Storage of Breast Milk

Storage Guidelines of Expressed Breast Milk:

Freshly-Expressed Milk
               Warm Room : 3-4 hours
               Room Temperature: 4-8 hours
               Insulated Cooler/Ice Packs : 24 hours
Refrigerated Milk
               Refrigerator (fresh milk) : 3-8 days
               Refrigerator (THAWED milk) : 24 hours
Frozen Milk (do not refreeze!)
               Self-Contained Freezer of Refrigerator : 6 months
               Deep Freezer : 12 months

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Mixing Expressed Milk:

Only mix milk at or near the same temperatures.
Freshly-expressed milk can be added to room temperature milk within 4-8 hours. Otherwise, refrigerate milk and then combine. Add refrigerated or partially frozen milk to already frozen milk.

Oops! I didn’t use/need what I HEATED!

Thawed milk needs to be used within 24 hours. Keep refrigerated until next feeding. Heated or warmed milk needs to be used within 2-3 hours. Simply smell milk if you think it may be bad. Don’t toss the milk! Use “bad” milk in the baby’s bath!

Does the milk have a metallic taste or smell funny?

See link for more info:

Helpful Information:

CDC Recommendations:

The STUDIES the Storage Guidelines are based on:

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Jaundice

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Often, one of the first challenges a mother faces is jaundice. Doctors and nurses may indicate that all jaundiced babies must be fed formula, but evidence suggests that this is not case. Infants can absolutely overcome jaundice and grow into healthy babies while consuming only breast milk. Although management of breastfeeding and jaundice varies among the nations, the principles and recommendations outlined in the link below apply universally.

Click here to read through the Academy of Breastfeeding Medicine’s Guidelines for Management of Jaundice in the Breastfeeding Infant Equal to or Greater Than 35 Weeks’ Gestation.

Low Milk Supply

One of the most common concerns of the breastfeeding mother is that they aren’t making enough milk for their baby. Let me assure you, true low supply, or the inability to produce adequate milk, is rarely the problem. What signals your body to make more milk? Removing milk!

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“But he wants to eat all the time!”

Ok…Let’s look at the whole picture:

  • Is baby very young? Newborns have a stomach that, at 10 days old, is still only the size of an egg, and he’s eating a perfect food that is completely digested quickly.
  • How old is he? Just like a teenage boy that eats all the time, babies are growing…and fast! There are several physical and developmental spurts that occur, usually around the same time for each child. Take a look at the Wonder Weeks chart (http://www.whosthatmom.com/wonder-weeks-week-by-week/) and see if your baby is either having a growth spurt or about to have one.
  • Is he latched correctly? Can you hear him swallowing? A proper latch is comfortable for you, not painful, and allows baby to efficiently remove milk from the breast. If you have access to an IBCLC, have them check baby’s latch. There are several valuable resources here, as well: http://kellymom.com/ages/newborn/bf-basics/latch-resources/

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“He fusses at the breast. I don’t think any milk is coming out.”

  • Let’s talk about supply and demand. Babies demand milk…and you supply it. Fussing at the breast, beating on you, on-and-off nursing, etc, all signal your body to make more milk. Your breasts don’t ever truly become “empty”, they continuously make milk.
  • Does he need to burp? Is he distracted or overstimulated? Are you distracted or stressed?
  • Is he getting too much milk? Check our document on oversupply to see if it sounds like you.

“I’m pumping barely anything.”

  • Pumping is never a good way to judge what you’re actually producing. Babies are much more efficient at getting milk out than a pump.
  • Also see our document on Pumping Tips for help when pumping at work.

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“My breasts feel empty. I think my supply dropped.”

  • Probably not. Most of us only experience super-full feeling breasts for a limited time. What is most likely happening is that your supply is regulating. Your body and your baby’s demands have come to an understanding and your are meeting his needs without becoming overfull.
  • Your breasts always make milk. When milk is removed, they make more. “Your breasts are a factory, not a storage facility.” They are never truly empty.
  • Babies can typically always get out more milk. Even if it’s minimal; they are very efficient at their job.

“How do I make more milk?”

  • Firstly…nurse your baby more. Most concerns about supply can be fixed by simply nursing more.
  • Nurse baby on demand. Let him decide when he wants to eat.
  • Pay attention to baby’s hunger cues. Rooting, smacking lips, sucking hands, etc, are all signs of hunger. Crying is a late hunger cue.
  • Soothe at the breast. Comfort nursing can be frustrating sometimes, but it is the best means of comforting your baby and ensuring an abundant supply of milk.
  • Nurse until baby lets go. Let him decide when he’s done.
  • Don’t be a clock-watcher. Allow baby to run on his own time.

Signs that your baby is getting plenty of milk:

Birth-2 weeks:

  • baby starts gaining weight after your milk comes in. Remember, weight gain varies with every individual. Don’t compare your baby to your friend’s or yourself.
  • baby is having at least 3 quarter-sized poops per day. These can be spread out over a 24 hour period. More than three is fine.
  • baby is swallowing when he’s nursed.
  • baby is nursing at least every three hours until he reaches about 10 pounds. Again, more is fine.

