I would never tell a mother to go ahead and use breastmilk left in a hot
car. I urge mothers to refrigerate quickly after pumping and to keep it
cold until it gets used.  I advise against heating the milk at all. (A
doctor told me that warming milk was purely optional but bacteria
promoting, so my kids only got expressed milk cold.) I also tell mothers
that the greatest source of contamination is the baby's salvia and so I
strongly advise them discard milk in partially used bottles after 2
hours.

However, for the scientific record, I believe that the first study
showing that unrefrigerated breastmilk had low bacterial counts involved
test tubes of breastmilk left unrefrigerated for 10 hours in an Israeli
lab in considerable heat (like about 39 degrees Celsius.) I am away on
vacation, so I don't have the cite, but it is referenced in lots of
materials on storage times.

I personally wouldn't use milk left in a hot car and I would never tell
mother it was ok to use, but it probably less dangerous than we might
think and MUCH safer than abm treated in a similiar manner. Anyway, I
think it is intersting to know the basis of the storage and use
recommendations put out by various organizations.

Warmly-
Judy Gelman
Washington, DC

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