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Wednesday, December 30, 2009

Milk Storage - Part I

As a working mom, knowing how to properly store milk was one of the very first thing I mastered. Properly storing milk is very important especially since I was not one of those moms who was able to produce 50oz or so of milk everyday. It is also important that the caretaker be taught how to correctly store, thaw, handle and feed expressed milk. During my August talk in Davao, one of the topics I focused on was milk storage. I made a summary of various guidelines I relied on in deciding how to store Naima's milk. I've had several inquiries about milk storage and recently learned about a donee having the throw away several ounces of milk because her pediatrician felt that the milk was improperly stored. So I decided to post the summary I previously compiled to help nursing moms avoid wastage.

For freshly expressed into a closed container, here is the guide which I follow:
  1. Room Temperature - 6-8 hours at 25°C# --> actually, I am conservative and store at 6 hours only, given the warm temperature that we have in the Philippines.
  2. Insulated Cooler with Icepacks - 24 hours at 15°C#%
  3. Refrigerator (store at back, away from door) - Up to 5 days at 4°C#
  4. Freezer (store at back, away from door/sides)
  • 2 weeks in freezer compartment inside refrigerator (-15°C) #
  • 3-6 months in freezer with separate door (-18°C) #
  • 6-12 months in deep freezer (-20)°C#
If milk has been previously frozen – thawed in refrigerator but not warmed, milk can be stored for 4 hours or less (keep for next feeding) at room temperature. It can be stored in refrigerator 24 hours (from the time milk is completely thawed) but cannot be refrozen.
If the milk was thawed outside the refrigerator in warm water, it can be stored only for completion of feeding at room temperature. If refrigerated, it can still be stored for 4 hours or until next feeding but also cannot be refrozen.
Meanwhile, if your baby has begun feeding, a lot of authorities recommend that the milk be used only for the completion of feeding then should be discarded. In our case, if Naima does not finish the milk in the bottle, I allow yaya to keep it in the refrigerator for the next immediate feeding on the same day. If the milk is still not consumed, then yaya throws the milk out. Please note however that this practice is not recommended and if you do decide to keep the milk for the next feeding, taste or smell the milk before giving to baby to ensure that the milk is not spoiled. (see note from LLLI below)

*General information is taken from the Australian Breastfeeding Association, unless otherwise indicated.
#The Academy of Breastfeeding Medicine
%Kellymom
@According to La Leche League, the accepted practice is not to refreeze thawed milk. While some mothers and caregivers reheat expressed milk that was unconsumed and refrigerated after a previous feeding, there is no research on the safety of this practice. There is also no research about whether freshly expressed milk left unfinished at room temperature should be discarded, or can be saved for a short time (perhaps up to one hour as reported by some mothers and caregivers) to finish the feeding if the baby wakens from having fallen asleep or still appears hungry.

Update:
In an article to be published in the Journal of Pediatrics, January 2010 issue, researchers led by Dr. Richard J. Schanler of North Shore University Hospital in New York have found that fresh breast milk can be refrigerated for up to 96 hours without compromising its integrity.

Over that time, the researchers found either no or minimal changes to the breast milk's composition -- including bacterial levels, acidity, immune-system proteins from the mother, beneficial fatty acids and protein.
Part II here.

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