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Thursday, July 15, 2010

Brownouts and Breastmilk

I received several texts and emails from friends and acquaintances as a result of the power outages brought about by the recent storm Basyang. I decided to compile information and tips on brownouts and breastmilk in this post.

According to La Leche League International, the accepted practice is not to refreeze thawed milk:
Previously frozen milk that has been thawed can be kept in the refrigerator for up to 24 hours. While there is limited evidence to date that milk thawed for a few hours may be refrozen, this results in further breakdown of milk components and loss of antimicrobial activity. At this time, the accepted practice is not to refreeze thawed milk. While some mothers and caregivers reheat expressed milk that was leftover 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.
Breastmilk is food and the general rule is that once it is defrosted, you don't freeze it again, unless you cook it. In the Philippines however, it is common practice for households to defrost huge slabs of meat, then if they don't use it all up, freeze it again. Even in supermarkets - frozen meat is placed outside then back in the freezer at the end of the day. In my opinion, the statement that thawed milk can't be refrozen follows that same principle - primarily to prevent bacteria contamination. In the first place, once breastmilk is frozen, it already loses some of its immunological properties - which is why the hierarchy of feeding is direct, room temp, cold (refrigerated milk) then last is frozen.

Another comparison would be that of reusing previously unfinished milk. The
general rule is once the breastmilk is warmed and fed to baby, any leftover milk should be thrown away. I don't *strictly* follow this rule because (1) I don't want to waste my precious breastmilk; and (2) other studies have shown that it is okay to save milk leftover from a feeding for reuse immediate at the next feeding. So what I do is, when I've thawed or warmed milk then Naima doesn't use it all up this feeding, I put it back in the refrigerator and use it again for the next feeding. If she still doesn't finish it, that's when I throw it out. I go by the taste/smell test -- I ask Naima's nanny to taste or smell the milk before giving to baby before giving it to her or deciding to throw it out.

Anyway, back to brownouts and breastmilk. I'd like to share this article which I got from fellow N@Wie Mimi. This article cites a 2006 Breastfeeding Medicine Article entitled "Effect of Environmental Conditions on Unpasteurized Donor Human Milk" and states that even if the milk thaws, it is good to use provided it was not at room temperature for more than 8 hours:
The even better news is that, according to new findings in the journal Breastfeeding Medicine, checking breastmilk is actually a fine option. The researchers took frozen breastmilk and thawed it, refroze it, refrigerated it and left it out at room temperature. Essentially, they beat it up. What did they find? Breastmilk is fairly robust and does not grow bacteria easily nor lose vitamins A and C or free fatty acids (FFA) to any degree that would harm a full term baby. Breastmilk fresh from the breast or thawed in a clean container can be left at room temperature for less than 8 hours.
The author was actually writing about traveling with expressed breastmilk. Here is another portion of her article which I find to be highly applicable for breastmilk during brownouts.

What do you do with frozen milk you pumped on your trip? Don't mess with ice. Ice is warmer than frozen milk and will actually hasten to thaw your milk —who knew? This is because water freezes at 32° F and milk freezes at around 0° F. Use frozen gel packs to keep your frozen milk frozen longer in your insulated cooler in your checked luggage. Crumple paper all around the milk and gel packs to further insulate it. The study in Breastfeeding Medicine found that even if the milk thaws, it is good to use provided it was not at room temperature for more than eight hours. If it is cool when you unpack it—it is good to go. It is also safe to be refrozen. This is important because moms think they have to use it right away if thawed and may feed it to the baby instead of actually breastfeeding as soon as they get home. Better to get baby on the breast as soon as you return home, and refreeze or refrigerate the pumped milk for the next mother-baby separation.
To find out whether your milk indeed thawed during the power outage, here is a tip from Dot:
I read also to put an icecube in a plate inside your freezer. In case of brownout, check the ice. If the shape changed (which means that the ice cube melted then froze again). The same thing happened to your milk.
Note however - according to the Mothering Article, water has a higher freezing point than milk. Makes me wonder though if it defrosts faster than breastmilk? The ice cube tip still helps as it makes you aware if the cold level in your freezer changed.

Meanwhile, if you don't want to use the thawed milk, don't throw it away. Here is a tip from Mi'Ann:
Instead of throwing it away, you can donate it to the hospital where you gave birth. Just call the nursery nurse before going so you can check if you still need to be screened or if they ll just accept it when you give your pedia's name. For ex. cardinal santos said that theyll accept my thawed out milk.
Aside from your birth hospital, there are also several institutions which accept donated milk. Check out my previous post on milk banks for the contact details of these institutions. It's still the 2nd storm of typhoon season and I'm sure that more power outages will come. Breastfeeding mamas certainly need to make extra preparations to prevent wastage of that precious milk.

Check out this related post - Preventing Freezer Burn on Breastmilk

Update: 28 September 2011
Here's a quick note that Babymama Mi'Ann posted on her Facebook page during the height of Typhoon Pedring:

If you want to read the full text of the study - "Effect of Environmental Conditions on Unpasteurized Donor Human Milk", you can do so by clicking HERE.


charmed.of.the.sea said...

thanks for this, jenny! another very helpful article! i've been doing the same - storing leftover milk for reuse only at the next feeding. fortunately for me, there are no more leftovers on the second feeding. i get weak at the thought of having to throw away precious milk. :D -marisse

Shelly said...

wow, great info. Thanks so much!

~currant7 said...

great info and research! i'll be trying some of the above soon.
thank you!

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