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2-6 weeks:

  • baby passes birth weight by around 2 weeks. Remember to calculate that by baby’s lowest weight.
  • baby continues to gain weight.
  • still has 3 quarter-sized poops per day. Until around 6 weeks, this is what we want to see. Others may tell you that it is normal for exclusively breastfed babies to go several days or even a week or more without pooping. That is not true until around 6 weeks, and even then, not the norm.
  • baby has gotten the hang of latching on and staying attached.
  • baby is sucking with long, steady sucks soon after latching.

6 weeks on:

  • baby continues to gain weight.
  • baby is meeting developmental milestones.
  • baby has plenty of wet diapers and regular poops (they become less frequent around 6 weeks).
  • baby is getting longer and gaining in head circumference.

What if your supply is truly low?

Sometimes baby really isn’t getting enough milk. It’s important to understand why.

It’s important to figure out if he’s not taking enough because you’re not making enough, or if you’re not making enough because he’s not taking enough, or if he’s taking plenty but not using it well.

Source: The Womanly Art of Breastfeeding, 8th ed., p.396

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What might be the issue with baby?

Possible causes of baby taking too little milk are:

  • he’s improperly positioned
  • his nursing time is being cut short
  • he’s being fed too infrequently
  • he has a tongue-tie or other latching issue

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What might be the issue with me?

Possible causes of mother making too little milk are:

  • thyroid problems
  • PCOS (Polycyctic Ovary Syndrome)
  • breast surgeries

If your supply is truly low and your baby is not thriving, it is our advice at Milky Mommas to seek out and meet with an IBCLC to identify and correct the problem.

Most of these scenarios are completely reversible, so don’t give up hope. Remember, if you must supplement due to medical indication – and at the recommendation of a professional – there’s a strong chance that supplementation need be only temporary and you can return to being your child’s sole source of nutrition.

A Response to “Fed is Best”

We don’t endorse the “fed is best” motto.
Fed is the standard. Fed is the only reasonable option when it comes to babies. To say “best” is to suggest that there is any other acceptable option than to feed the baby… there isn’t. “Fed” is not optional. You have to feed the baby no matter what; we get that.
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The World Health Organization ranks the preferred methods in order as follows:
1) Breast milk at the breast
2) Mother’s expressed breast milk
3) Donor breast milk
4) Formula.
I want you to know that when we say we don’t endorse the “fed is best” motto, it’s not because we think mothers and babies who require formula are wrong or terrible. What we here at Milky Mommas are saying is not that breastfeeding makes you a good mom and formula feeding makes you a bad mom. Far from it!

It’s because saying “fed is best” is saying that all options are equal; that infant feeding methods don’t matter. That no matter what you choose, it’s all the same, it’s all “best” for baby. And that is scientifically inaccurate.
We wouldn’t be here with over 55k members if it didn’t matter. Women wouldn’t be feeling conflicted about having to use formula if it truly didn’t matter. We know that breast milk is the biological norm. We are not saying that no one should ever use formula. What we are saying is that there are certain risks associated with formula* (well documented in many, many studies) and that it is not a NUTRITIONALLY equal choice to breastfeeding.
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There are some circumstances where breast milk is truly not an option, and of course – the most important thing is a fed baby. There are circumstances where a baby absolutely needs supplementation to be healthy, to grow, and to thrive. We can get behind the hashtag #fedisimportant, or #fedmatters. It does! You HAVE to feed the baby, by any means necessary! But when we start to say that fed is BEST, it silences an important conversation about breast milk. And that conversation is VITAL for moms and babies.
It is a women’s rights issue, it is a public health issue.** It is a conversation that is important to you, as well. We know that because you put in the work to breastfeed your baby as much as you can. We know that you are doing a great job!
What we are saying, is that while we support our members who must use formula, pretending that what our babies are fed doesn’t matter contradicts everything we stand for. We know that colostrum is the foundation for a strong and healthy immune system. We know that breast milk protects babies from illness through living immunological properties like probiotics and antibodies. We know that breast milk meets every need for healthy brain development and offers some protection against diseases like asthma, allergies, diabetes, obesity, and childhood leukemia.***

Many mothers have no choice but to use formula, we totally get that. It is so hard when we are unable to meet our breastfeeding goals, especially when it isn’t by choice! And thank goodness there is formula, for when babies truly need it and breast milk is unavailable. We would never dream of suggesting that a baby just go hungry rather than be fed formula. Many of our admins have partially or completely formula fed some of their babies!

There are markers for determining a medical need to further assess breastfeeding or supplement.****
We frequently encourage members whose babies show these markers to take heed and be proactive. We are not suggesting members exclusively breastfeed at any cost.

When we share information about breast milk vs breast milk substitutes like commercial formula, it isn’t meant to hurt anyone’s feelings. We share evidence here, we share studies and statistics and what science understands to be of the greatest health benefit. We are here for support, but we can’t compromise the integrity of our information for it. We are here to educate and advocate for the use of human breast milk. We understand the value and importance of human breast milk. That’s the science of health, not a judgement on mothers. We understand that many women may find themselves sensitive to the things they see here because of their own complex emotional journeys. That is unfortunate, and deeply personal. We wish for anyone who is experiencing strong emotions to find peace with their circumstances. Please feel free to contact an admin at any time with your concerns. ♡
References:
**“If every child was breastfed within an hour of birth, given only breast milk for their first six months of life, and continued breastfeeding up to the age of two years, about 800 000 child lives would be saved every year.”