Hello, Kim.
       I read information years ago that I have used ever since.  I do not
have the citation, because way back then, I never expected to still be working
with breastfeeding mothers, much less be an IBCLC, and never imagined at the
time that I would need such details to be kept track of!  However, I have given
the information to *many* mothers, and I know of other IBCLCs who have done so
too, and no babies have ever gotten sick from it, to our knowledge.
       Once the baby has had his mouth on the bottle, his saliva has
introduced bacteria into the milk.  Breastmilk has anti-bacterial properties, but
bacteria will multiply too quickly for the breastmilk's a-b properties if left out
at room temperature.  So, once baby has had his mouth on the bottle, any
leftover milk must be stored in the refrigerator, once mother/caregiver knows baby
is finished with the feeding.  *The breastmilk does NOT have to be
discarded.*  The mother/caregiver has 9 hours or one re-heat (gently done under warm
running water), whichever comes first, to re-use the leftover breastmilk.  So if
the leftover milk is the last feeding of the day at the babysitter's and mom
will nurse baby directly at breast through the evening and night and baby won't
be back at sitter's until next morning, that is longer than 9 hours, so any
leftover milk from that last feeding should just be discarded.  If baby
bottle-feeds at 10 a.m. (as an example) and leaves an ounce in the bottle that he
doesn't usually leave, then gets fussy at 11 a.m., babysitter may think that baby
is finally ready to finish that bottle.  Just as babysitter gets milk warmed
to serving temperature, baby lets out a large burp and falls asleep.  The milk
was re-heated, so it needs to be discarded even though baby sitter didn't get
to give it to baby, because the re-heat would allow the bacteria to multiply
too quickly if is was then to sit until baby was ready for next feeding.
       As I said, I don't have the citation, but many mothers have used this
system for years, and the babies have stayed healthy.
       Dee

Dee Kassing, BS, MLS, IBCLC
Collinsville, Illinois, in central USA

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