Prepare Breast Milk

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Many nursing mothers choose to pump and store breast milk so that their baby will still receive breast milk when they are not available, like when they are at work or sleeping. If you choose to store breast milk it is important that it is stored and prepared properly before it is given to the baby.[1]

Steps

Expressing Breast Milk

  1. Wash your hands before you handle or express breast milk. This is very important to prevent bacteria on your hands from contaminating the milk. Babies’ immune systems are not as well-developed as those of adults, so bacteria that wouldn’t make older people sick can be harmful to an infant.[2]
    • Scrub your hands thoroughly with soap. Don’t forget to include under your nails and between your fingers.
    • Rinse your hands in warm running water. Let the water run over your hands and wash away any dirt or bacteria that may be there.
    • Dry your hands with a clean towel.
  2. Start the milk flow. If you express or pump at the times when your baby would normally feed, this will help you to continue making milk on schedule for your baby. You do not need to wash your breast or nipple before expressing milk. You can start the milk flow by sitting in a quiet place and thinking about your baby. If you have trouble, you may want to try:[3]
    • Looking at a photo of your baby
    • Holding a blanket or item of clothing that smells like your baby
    • Gently massaging your breasts or nipples
    • Putting warm, wet compresses on your breasts
  3. Express milk by hand. This technique has the benefit that it is convenient and free. You don't need to bring any specialized equipment with you. It may require some practice. Once you are good at it, it can be as fast as pumping.[4][5]
    • Put your thumb and forefinger on opposite sides of your areola.
    • Move them backwards against your chest.
    • Gently squeeze your fingers together while moving them slightly towards your nipple. Your fingers should not slide along your skin.
    • Release the pressure. Continue this process while moving your fingers to different positions around your areola.
    • Collecting the milk can be difficult when expressing milk by hand. Try expressing into a large, clean bowl or a sterilized container with a large mouth — you may want to place these containers on a table that is about hip-height or hold them with one hand. You can also express into a milk storage bag, holding the bag with one hand and using the other hand to express the milk.[6]
  4. Pump following the manufacturer's instructions. There are two main types of pumps: manual and electric.[7]
    • Manual pumps require that you work it with your hand. It requires some skill and practice. This option is generally best if you only need to pump occasionally. It may also increase your risk of a breast infection. Manual pumps generally cost $50 or less.
    • Electric pumps run on batteries or electricity. They can also pump both breasts simultaneously. They usually cost between $150 to more than $250.
    • Pumps must be washed with soap and water between uses.
  5. Do not use a secondhand pump. There is a difference between pumps that are available for purchase and pumps that are available to rent. Rental pumps are closed system pumps, which means that there are certain parts of the pump that never come into contact with the milk. A purchase pump is an open system, which means that the pump motor comes into contact with the milk. Unfortunately, the way the open system pumps are built means they cannot be completely sterilized, like a rental pump. So, if you use a secondhand pump, your baby may receive particles of another mother's milk.[8][9]
    • Viruses such as HIV (AIDS) can be spread through breast milk.
    • Rental pumps can be obtained from hospitals or breastfeeding organizations.
    • Breast pumps must be covered by health insurance under the Affordable Care Act.

Storing Breast Milk

  1. Prepare a clean container to store expressed milk. It is important that the container be sterile and strong enough that it won’t break. It should also be BPA-free.[10][11][12]
    • You can store the milk in a sterile bottle. The cap must be water- and airtight so that it cannot spill or get contaminated. Bottles with screw tops work well. Bottles have the advantage that they are stronger and less prone to tearing and leaking than bags. Because milk expands as it freezes, do not fill the container to the brim.
    • Bottles can be sterilized by using a commercial cold water sterilizing solution, steam sterilizing, or boiling. Follow the bottle manufacturer’s directions for how to sterilize your bottles. The directions may instruct you to boil the bottle for several minutes. Steam sterilizers can be purchased at your local pharmacy.
    • You can purchase bags designed for storing breast milk at your local pharmacy or any store that carries baby items. Bags can be put into a plastic container to protect them while they are stored.
    • Do not use ordinary thin plastic bags or formula bottle bags because these are not as strong. They are more prone to tearing.
    • Write the date on the container so that you will know how long it has been stored. If you are providing the milk to someone else, like a day care agency, label it with the child’s name.
    • You may also want to write how many ounces you pumped so that you will know how many bags you need to thaw at a time.
  2. Do not add fresh milk to frozen milk. The fresh milk is warmer and it will cause the frozen milk to partially thaw, providing the opportunity for bacteria to grow.[13]
    • If your baby does not drink all of the milk from one feeding, do not save the milk to be used again. Some people find it useful to store each 2 to 4 ounces separately. This means that you only need to thaw the amount for one feeding.
  3. Follow the recommended guidelines for storing milk. The amount of time that you store milk depends upon the temperature at which it is stored. The following guidelines are for healthy infants that were carried the full term. For premature or sick infants, follow the guidelines provided by your hospital or doctor.[14][15][16]
    • Milk can be kept at room temperature (77°F or 25°C) for no longer than six hours. It should be kept cool and covered. If the room is warmer, you should not keep it for longer than four hours.
    • Milk can be kept in an insulated cooler bag (5 to 39°F or -15 to 4°C) for 24 hours. Ice packs should be in the insulated bag with the milk.
    • Milk can be stored in a refrigerator (39°F or 4°C) for five days. The temperature will be the most constant at the back of the refrigerator.
  4. Observe the recommended time limits when freezing milk. If you store the milk at the back of the freezer, the temperature will be the most constant. This will minimize temperature fluctuations that occur when you open and close the freezer. If milk is stored for longer than the amount of time listed, it starts to degrade and is less nutritious.[17]
    • Milk stored in the freezer section of a refrigerator (5°F or -15°C) can be stored for two weeks.
    • Milk stored in a separate freezer section of a refrigerator (0°F or -18°C) can be kept for three to six months. The freezer compartment should have a separate section so that the temperature doesn’t rise every time someone opens the refrigerator.
    • Milk stored in a deep freezer (-4°F or -20°C) can be kept for six to twelve months.

