I have a question about using frozen breastmilk in the hospital nursery.  I
was just having a conversation with a fellow RN and we both admitted that we
were a bit perplexed about what approach was best.  If a baby is born at,
say 25 weeks gestation and mother pumps very successfully and ends up with a
ton of milk, what approach is best for using it?  An infant born at that age
will sometimes not have ANY breast milk for a long time.  And when she does,
she'll start off with just drops and a few cc's, working up to larger
amounts.  In the meantime, the milk piles up in the freezer because mother
is making MUCH more than a baby would use at that age.  So my question is:
Do you recommend pulling the oldest milk out and feeding that first?  It
would seem logical that you'd want the baby to have nutrients and antibodies
in the colostrum.  Or do you use the most current milk since it's designed
more for the baby's current age?  If you use the most current milk, what
about the milk in the freezer?  When does the old stuff get used?  If mother
continues to make enough to meet the baby's needs, does the rest just get
wasted?  (I realize she could also donate it.)

Anyone care to chime in?  Each time I go to the freezer in the middle of the
night to pull milk out for a baby, I always stand there for a moment, trying
to figure out whether to use the oldest or newest milk.

Thanks in advance for anyone that can help!

Christina Harris, RN
Seattle, WA

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