Debbie, I wish I had time to search for this for you, and I haven't looked
at the link you gave, but you could try looking for papers as follows
(perhaps on PubMed?):
Barger J, Bull PA, A comparison of the bacterial composition of breastmilk
stored at room temperature and stored in the refrigerator. Int J of
Childbirth Ed 1987;2:29-30.
Hamosh M, Ellis LA, Pollock DR, Henderson TR, Hamosh P. Breastfeeding and
the working mother: effect of time and temperature of short-term storage on
proteolysis, lipolysis and bacterial growth in milk. Pediatrics
1996;97.4:492-498.
Jeffery B, on Pretoria Pasteurization (looking at HIV, and another study
looking at bacterial content of home-pasteurized milk)
Israel-Ballard on flash-heating, or flash-boiling, also looking at HIV and
bacterial content of heat-treated EBM
Brusseau, Rachel - something in the Lactnet archives from around 1996 -
1998 or so. I have a copy of an unpublished (?part of a thesis?) paper she
sent me in May 1998 looking at EBM from mothers of healthy full-term
babies, where they expressed their milk into un-sterilized feeding bottles,
warmed it to 37 degrees C, fed the babies, put the left-overs in the fridge
for 2 days, and then looked at the bacterial content. It rose, but not to
harmful levels. None of the babies became sick. The mother whose
bacterial content rose the most had frozen her milk. The results seem to
indicate that mothers don't have to discard previously warmed breastmilk,
even from a previously-sucked bottle.
The general gist seems to be that fresh breastmilk has the best safety
record when stored, (also try Narayanan et al looking at EBM for low
birthweight infants, thebabies fed raw milk did better). Pathogens which
can multiply to dangerous levels come from containers or hands, not from
the milk itself, which contains antibodies to them, causing them to reduce
over time, rather than multiply. It makes sense to treat breastmilk as
gently as possible, so as to conserve as many of the nutrients and
protective components as possible. If heated or frozen some of the
antibacterial properties may be lost, but not all. The mother's own milk
is safer than donor milk because the mother is producing antibodies to
pathogens in her baby's own environment, and in fact containers used for
EBM which will be fed to healthy babies at home do not even need to be
sterile, just washed with hot, soapy water, and rinsed, as do
hands. Certainly formula needs to be discarded within an hour of being
reconstituted, and everything needs to be sterilized, because bacterial
content of a dead, non-sterile liquid can reach dangerous levels. But
breastmilk is a different "product" altogether, being living tissue, so
different standards apply.
Hope this helps.
Pamela Morrison IBCLC
Rustington, England
At 05:07 22/12/2005, you wrote:
>...... Recently, I had a mother tell me
>that the information that I was providing was incorrect. I told her that
>once
>she heats breastmilk, it should be used within the next hour, and it should
>not be reheated. She used a web page from kellymom.com to prove me
>wrong. I
>had a discussion with Kelly Bonyata, creator of Kellymom.Com. The page
>about
>reheating breastmilk involves direct quotes from experts like Dr. Ruth
>Lawrence and Jan Barger. I respect both of these women very much, but there
>appears to be NO research based evidence to back up their
>statements. If there
>is, I would love to see it. My purpose in bringing this issue up is not to
>create any battle. I am just curious about how other LC professionals
>deal with
>the question of reheating breastmilk that has already been heated. Just in
>case you are wondering, here is the page that I am discussing. Again, my
>purpose here is strictly a professional one.
>
>_http://www.kellymom.com/bf/pumping/reusing-expressedmilk.html_
>(http://www.kellymom.com/bf/pumping/reusing-expressedmilk.html)
>
>
>Debbie Albert, RN, Ph.D., LMHC, IBCLC, RLC
>Tampa Lactation Counseling
>Tampa, FL
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