British expat and mum-of-two Rebecca Cunniffe has had a number of mishaps over breastmilk storage. She recalls in an interview with Gulf News, “When my first born was little, [besides] breastfeeding him, I had to express a lot as well (like five times a day) to top him up as he wasn’t good at feeding due to tongue tie. Every drop of milk I pumped was precious!
“I used to take a ‘top up’ bottle of expressed milk with ice blocks in a special part of my change bag when we went out. The dismay at realising the unused milk not been put back in the fridge when we got home and stayed in the bag overnight, so had to be chucked out [was real].”
She also talks of the problem of traveling with bottled milk. “Frozen expressed milk always confused the airport security staff, they seemed to think it was some form of powder. After scanning in a special machine their curiosity was satisfied and we were on our way.”
This problem – of storage and usage of this elixir in time – stretches across motherhood.
While the World Health Organisation recommends feeding babies less than six months old on a steady diet of breastmilk and nothing else, the demands of everyday life mean a mum must be ready to pump and store at a moment’s notice. The guidelines though can befuddle even the most well-read-up new mother. So we asked the experts about the ways to express and store these containers.
But first a quick note on containers. The American Academy of Pediatrics explains that “milk is a biologic substance and full of probiotic and commensal bacteria. Hand washing, using clean or new containers, minimising milk transfers (which waste fat and calories) and pumping directly into storage containers are recommended.
“Plastic or glass containers are fine, no evidence supports one over the other. Mothers can mix warm milk and cold, or even consider pooling milk from 24 hours together, which may help even out variability in nutrients due to pumping time or breast emptying (which influences fat content of the milk).”
If you are unable to breastfeed your baby directly, it is important to remove milk during the times your baby normally would feed. This will help you continue to make milk.
If you are trying to store the milk, the academy warns, the lipases in human milk continue to break down triglycerides even in frozen milk. “These free fatty acids can give the milk an unpalatable taste, but cause no GI upset, no additional bacteria, or altered nutrition.” While some children may reject this milk, others may not notice.
Still, if daily constraints call for a pump and dump in fridge, here’s how you can be an effective store keeper.
Dr Rajendra M. Joshi, Specialist Pediatrician at Prime Hospital, says: “If you are unable to breastfeed your baby directly, it is important to remove milk during the times your baby normally would feed. This will help you continue to make milk. Before you express breast milk, be sure to wash your hands. Also, make sure the area where you are expressing is clean.”
If you need help to get started, he recommends, keep a picture of your baby, a baby blanket, or an item of your baby’s clothing that has his or her scent on it nearby. You can also apply a warm moist compress to the breast, gently massage the breasts, or sit quietly and think of a relaxing setting.
There are three ways in which you can make your expressing of milk easier.
STORAGE OF BREAST MILK
The standard baby bottles of glass/plastic/clean food storage containers with tight –fitting, leak proof lids can be used to store milk, says Prachi Omkar Shetye, Physiotherapist and Lactation Consultant. “Baby bottle nipples are inappropriate, since milk contamination is possible through the nipple hole. Disposable feeding bottle liners are not recommended for long-term storage,” she adds.
Dr Joshi adds some tips for ensuring a log is kept of the milk.
- After each pumping label the date on the storage container. Include your child’s name if you are giving the milk to a childcare provider.
- Gently swirl the container to mix the cream part of the breast milk that may rise to the top back into the rest of the milk. Shaking the milk is not recommended – this can cause a breakdown of some of the milk’s valuable components.
- Refrigerate or chill milk right after it is expressed. You can put it in the refrigerator, place it in a cooler or insulated cooler pack, or freeze it in small (2 to 4 ounce) batches for later feedings.
TIPS FOR FREEZING MILK
If you are freezing the milk, tighten bottle caps or lids after the milk is completely frozen, says Dr Joshi. Try to leave an inch or so from the milk to the top of the container because it will expand when freezing. And store milk in the back of the freezer – not in the freezer door.
Here’s a look at the temperatures at which you can store milk and for how long.
