EBM for the mother's own baby (if a healthy full term) can surely be treated 
with greater lee-way than milk intended for a sick/prem infant.   Also, 
could one or two samples of a mother’s stash be tested for bacterial load 
before she throws it away?

Three studies mentioned in  “Best Practice for Expressing, Storing and 
Handling Human Milk”, Frances Jones, 3rd edition 2011, published by Human 
Milk Banking Association of North America (HMBANA), pp 27 :

Rhodes tested thawed pasteurised milk for a week, sampling 6 samples every 
12 hours.  The milk was held and sampled in a NICU setting.  This trial was 
followed by an expanded study using 50 samples with sampling done once a day 
for 7 days.  The thawed pasteurised donor milk did not grow bacteria over 
the week and the author concluded that with careful handling thawed donor 
milk could be used beyond 24 hours.
Rhodes, J.  Refrigerator Shelf Life of Human Donor Milk.  JHL 2006 22(4). 
p464-5.

Cohen et al collected pasteurised DBM for a regional level 3 NICU that had 
been thawed, stored in the fridge and used in a clinical fashion by multiple 
nurses for multiple babies.  Of the 23  bottles stored in the fridge (thawed 
for 7-122 hours), all samples were sterile.  One bottle of milk thawed only 
12 hours but left on the counter for those 12 hours grew 100 CFU, 
highlighting the need for appropriate storage and handling.
Cohen R et al. Bacterial culture results of thawed banked human milk after 
extended time periods. AAP National Conference 2006.

Rechtman et al examined milk frozen for 2 months at –20°C and then –80°C 
until defrosted and tested for bacterial load, vitamin A, vitamin C and free 
fatty acids.  The milk was refrozen, thawed and retested in a 24 hour 
period.  Some of the samples were repeatedly frozen and thawed over the 24 
hours.  The total length of time the milk was stored, the number of donors, 
and the total number of samples were not described.  The researchers 
concluded that raw milk is robust and can be refrozen.
Rechtman, D, M C Lee, H Berg. Effect of environmental conditions on 
unpasteurised donor human milk. Breastfeed Med 2006.  I(1): p 24-6.
~~~~~~~~~~~~~~~~~

Nancy Wight is also quoted from 2011 as saying that in her NICU, milk has 
been safely used for up to 48 hours after thawing.  Any comments, Nancy, if 
you are still on Lactnet?  HMBANA's guidelines continue to be conservative 
(ie use within 24 hours after thawing) until the above studies are 
replicated, especially since the population using donor milk is so 
vulnerable.  However in a home setting, I believe that the quoted studies 
indicate that the life of thawed breast milk can be extended beyond 24 
hours, if it remained chilled.

I would love to read the original Rechtman study, as it tests food quality 
after re-freezing, not just sterility.  Cohen's study implies that if the 
milk remains chilled after thawing (which it would presumably do in a closed 
freezer for  some days with the power off?) then it's likely to remain 
sterile.  I've certainly had no growth from samples of pasteurised milk 
tested up to 3 days after defrosting and use in a high care setting.

Best wishes to all experiencing power disruptions and inclement weather.
Jacquie Nutt IBCLC

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome