This topic comes up periodically and Lactnetters line up on predictable
sides of the issue. We do tend to be attracted to the studies and research
that agrees with our prior positions.
As with any study, outcomes can vary and then one chooses which ones to
file as acceptable. We have witnessed the AAPs rejection of studies that,
to us, are evidence of the harm of infant formula. The decision makers are
citing research that refutes the ones that we hold as authoritative. And
the more a topic is studied the more variability in the results.
We need to keep up with the research but we need to, then, use our own
judgement as to how to respond to that research. We Lactnetters come from
varied fields of practice and we make our decisions based on our work
environments and experiences.
In my practice I choose to accept the safety of human milk at room
temperature of up to 10 hours, refrigerator for up to 8 days and thawed
milk used based on the manner in which it was thawed. (I would like to know
if it is good for longer times. And I don't mean just barely safe, but just
fine.) I also accept the premise that human milk kills bacteria and
viruses, including cancer cells, and is protective for our infants
regardless of their age. I accept the study by Rachel Brusseau that the
antibacterial action of human milk continues after an infant drinks from a
bottle, getting her oral bacteria into the milk, and that the milk will
destroy the bacteria.
I know that pumping milk and giving it to infants at a later time is not a
natural action and there do need to be guidlines for the handling of this
milk. Experience has shown me that as an alive substance it is highly
protective and does not have to be treated as barely safer than
manufactured baby milk.
I have been working in lactation for long enough to see many trends and
practices come and go. I know that whatever we are embracing today as the
latest research may be thrown out as absurd at a later time. The words that
we use now will be considered unfit a few years from now. Researchers
discover something that another one refutes later.
I will add a post that Rachel Myr sent to us in December. This was not a
long-range study, but a "test" with intriguing results.
A test *was* performed a few years ago, by some members of the Breastfeeding
Council in Norway, in which bacteria were inoculated into samples of freshly
expressed breastmilk; breastmilk that had been frozen, then thawed at room
temperature; breastmilk that had been frozen, then thawed in a microwave
oven; breastmilk that had been frozen, thawed at room temp, re-frozen and
re-thawed at room temperature, and freshly mixed formula.
The formula and the microwave-thawed samples grew similar and large amounts
of bacteria. The samples that were thawed at room temperature, even the one
that had been thawed and re-frozen, grew almost nothing, as did the freshly
expressed milk. This is part of the reason we advise against thawing or
warming breastmilk in a microwave oven, the other part being the risk of
burns to the baby from uneven heating of the milk.
We each must decide what information to accept and what to reject. We
don't have to agree and we can respect the bases of another's practice. It
is good share our opinions while we accept others' opinions so that we can
make their own decisions and practicing with integrity.
Patricia Gima, IBCLC
Milwaukee, Wisconsin
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