Wednesday, January 13, 2010

Breastmilk Collection and Storage Guidelines for Normal Newborns

Collecting Breastmilk
First, wash hands well.
Wash breastpump equipment that contacts the breast, milk or collection containers in a dishwasher or by hand, in hot soapy water. Rinse with cold water and air dry on clean towel. Check with your hospital or other for any other instructions.
When to pump depends on you and your baby's schedule. Your milk supply usually is most plentiful in the morning, so that is a good time. Try to pump midway between feedings. Be flexible. If your baby skips a feeding, nurses a shorter time than usual, or only nurses on one side, pump out the rest of the milk and save it. If you are planning to return to work and continue breastfeeding, begin pumping one to two weeks before you return. Try to simulate what your pumping schedule will be at work.
Before pumping, get comfortably seated and relaxed. Pump your breasts according to the breastpump manufacturer's instructions.
There are several containers available for storing breastmilk. These include specially designed plastic bags, plastic bottles or glass containers. There are advantages to each.
1. If you are going to freeze your breastmilk, leave some space at the top of the container. Breastmilk, like most liquids, expands as it freezes.
2. When using plastic bags, use those designed for breastmilk collection. Before storing, fold the top several times and seal with freezer or marking Tape. Place smaller bags in a larger bag to help protect against punctures. Medela's sterile CSF™ (Collection Storage Freezer) bags, come with twist ties for easy sealing and don't need to be double bagged.
3. Mark the date and amount on each container.
4. Freeze your milk in two ounce to four ounce portions. Smaller amounts thaw quicker, and you will waste less milk if your baby consumes less than you anticipate.
5. You may continue to add small amounts of cooled breastmilk to the same container through out the day. Chill in the refrigerator until evening. Then, freeze in appropriate amounts.
6. You may also add to pervious frozen milk. First refrigerate all freshly expressed milk until cold, and then add to frozen milk. The newly added milk must be for a lesser amount that the previously frozen milk.1

7. If you carefully washed your hands before pumping or expressing, your breastmilk will be safe for around 4-10 hours at room temperature, 66°-72°F.2,3 Immediate refrigeration, however, is recommended.
8. Fresh milk may be stored in the refrigerator from 5 to 7 days at 39°F.4
9. Frozen milk may be stored in the back of the freezer portion of a refrigerator-freezer for up to six months.5
10. Frozen milk may be stored in a -20°C deep freezer up to 12 months.6
11. Defrosted milk may be kept for up to 24 hours in the refrigerator.7
Storage Guidelines
Room Temperature Refrigerator Home Freezer -20°C Freezer
Freshly expressed breastmilk 4-10 hours 5 to 7 days 6 months 12 months
Thawed breastmilk (previously frozen) Do not store 24 hours Never refreeze thawed milk Never refreeze thawed milk

To defrost frozen milk:
Place milk in refrigerator the night before you are going to use it. Refrigerator defrosting takes about 8 to 12 hours.
Place the frozen milk under warm running water or in a pan of warm water. Don't use hot water, as this can destroy some of the milk's immunological components.
Never microwave breastmilk! Microwaving breastmilk can change the milk composition, and has the potential to burn the baby.8

Fat in breastmilk will separate and rise to the top. By gently swirling the container you can mix fat that may have separated.
Never refreeze thawed breastmilk.
Remember, the color, consistency and odor of your breastmilk may vary depending upon diet, or exposure to other foods in your refrigerator or freezer.
Intake Guidelines
How much breastmilk should you anticipate for your baby for each feeding? That depends on the individual infant, but here are some guidelines.9
Age Amount Daily Total
0-2 months 2-5 oz. per feeding 26 oz.
2-4 months 4-6 oz. per feeding 30 oz.
4-6 months 5-7 oz. per feeding 31oz.

Weight Amount
8 lbs. (3,600 gr.) 21.3 oz. (639 ml)
in 24 hours
9 lbs. (4,000 gr.) 24.0 oz. (720 ml)
in 24 hours
10 lbs. (4,500 gr.) 26.7 oz. (801 ml)
in 24 hours
11 lbs. (4,900 gr.) 29.3 oz. (879 ml)
in 24 hours
12 lbs. (5,400 gr.) 32.0 oz. (960 ml)
in 24 hours
14 lbs. (6,400 gr.) 37.3 oz. (1,119 ml)
in 24 hours
16 lbs. (7,300 gr.) 42.7 oz. (1,280 ml)
in 24 hours

1 Lauwer. J, and Woesner C: Counseling the Nursing Mother, p. 436.
2 Hamosh M, Ellis L, Pollock D, Henderson T, and Hamosh P: Pediatrics, p. 492, 1996.
3 Barger J and Bull P: A Comparison of the Bacterial Composition of Breastmilk stored at Room Temperature and Stored in the Refrigerator. Int J Childbirth Educ 2:29-30, 1987.
4 Sosa, Roberto; Barness, Lewis: AJDC, Vol. 141, Jan. 1987.
5 Instructions from Mothers' Milk Bank at Valley Medical Center, San Jose, CA, Maria Teresa Asquith, Ronald Cohen, MD.
6 Ibid.
7 Lauwers J, and Woessner C: Counseling the Nursing Mother, second edition, p. 437, 1989
8 Renfrew M, Fisher C, and Arms S: Beastfeeding: Getting Breastfeeding Right for You, p. 95, 1990.
9 Sciepien G, Barnard M, Chard M, Howe J, and Philips P: Comprehensive
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