This is in response to questions re storage guidelines from Kathleen Saenz
or Melanie Ashworth.

Why is your unit going through breast-milk panic?  What's going on?

Our chief of neonatology has had the conviction that we MUST freeze  EBM for
babies under 1500 grams due to possible CMV transmission.  Although CMV can
be cultured in EBM (in about 50% of the population), no one can prove that
babies got it specifically from the EBM, but perhaps contracted it
perinatally (any time within the first 44 days).  So right now, we're stuck
with freezing EBM  for 3 days.  Freezing only lowers titres, but our chief
is insistent at this point.  This also means that infants less than 1500
grams cannot breastfeed.  They can receive frozen EBM via bottle, cup.

I called 6 large units around the country to poll them about this issue -
they all prefer fresh EBM but will use frozen if fresh is unavailable.  I
was able to get CMV rates from 3 of these units, and they were lower than
ours for 1997.  Half of the infants who contracted CMV in our unit were
receiving formula - maybe we should freeze the formula for 3 days??

Our guidelines for storage:
fresh milk at room temp                 4 hours
fresh milk under refrigeration          48 hours
freezer storage                         3 months (in-hosp., or 6 months in
home freezer and
                                                1 year in deep freeze)

defrosted milk refrigerated             24 hours
defrosted milk room temp                4 hours

The reason we can leave milk out for 4 hours:  continuous feeds are out for
3-4 hours.


  Please respond about why your unit is in a turmoil over breastmilk.

TIA

Dani Hudspeth RN, BSN, IBCLC
Dallas, TX