June,
My recommendation would be based on the condition of the infant.
If this is a well baby whose mother is having the caregiver use
her expressed milk becoz she is away at work, then I would ask mother to use
the oldest milk first. The reason for this is that the baby is a healthy
thriving infant who has access to fresh milk right from the source most of
the time. I would not want any of her milk to "expire" or be beyond a safe
use date, so we would use oldest first.
If, on the other hand, we had a sick or very preterm infant, who maybe did
not start oral feeds for a couple days and mom has milked pumped and baby
often or almost always drinks expressed milk...then we would want him to
have access to all the cells and immunoglobulins that would be most active
in fresh milk. So in this case, even though we had older milk in the
freezer, if we had some fresh milk pumped we would feed that to baby
whenever we had it.
That is my interpretation of this situation.
Hope it is helpful to you.
Laurie Wheeler RN, MN, IBCLC
Mississippi USA

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