Hi Netters,

I apologize to all of you that have read my posts from the past on this topic
of collection, storage, and freezing of breast milk, but it is obvious to me
that there still is some confusion about it.  I directed Chicago's Milk Bank
for over 5 yrs (ten yrs. ago) and have closely followed the changes of
guidelines, studies, reseach, and clinicals that have taken place over the
past years.  I always questioned about the natural preservative that human
milk has with all of the immunological properties.  That is why I (and Jan
Barger) did our research on "A  Comparison of the Bacterial Compostion of
Breast Milk Stored at Room Temperature and Stored in the Refrigerator" in
1986 from grant money we received.  It was facinating to me that some of the
milk at 24 hrs still had minimal bacterial levels and that some of the milk
in the refrigerator had higher bacterial levels than milk at room
temperature.  What we have seen over the years is that what we once
speculated as true is now false and visa versa.  I remember lecturing that it
was better to store fresh milk in plastic because the leukocytes collected on
the sides of the glass.  Then Cutberto Garza did a study years later that
showed after 24 hrs, the leukocytes fell back into the milk.  So then we
could go back to saying storing fresh breast milk in glass was OK.  What do
we know about freezing human milk????  For years, many found it was
convenient to store the milk in ice trays (just pop the cube up, defrost it
and it was ready-to-feed),  disposable bottles (polyethlene bags years ago
only designed for refrigerated milk), and later zip-lock bags.  Does plastic
leach into milk?  I remember we use to think and say that, but where is the
clinical documentation?  Another presumption?  Then the Milk Bank came out
with recommendations for Mother's Milk for hospitalized, premature babies.
 NOT NORMAL NEWBORN and NOT BABIES IN DAY CARE.  Yes, I am yelling.  Everyone
went crazy when they heard about the 60% decrease in sIgA in breast milk
stored in polyethylene vs glass.  For those of you not familiar with what
this all means, sIgA is secretory IgA and is the most significant
immunoglobulin in human milk.  Concentrations are highest in colostrum and
slowly decrease with time.  sIgA  provides local intestinal protection
against viruses and bacteria, especially of  concern with the premature is E.
coli and the association of NEC (necrotizing enterocolitis).  sIgA is higher
in preterm mother's milk vs term mother's milk.  Not too suprising huh?  Back
to the research,  Goldblum, Garza, Nichols, Goldman, et al published a paper
in Nutrition Research, vol. 1, pp. 449-459, 1981, "Human Milk Banking,
Effects of Container Upon Immunologic Factors in Mature Milk".  The
containers used were pyrex glass, gerber polyethylene bags and polypropylene
(hard plastic) containers.  The milk was stored for 4 and 24 hours at 4 degee
C which is refrigerator temp.  WE ARE NOT TALKING ABOUT FROZEN MILK.  I am
trying hard not to yell.  Results: " Total IgA and sIgA in milk were not
altered by the type of container or length of storage." "sIgA antibodies to
E. coli O antigens were lower in polyethylene containers, PRESUMABLY because
of selective binding to the container surface."  "Lysozyme and lactoferrin
concentrations fell substantially after storage for 24 hr in pyrex or
polypropylene containers.  It was not ascertained whether this was due to
adherence of proteins to the vessel surgace, proteolysis, or other
mechanisms."  It is interesting why there is so much talk of decreased sIgA
in polyethylene bags, but no talk of the decrease of lysozyme and lactoferrin
in pyrex and polypropylene.  When talking to a bacterioIogist from Fermilab,
she said there was a much more sophisticated way to measure all these levels
today.  I guess the point is there is much more needed research and until we
know more, let's stop spinning our wheels and concentrate our time and energy
on getting these babies breastfeeding and secondary, successfully pumping and
feeding the babies human milk in any container.  For if we make it so
difficult, expensive, complicated and she switches to formula, what benefit
is there then. No sIgA in formula!!  Terry Asquith from San Jose, CA Milk
Bank, and I always laugh when we get talking on this topic, especially with
the normal newborn.  She will say these mothers could probably store their
milk in anything even in a little plastic baggy and it still would be better
than formula.  Amen.  I will get off my box for the night.

Pat Bull, RN, IBCLC
The Breastfeeding Connection/Medela, Inc.
Naperville, IL  where it will not stop raining