I originally learned of the studies on leaving breastmilk out longer through La Leche League. Of all of the breastmilk collection pamphlets out there, LLL's is based on this research and is the most liberal. One of the explanations that I was given is that they wanted to address the plight of the women who don't have easy access to refrigeration, such as migrant field workers. If breastmilk can be safely kept out for several hours, then we could empower these women to pump and save for their babies instead of having to opt for ABM. The good outweighs the risks, right? To balance this out, we do also specify that this info is good for milk that has been kept at a reasonable room temperature. It does not apply to milk left out in the sun, or in a hot car, etc. Personally, I think that the smell & taste tests are good criteria when in doubt, because environmental conditions can and do influence perishability. As for the discussion of the individual environment's of client's homes, well, we cannot control for that. All we can do is emphasize that the research defends longer sitting times for milk that is cleanly collected and not exposed to excessive heat; the rest is up to the mother. I give the moms this extended storage information, and also caution them not to purposely leave milk out or keep for 5 days; I tell them that this info is a guideline for those times that she forgets or miscalculates, and that otherwise prompt refrigeration or freezing is the best choice. -Lisa ****************************************************************************** Lisa A. Marasco, IBCLC / [log in to unmask] International Board Certified Lactation Consultant / [log in to unmask] ******************************************************************************