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Subject:
From:
Lois Arnold <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 21 May 1997 09:10:42 -0500
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To correct Mary Kay Smith's post on this subject, the new LLLI
guidelines are NOT in line with HMBANA guidelines.  HMBANA only has
storage recommendations for the hospitalized infant which recommend 48
hrs. in the refrigerator.

A work group established by Wellstart International met in August 1995
to discuss storage and handling issues for the healthy term infant and
day care issues.  It was the consensus of this group of experts that 72
hours in the refrigerator was a prudent recommendation for healthy term
infants, despite the Pardou study quoted by Mary Kay.  I hope, as a
member of this work group, that this consensus information will be
published in the AAP statement that is hopefully forthcoming and has
been promised for some time.

Re the Pardou study:  this study was done on samples of only **1ml**,
not real-life situations, and frozen samples were thawed by
"cold-thawing" in a microwave.  Bacteria counts were known for every
sample [not the case for healthy term infants being breastfed] and milk
was not included in the study if beginning bacteria counts exceeded
100,000 CFU/ml.  Anything above that was considered unsafe for feeding.
[For comparison, the dairy standard is 1,000,000 CFU/ml]

It is also imprudent to make recommendations based on only one study.  A
recommendation should be made to include as many outliers as possible.
I believe conservative is better, and feel very uncomfortable making a
blanket recommendation to refrigerate all expressed milk for 8 days when
I know nothing about how moms are cleaning collecting equipment, whether
or not they are able to wash their hands before expressing, what type of
work environment they are expressing in, etc.

Lois Arnold, MPH, IBCLC
Executive Director, the Human Milk Banking Association of North America,
Inc.

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