Sharon-
I've made my handout re: storage/handling of br. milk as specific as I can,
based on Jan Barger & Pat Bull's research findings & the info in LLLI's BAB.
As follows:
freshly-expressed breastmilk - @ temp. 66-72 degrees F, up to 10 hours
@ temp. 73-79 degrees F, 4-6 hours
thawed breastmilk - do not store at "room temperatures" - refrigerate - use
within 4 hrs after warming.
(I do tell people in this super-hot weather we were having that when it's
over 80 degrees where the breastmilk is, it should go in the fridge ASAP.
Also reminders that a hot car, even when it's only 75 out, is much, much
hotter and not the place to keep breast milk at the ambient temp.)
This information about how long EBM can be safe at "room temp." is perhaps
the single most surprising little tidbit I have to drop on folks about
BFing. My supervisor at WIC didn't want me to put this in our handouts,
although she's generally BF-friendly, just because she can't believe it (I
did anyway, after showing her the research refs.) Most of the docs I know
don't want to accept those guidelines either. Seems to me they mistrust both
women and breastmilk - the thinking seems to be "well, we can't tell them
THAT, because then they'll be leaving the stuff out in 100 degree weather,
24 hrs/day, and they'll poison their babies. Plus it will make the moms
sloppy and lazier even than usual".
This is an interesting case of research-based practice; the research gives
us storage times that "just sounds too long" to people, so they just don't
believe it, and insist on giving out info that they are more comfortable
with, whether there's evidence for it or not. But in presenting the data
that support these storage times, there's a good opening for discussing the
other properties of breastmilk as a living substance with bacteriostatic
qualities, etc.
This is not your formula company's inferior, cow milk-based formulation,
this is the REAL STUFF!
Cathy Bargar, RN, IBCLC Ithaca NY
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