Monday, November 29, 2010

Storage and Handling of Breast Milk


One of the best things about breast milk feeding is its flexibility in handling and storage.  Breast milk can be collected, refrigerated or frozen and used later as desired!  This allows us so much freedom… to share lunch with a friend, to have a relaxing massage, to spend a few hours shopping, etc., etc.!
All mothers should have information about the storage and handling of breast milk.  This is most easily described in a table format, so here it is:
Breast Milk
Room Temperature
Refrigerator at ≤ 39 degrees
Refrigerator Freezer
Deep Freezer
Fresh
Use within 4-6 hours
Use within 3-7 days
Use within 6 months
Use within 12 months
Frozen then thawed in refrigerator
Use within 4 hours
Use within 24 hours
Do not refreeze
Do not refreeze
Frozen then thawed in a warm water bath
Use right away
Use within 4 hours
Do not refreeze
Do not refreeze

Although the immunological composition of cold-stored milk will have been altered, it is still the next best thing to fresh breast milk for your baby.  In preparing bottles for feeding, many of us assume that milk must be warmed.  However, many babies actually enjoy chilled milk straight from the fridge!  Some prefer room temperature.  Others seem to like it slightly warmed.  To warm chilled milk, place the unopened container in a warm water bath (cup or bowl) for a few minutes.  Warning:  Because babies can be badly injured, please remember never to use a microwave to heat baby’s milk.
I have discussed how to collect breast milk (by hand and by pump) in a previous blog, so please select keywords “milk expression” or “collection” for more information.  BTW, I will be chatting very soon about introducing bottles to babies.  I hope this discussion on milk storage was helpful.  Please feel free to post any questions your may have by clicking on the comment link.  Happy milk storage!

Friday, November 19, 2010

Collection of Breast Milk for Storage


This topic came up at our Moms MoBap Morning meeting the other day.  Michelle and Crystal were wondering how and when to begin this process in preparation for their return to work.  
First of all, you can start collecting anytime after breast milk production is well established.  Many mothers begin around the third week after birth depending upon when they plan to return to work.  Expression of milk for storage should be done in the morning hours when we typically have more milk.  Always feed baby first so he gets what he needs.  It is important that you choose a time when things are quiet and you can relax.
1) Always wash your hands before you begin.
2) Expression may be done manually (by hand) or with a breast pump.
   A.  If you are expressing manually, choose a clean collection container with a wide opening (like a bowl or wide mouth jar).  Place your thumb on top and index finger below your breast.  Keeping your fingers apart, move them into place over your areola (the brown area surrounding your nipple) to about ½ inch behind where the nipple and areola meet.  Step 1, keeping your fingers in place and apart, push into your breast (toward your ribs).  Step 2, gently squeeze your fingers together as you roll them toward your nipple.  Do not slide your fingers over your skin.  Step 3, release the squeeze but keep your fingers in place.  Repeat these 3 steps over and over at a comfortably rapid pace.  Practice aiming your milk as it begins to stream into the collection container (you can see why a wide opening is helpful!).
   B.  If you are using a pump, be sure to adjust the suction control to its lowest setting.  Then, as you pump, turn it up gradually to the highest level that is comfortable.  If you are using a double electric pump, wrap your hands around the flanges as you hold them to your breasts.  This will help to maintain a good seal and allow you to massage your breasts with your thumbs.  This will increase your output.  Do not be concerned if only small amounts of milk are obtained at first.  Over time, your output will increase.
   C.  Helpful Hint:  For a mother whose baby often takes only one breast per feeding, expression may be done on one breast while baby feeds on the other.  This takes advantage of the natural milk ejection reflex where milk flows freely toward the nipple and can be easily collected.
Remember that expressing your milk should never hurt!
3)  Milk may be stored in various types of containers including polypropylene BPA-free bottles, polyethylene bags or glass.  There are containers available for purchase specifically designed for breast milk storage.  Here are some guidelines for storage:
   A. Freshly expressed milk can be kept at room temperature if it will be used within 4-6 hours.
   B.  It can be stored in the refrigerator and used within 7 days.
   C.  If it will be frozen, store it in portions of 1, 2 and 3 ounces.  Until you get an idea of how much baby will take in a feeding, you won’t have to waste milk left in the bottle.
   D.  Because milk expands when frozen, leave an air space between the milk and the top of the container.  We wouldn’t want it to burst and be spoiled!
   E.  Milk should be stored in the bottom and back of the freezer, never on the door.
Michelle and Crystal, I hope this helps.  Next week I will chat about handling of stored breast milk, so keep an eye out!

Thursday, November 11, 2010

On the Issue of sleep


Published recently in the journal Pediatrics, researchers report that they found no difference in the amount of sleep a mother receives whether she is breastfeeding or formula feeding her baby.  In their study, 80 new mothers were monitored electronically over a ten-week period beginning at 2 weeks post-partum.  Additionally, the mothers completed daily diaries.  Researchers measured total sleep and time awake, sleep quality, fatigue and daytime sleepiness.  In addition to finding no difference in the amount of sleep, the researchers found no difference in fatigue or daytime sleepiness.
The fact is many of us have long believed that breastfeeding mothers get as much sleep (if not a little more) and perhaps a better quality of sleep than their formula feeding counterparts.  One reason may be that when we breastfeed, the hormone relaxin is stimulated and released from our brain.  Relaxin helps us to feel more relaxed.  So, we tend to fall asleep very easily after feedings, nature’s way of encouraging rest for a new mom.  Furthermore, little effort is required to bring baby to breast when he awakens for a feeding.  And the milk is already warm and waiting!   No formula mixing, warming, etc. is necessary.  More time to sleep!  Finally, breastfed babies tend not to over-feed or take in large amounts of air during feedings, so they are not prone to the discomforts of stomach distention and aerophagia commonly seen in formula / bottle-fed infants.  In the event you’d like to read more, I have added a couple of links to more information about the study.  However, please don’t lose valuable sleep over this.  Remember the old adage “sleep when your baby sleeps” and you should be fine!
Happy Sleeping!