Your baby would have started to breastfeed properly with a proper latching technique when it is about a month old. This is the time when you can introduce bottle feeding. The switch to bottle-feeding will take some time as the baby feeds on the mother’s breast. But you have to introduce the bottle at some time. This is as good a time as any. Make sure you follow the tips for getting the baby used to the bottle.
One of the things that you first feed to a baby through the bottle is expressed or pumped milk from the mother’s breast. You can also use infant formula that you can buy at the store. Your pediatrician can recommend a few brands. However, expressed milk is the best thing to feed the baby in most cases. There are different storage and preparation techniques for expressed breast milk. These are not the same as storage specifications for cow’s milk. Following these guidelines will ensure that the stored breast milk is safe to feed the baby.
There are some general guidelines for storing expressed human milk at different temperatures. These guidelines depend on various factors such as
- milk volume
- when the milk is expressed
- the temperature that it is stored at
- room and ambient temperatures when the milk is expressed
- temperature fluctuations in the refrigerator and the freezer
- cleanliness of the environment in which the expressed milk is stored
All of these factors determine how long it will last before getting spoiled.
The following points will give you an idea of how long you can keep breast milk at different temperatures. When referring to storage temperatures, we consider
- 20 – 25°C or colder as room temperature
- 10 – 4°C or colder for the refrigerator
- -18°C or colder for the freezer.
Freshly expressed or pumped breast milk will last up to 4 hours at room temperature. You can store this for up to 4 days in the refrigerator. If you are storing freshly expressed milk in the freezer, it is best to use it within six months. The milk can also last up to 12 months in the freezer, but this is considered almost acceptable. You can store freshly pumped breast milk in a cooler or insulated cooler pack with ice packs for up to 24 hours after pumping.
If the breast milk is thawed or previously frozen, it cannot be kept long. It can only be kept out at room temperature for about 1–2 hours. You can store it for up to 1 day in the refrigerator. Human milk should never be refrozen, so previously thawed milk should never go back into the freezer.
You should use leftover breast milk from feeding within an hour or two of the baby finishing the feeding. After this period exceeds, you have to throw the milk in the bottle out. There are high chances of the milk getting spoiled. Bacteria could also start developing in the milk.
When you are bottle-feeding your baby, you must pump it carefully before storing the breast milk. As with everything that concerns the baby, pumps are highly susceptible to bacteria build-up. You have to ensure that the milk you are giving to the baby is the best. Get help from your pediatrician or lactation consultant on how to best express breast milk. They will also be able to recommend good manual or electric pumps. Here are some points to keep in mind before expressing or handling breast milk:
– Use soap and water to wash your hands thoroughly. If there is no soap and water available for some reason, use an alcohol-based hand sanitizer to clean your hands. Germs from surfaces can easily be transmitted from the hand to the milk or the bottle while preparing it.
– If you are using a manual or an electric pump to express milk, it is imperative to make sure that it is clean. Check the pump kit and the tubing. If the tubing appears moldy, replace it immediately. Keep a couple of tubes handy for when this scenario arises. It helps wipe down the pump and the countertop with a disinfectant wipe to make sure they are clean.
After you have expressed the breast milk, storage is critical. You can buy breast milk storage bags made specifically for this purpose. If you do not have these, use food-grade containers. The containers should be made of plastic or glass. The lids should be tight fitting. When choosing containers, make sure they are BPA-free. Containers made of plastic and containing recycle number 7 may contain BPA. You should never store breast milk in bottle liners or plastic bags that are not intended for storing breast milk.
When storing the breast milk in the milk storage bag or container, clearly label the same with the date the milk was expressed. This will help you keep track of the milk in the refrigerator or the freezer. You can follow recommended storage time guidelines. You should not store breast milk in the refrigerator or freezer door. Items stored in the door are subject to more temperature changes from the door opening and closing. This is not good for breast milk.
If you will not be using freshly expressed breast milk within four days, it is good to freeze it right away. Freezing will retain the quality of breast milk. Also, store breast milk in small amounts so you do not end up wasting milk that your baby may not finish. It is recommended that you store the amount your baby needs in one feeding. This will ensure that you only have to thaw one bag at a time and fill a bottle with it at the time of feeding.
When freezing, leave some space at the top of the milk container where the milk is being stored. Like most liquids, breast milk expands as it freezes. Thaw the oldest breast milk first. The quality of breast milk can decrease over time. The ones that were stored first must be thawed and served first.
Frozen breast milk can be thawed in several different ways-
- Overnight in the refrigerator.
- Leave it to rest in a container of warm or lukewarm water.
- Run a tap of lukewarm water and hold it under the tap.
Using a microwave to thaw or heat breast milk should never be done. Microwaving breast milk can destroy the nutrients in it. Once you thaw breast milk in the refrigerator, you should use it within 24 hours. If the breast milk is brought to room temperature or warmed, use it within 2 hours. Remember, never refreeze breast milk after it has thawed.
If you are leaving your baby with someone else, clearly label the container as to when they should use it. When using a child care provider, talk to them about any requirements in labeling and storing breast milk to make it easier for them to be precise. For example, a nanny may need labeling in a regional language. Freshly expressed breast milk can be carried in an ice pack or cooler when traveling. It must be used within the first 24 hours, so do not express more than needed.
Another concern for new mothers who go back to work after maternity leave is the time to pump. Most workplaces understand what you are going through and give you breaks during which you can use an empty room to pump. The expressed milk can be stored in the office refrigerator with all the required permissions. If your office does not have one, make sure to carry your cooler and keep the breast milk with ice packs.
Breast milk is usually at the right temperature for the baby to drink directly from the breast. When bottle-feeding, some mothers like to serve it at room temperature. Others serve it cold. If you are warming up the milk to nurse the baby, make sure you do not do this directly on a stove or in the microwave. Warm up the milk gently by placing the container in some lukewarm water. Always test the milk temperature before serving by putting a few drops on your wrist before giving it to the baby.
Swirl the bottle around to mix the fat. This may have separated during the storage. Breast milk should not be shaken. We like to say babies prefer their milk quite the opposite of how James Bond likes his martini.
Your pediatrician or lactation consultant will be able to assist you further in terms of any other clarifications you may have regarding bottle feeding, breast milk expressing, infant formula, or supplementation options if necessary.