Preparing Stored Breast Milk

  1. Use the oldest milk first. This will help you to avoid storing milk too long or wasting it. In addition, the nutrients in human milk change over time so that the milk provides your baby with what it needs at the current time. This means that by preventing some milk from getting too old, you make sure that your baby gets what they need at each feeding.[18]
    • After three months, the fats in frozen milk begin to degrade, reducing the nutritional quality of the milk.[19]
    • The milk loses vitamin C over time, so the sooner you use it the better.
  2. Thaw frozen milk carefully. The milk should be fed at body temperature. If your baby will drink cold milk, you can also feed them directly after taking it out of the refrigerator. Thawed breast milk may look a little different or have a consistency that is a little different from fresh milk. This is okay and it is still safe to feed to your infant. Thawing can be done either in the refrigerator or using warm water.[20][21]
    • If you plan to use the milk the next day, you can put it in the refrigerator to thaw overnight.
    • Milk can also be thawed by running the closed, watertight container under warm water or putting it in a bowl of warm water.
    • Milk that is thawed should be used within 24 hours or thrown out.
  3. Do not thaw milk in the microwave. A microwave will heat the milk unevenly. This means that some of the milk might be too cold and some might be so hot that it might burn the baby.[22][23]
    • Bottles that are heated too quickly may explode in a microwave.
    • If the milk is heated too much the nutrients may start to degrade, making it less nutritious for the baby.
    • Heating the milk too fast may damage the antibodies in the milk that help build up the baby’s immune system.
  4. Check the temperature of the milk. Breast milk can be given warm or cold; however, if it is too hot it may burn the baby.[24]
    • Swirl the milk gently to mix it. This will mix and distribute the cream part, which rises to the top, throughout the milk. Do not shake the milk because that can cause some of the nutrients to break down.
    • After swirling, apply a few drops to the inside of your wrist. It should be warm but not hot. It should not feel uncomfortable.

Tips

  • Moms that have too much stored milk may not know to do with it. Local milk banks, usually affiliated with a hospital, are a great way to help other babies. Consider donating your excess milk.

Related Articles

Sources and Citations

  1. http://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/breast-milk-storage/art-20046350?pg=1
  2. http://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm
  3. http://www.womenshealth.gov/breastfeeding/pumping-and-breastmilk-storage.html
  4. http://www.womenshealth.gov/breastfeeding/pumping-and-breastmilk-storage.html
  5. https://www.llli.org/docs/0000000000000001WAB/WAB_Tear_sheet_Toolkit/06_hand_expression.pdf
  6. http://www.llli.org/nb/nbmarapr96p51.html
  7. http://www.womenshealth.gov/breastfeeding/pumping-and-breastmilk-storage.html
  8. http://www.llli.org/llleaderweb/lv/lvjunjul04p54.html
  9. http://www.womenshealth.gov/breastfeeding/pumping-and-breastmilk-storage.html
  10. http://www.womenshealth.gov/breastfeeding/pumping-and-breastmilk-storage.html
  11. http://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm
  12. http://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/breast-milk-storage/art-20046350?pg=1
  13. http://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm
  14. http://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm
  15. https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/pages/Storing-and-Preparing-Expressed-Breast-Milk.aspx
  16. http://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/breast-milk-storage/art-20046350?pg=2
  17. http://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm
  18. http://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/breast-milk-storage/art-20046350?pg=2
  19. https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/pages/Storing-and-Preparing-Expressed-Breast-Milk.aspx
  20. http://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/breast-milk-storage/art-20046350?pg=2
  21. http://www.nhs.uk/conditions/pregnancy-and-baby/pages/expressing-storing-breast-milk.aspx
  22. http://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/in-depth/breast-milk-storage/art-20046350?pg=2
  23. http://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm
  24. http://www.womenshealth.gov/breastfeeding/pumping-and-breastmilk-storage.html

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