Expert: Sally Wendkos Olds - 8/24/2007

Question
Hi,

I have a 2.5 wk old newborn and have been trying to pump out extra milk immediately after and between feedings.  I would like to start freezing some 2-3 oz bottles of breast milk for reserve.  But the issue is that in most pumpings, I only produce ~1-1.25 oz (even though my baby's growth and #BM/W's seems fine, according to my doctor...she says baby's sucking efficiency probably produces more milk oz than an electric pump).  So in order to freeze 2-3 oz bottles, I would need to combine milk from a few different pump sessions.  Is it ok to refrigerate earlier pumpings until I have 2-3 oz to freeze (so long as i don't refrigerate longer than 24-48 hours)?  Or should I just freeze the 1-1.25 oz portions immediately?

Thanks,
Lisa

Answer
Dear Lisa,

First, congratulations for giving your baby the best start in life by breastfeeding!

Your doctor is right -- that a vigorously suckling baby is more efficient than even the best pump!

Yes, it's okay to refrigerate each pumping separately. Chill the pumped milk right away in the refrigerator. On the second pumping, first chill the milk in a separate bottle. Then once it is chilled, you can pour it into the same bottle and either refrigerate or freeze it, depending on when you plan to use it. I am attaching an excerpt from my book (see below) from the chapter "Expressing and Storing Breast Milk."

Regards,

Sally

Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters.
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  STORING COLLECTED BREAST MILK
CONTAINERS
The best containers for storing your breast milk are four-ounce plastic nursing bottles or disposable plastic milk storage bags, depending on your preference.
  * Plastic has an advantage over glass. For one thing, of course, plastic doesn't break when dropped, and you don't want to waste that liquid gold. In addition, if you are going to store your milk for less than 24 hours, you want plastic bottles, since some research suggests that some of the leukoyctes (white blood cells) in breast milk cling to glass, making them unavailable to your baby. They don't cling to plastic. However, the cells detach from glass after about 24 hours. So if you will be storing your milk that long or longer, the composition of the container doesn't matter.
  * You want the small four-ounce bottles rather than the eight-ounce ones, so that you can defrost small amounts of milk at a time. Once thawed, milk should not be refrozen.
  * Some women like the disposable milk storage bags made especially for storing breast milk. These bags lie flat in a freezer, are easy to stack, and thaw quickly. However, other mothers find them hard to handle and easy to puncture. The bags do need careful handling to avoid spillage and puncture, they sometimes split when frozen, and they absorb odors from nearby foods (although babies don't seem to mind milk that smells like the garlicky sausages in the next container). Double-bagging helps to overcome some of these difficulties. Some of these bags have a layer of nylon in addition to the plastic to prevent contamination of milk should the bags split or be punctured. At this point, then, it seems a matter of personal preference.

CLEANING AND STERILIZING
If you're collecting milk to be given to your own baby within 48 hours, you don't need to sterilize your bottles, rubber nipples, and pumping equipment. Wash everything thoroughly with a bottle brush and nipple brush to remove any milk scum, and then wash in a dishwasher or a basin of hot soapy water. Be sure to rinse out all the soap.
  If you are going to take milk to the hospital for a sick or premature baby or for donation to a milk bank, the hospital will probably give you instructions. If not, or if you want to freeze the milk for your own future use, do the following to sterilize your containers and equipment. If you have a dishwasher that uses 180„a water, this will sterilize everything well enough. (Check to be sure all the pump parts can be safely washed in the dishwasher.) Otherwise, do this:
  To sterilize just a few things, pad the inside of a large soup pot with a clean towel, and fill it with enough water to completely cover the items you're sterilizing (bottle, cup, bottle caps, nipples, funnel, etc.). Bring the water to a boil over high heat; then turn down the heat just enough so that the water continues to boil gently. After five minutes of boiling, remove the nipples with sterile tongs. Place them on a clean towel. Allow the other items to boil fifteen minutes longer. Do not touch the rims of the bottles or the insides of the caps.
  
  BOX 17-3   STORAGE TIMES FOR COLLECTED MILK
Basically, your collected breast milk will keep for several hours at room temperature if it's covered, it will keep in the refrigerator for about two days, and if you want to keep it longer than that, you should freeze it.
  The following guidelines should assure safety and maximum benefit to your baby.
  * To be given to baby within 30 minutes: No special storage needed. Can be kept at room temperature.
  * To be given to baby within 6 to 10 hours: Pour into clean container; cap tightly. You do not have to refrigerate the milk; human milk kept in a capped clean container does not grow bacteria, even at room temperature (66 to 72„a F) because of its ability to slow the growth of bacteria. However, if the room temperature is higher than 72„a, refrigerate it.
  * To be given to baby within 48 hours (2 days): Pour into clean container; cap tightly. Refrigerate at 40„a F (4„a C) or below.
  * To be given to baby within a week: Pour into clean container; cap tightly. Quick-cool in the refrigerator for 30 minutes. Then freeze in refrigerator-freezer unit.
  * To be given to baby within 1 to 2 weeks: Pour into sterile container; cap tightly. Quick-cool in the refrigerator for 30 minutes. Then freeze in refrigerator-freezer unit.
  * To be given to baby within 3 to 6 months: Pour into sterile container; cap tightly. Quick-cool in the refrigerator for 30 minutes. Then freeze at 0„a F (-18„a C) or below in the freezer of a two-door refrigerator or a deep freeze that is not opened often. Not all freezers stay cold enough for long-term storage. Check temperature with a freezer thermometer at different places in the unit. The freezer should maintain a constant temperature of 0„a. If it keeps ice cream very solid, it is probably cold enough.
  If your freezer does not get this cold but does keep other frozen foods hard, keep the milk in the center of the freezer and use within three to four months. Frost-free refrigerators, which have a warming element, generally do not maintain 0„a.
  To find out whether your milk thaws and then refreezes in your freezer, check by keeping an ice cube in a little jar; if you check it a day later and find that it has melted and refrozen, you'll know that this has probably happened to your milk, too. If so, you'll have to discard the milk.
  It's best to use milk soon after collecting it, and preferably within three months. For one thing, milk collected when your baby is two months old will not meet her needs as effectively when she is six months old.
  * Keeping breast milk longer than 6 months: This is not a good idea. While instructions are sometimes given for keeping frozen milk up to two years, long-term freezing alters the chemical composition of the milk. (Some of the fats break down, and the milk loses some of its ability to fight harmful organisms.) Furthermore, you run the risk of contamination if you lose electrical power during that time and the milk thaws and refreezes.
  * Do not refreeze milk that has defrosted. If frozen milk has started to thaw, refrigerate it immediately and use it within 12 hours.
  END OF BOX