- 没改标题：「70 ℃ 以上」仍是世卫、联合国粮农组织的建议，标题只许加字。足月健康的孩子按罐上温度冲的说法放在备注。
- 国内官方对冲奶水温的说法没查到原文，没写。