What are others doing in terms of the length of time fortified human milk 
can be stored?  We are revising policies in preparation for our nursery 
redesignation later this year.  The question arose - must any remaining 
fortified milk be discarded after a feeding or can it be stored for a 
length of time?  We normally use one packet of fortifier per 25 ml of EBM.  
One of our babies (32 weeks) is currently ordered to get 38 ml/fdg.  
Someone in the nursery has said that the remaining 12 ml of fortified EBM 
must be discarded each feeding.  This poor mom is struggling for every 
drop - throwing away any of her milk is completely unacceptable!  The nurse 
is fortifying 50 ml with 2 packets of fortifier, feeding the baby the 
required 38 ml and discarding the rest.  There are 2 schools of thought 
raging right now.  If EBM is viewed as a medicine, hospital policy states 
that any medication mixed at the bedside is to have any remainder 
discarded, not saved for the next dose.  The manufacturer's directions for 
use state that fortified milk must be discarded after 4 hours at room 
temperature if used for tube feeding; for bottle feeding, it must be used 
immediately and cannot be used if unrefrigerated for more than 2 hours, and 
any remaining after a feeding, must be discarded after 1 hour.  Unused, 
freshly prepared milk can be regrigerated up to 24 hours.
Our nurses, for convenience, would like to make up at least a shift's worth 
of feedings, which would be refrigerated between feedings.
One of our sister hospitals' policy states that the fortified EBM cqn be 
stored refrigerated for up to 24 hours.
Any thoughts would be appreciated.

Pam Hirsch, BSN,RN,IBCLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL   USA

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