I was one of the people who reviewed the storage guidelines.  I read the
most recent literature (esp. the study by Hamosh).  Since the ambient room
temperatures
of people's environments is variable, and since often moms who are pumping
are pumping in work situations (where there may be less hygienic situations)
I feel that guidelines should be evidence based.  The Hamosh study describes
past research that documents the safety of refrigerated and frozen milk, but
focuses on the effect of time and temperature of milk stored at "suboptimal
storage conditions."

The Hamosh study (and other studies) also looked at increased lypolysis in
milk that was not-refrigerated.  While this action obviously occurs to keep
bacterial growth suppressed, it affects the milk lipids in ways that change
creamatocrits.  I think that it is not so much an issue that the bacterial
growth would increase so dramatically within 10 or even 12 hrs to the point
that a healthy child would get sick, I think there is reason to be concerned
that a sick or premature infant might.  What people think of as "room
temperature" varies widely.  5 minutes on the seat of the car parked in the
sun while mom runs into the store for a quick errand is also an issue.  With
the easy access to lightweight and inexpensive coolers that will protect
milk for 24 hrs (also in Hamosh study) why would we not want to have optimal
milk storage?

Hamosh states that milk can be held 24 hrs at 15 degrees C (about 59 F) and
at room temperature of about 25 degrees C (about 77 F) for 4 hrs.   The
reference for this is:  Hamosh, M et al:  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.

In her most recent edition, Lawrence cites this recommendation.


Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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