Expressing and storing breastmilk
While it is not necessary to introduce a bottle to breastfed infants, many mothers choose to do so mostly to be able and leave their children with a care giver for when they need to go back to work.
It is thought that unless you introduce a bottle before 3 months of age, your infant will refuse it. While this can happen, the reason is more to do with developmental milestones really as between 3-4 months of age they go through a lot of development and therefore, need extra comfort at the breast. That said, some infants can be choosy and you might need to try various different brands of teats to find one that is acceptable for your little one.
Many are surprised by the small amount of milk they express especially in the beginning. It is taken for granted that if you have a good milk supply, you will express loads of milk. This is normally not the case and especially if you need to express milk from the very first day of life of your little one; because colostrum is very thick. The most important thing to remember when starting to express milk is that the amount of milk you pump is not an indication of how much milk your baby receives directly. Babies are more efficient than pumps and can transfer more milk than a pump.
There are different kinds of breast pumps available today but you might want to hand express your milk. Hand expression can be quicker than the pump and yields more milk as well! Once you decide on the best way to express milk, all you need is to find that quiet time and start. Many women complain that not a drop of milk came out when they started pumping. The reasons can vary but generally speaking unless you are relaxed, no milk will come out and at first your breasts need to get used to the different sucking pressure of the pump/hand.
Many women find the following aids helpful to pumping:
- Applying a warm compress beforehand
- Breast massage during pumping
- Having the baby close by or a picture of them
- Pumping often
NOTE: The hereunder guidelines apply for mothers who have healthy full-term babies (check with an International Board Certified Lactation Consultant for guidelines pertaining to storage and handling of breastmilk for pre-term or ill babies).
Milk can be stored in clean glass or plastic containers.
When storing milk label with the full date to use the oldest milk first. Stored milk will separate; this is normal and swirling it gently will mix it up again. You can combine milk expressed at different times within a single day.
Breast milk in Malta can be left out at room temperature for not more than 1 hour (in Winter). In a good cooler with ice packs in, it can be stored for up to 6 hours. Milk can be left at the back of the fridge, where it is coldest, for up to 3 days and frozen in a fridge freezer (i.e. the fridge & freezer having separate doors) for up to 3 months. It is important to note that when reading articles on storage of milk from other countries the storage time is longer. However the shorter storage time ensures that milk is fresher and has not lost much of its immunological properties.
Handling and Thawing Milk
Frozen milk is best left to be thawed overnight in a refrigerator – this usually takes approximately 12 hours. If you need a quicker method, it is best to put it in a small basin that is gradually warmed up. Once thawed, breast milk can not be refrozen and must be used within 24 hours.
Breast milk should be heated up to room temperature so as not to kill important immunological properties. This could be done by putting it in a basin of warm water. Heated milk can not be reheated. It is important to remember never to heat milk directly on the stove or in the microwave.
It is best to store milk in small portions (2-4 oz/ 60-125 ml) to avoid waste. It also thaws and warms quicker.
Extensive research has not yet been done to determine if it is safe to give a baby milk that was left over from a previous feeding or milk that was previously warmed, but not used. However, most lactation experts agree that milk that is not finished at one feeding may be offered at one more feeding before needing to be discarded. Human milk has antibacterial and antimicrobial properties that result in slower spoilage as compared to other foods. (Becky Flora IBCLC)
Can Breast milk turn sour?
Human milk rarely spoils and when it does it has a distinctive sour taste and odour. That being said some mothers do find their milk is not fresh any more and smells soapy. If you continue to find such milk, check again the handling and storage guidelines. If these are being met you might be one of those few mothers who are thought to produce an excess of an enzyme called lipase which helps breakdown of fats in human milk. Most babies will not mind a mild change in taste and the milk is not harmful, but the stronger the taste the more likely that baby will reject it (Kellymom).
One way to keep milk from spoiling so quickly is to halt the breakdown of fats by scalding the milk just prior to storing it. This is done as soon after expression as possible and over a stove eye. Scalding the milk involves allowing small bubbles to appear on its surface but removing it from the heat before an actual boil occurs. The milk should then be stored immediately either in the refrigerator or freezer (Becky Flora IBCLC).
Other Resources:
My Power went out and I have milk in the freezer by Kellymom
What are the LLLI guidelines for storing my pumped milk by LLLI
Storage and handling of Breastmilk by Becky Flora IBCLC
Hand Expression of Breast Milk by Stanford University
My Expressed milk doesn’t smell fresh what can I do? by Kellymom