Dr Prachi Omkar Shetye, Physiotherapist and Lactation Consultant at Somerset Clinic, offers guidelines on using the stored milk. She says, “Breast milk should always be given at room temperature as this reactivates the antibodies in breast milk.”
Breast milk should always be given at room temperature as this reactivates the antibodies in breast milk.
She recommends doing the following:
- Put the storage container in a bowl/pan filled with warm water. Hold the container under running water.
- Shake gently to mix the contents as expressed milk separates since it is not homogenised.
- Never in the microwave/on the stove.
Dr Bindu Ammini, Specialist Gynecologist, Aster Clinic – Qusais, warns that extra precautions must be taken if the baby is in the NICU or is hospitalised. “If the baby is in the NICU or is hospitalised then the breast milk may be fed through tubes through the nose or mouth or from a tiny cup. Storage guidelines are stricter for babies who are hospitalised and have weaker immune systems.Freshly pumped breast milk for premature infants should be used within one hour or refrigerated,” she says.
Storage guidelines are stricter for babies who are hospitalised and have weaker immune systems.
Cunniffe’s sadness about the milk she spilt was well earned it turns out. “If you are planning to use it outdoors, then using an insulated cooler bag maintaining the temperature of -15 C to -4 C by keeping ice packs with milk containers and limiting the opening of the cooler bag, the breast milk can be stored for up to 24 hours,” explains Omkar Shetye.
Other UAE-based mums on their breastfeeding journeys
Banking breastmilk? Try not to lose your sanity in the process
I can write books on my endless pursuit of breastmilk when my twins were born. Both preemies, the girls spent close to 40 days in the NICU, with my post C-section bedrest spent running between hospital and home to stock up on the breastmilk for the bubs.
A friend who had delivered several months earlier had just one advice: stock up the stash for days when your body needs a break. Between brewing Mother’s Milk tea, popping fenugreek tablets like they were candy and chowing down on moringa leaves, I had the home remedies down to pat. Now all I needed was enough supply to freeze away for the days I hibernated.
The process was slow and painful, with the nurses at the NICU not helping with their harsh words, which bordered on shaming a new mother bursting with hormones. ‘Breast is best’ may be the mantra, but there’s nothing wrong with ‘fed is best’ either. Do what you can but don’t wreck your emotional state over a few extra drops of milk. Trust me, there will be plenty more tears to shed by the time your baby turns one.
Armed with a breast pump and trashy romance on my Kindle, I spent hours those first few weeks trying to get the supply going. One nurse told me to keep staring at my babies to get the supply up, so I naturally bordered on stalking to get the juices flowing. Sleep-deprived and probably not showered for days (probably one), I still remember filling that first Medela bottle and proudly placing it in the freezer like a precious jewel.
There were days the supply surprised even me, and there were days when tears mixed with what was being scurried away ever so slowly. Once the girls came home from the NICU, building the bank became all the more harder with motherly duties coming in the way, but for days when I absolutely needed to pump, the husband was on hand with a bottle of water and a comforting pillow.
If you want a word of advice from a mum who is just about ready to end her breastfeeding journey: if money and space permits, do invest in a freezer. I’ve had countless times when breastmilk fought for space between the Rocky Road. And don’t remind me of the freezer breakdown of November 2020, when my heart nearly stopped with the sound of the machine cranking to a stop. Pouring your breastmilk down the drain is heart wrenching. But pro trip: if your baby can’t drink it, do think about using the milk for their bath time.
Being a new mum is hard and the stress of producing enough breastmilk can be harder than anything you may have ever imagined. Just hang in there and take it one day at a time. You got this.
How Facebook helped me save my baby's stored milk.
Savitri Rahmadani is the mother two children aged seven and four, and credits UAE-based Facebook group Breastfeeding Q&A for helping her learn about both breastfeeding and storage. She recalls a time a fellow member of the group also helped her save her stash. “I work in a five-star hotel and have long hours, so I obviously have breast milk stored at home. One day when I was pumping, the electricity went in the building went off and they said it would take eight hours to get back. I wrote on the group and another mum said she lived nearby. So you know what I did – I shuffled all the milk to her house until the electricity came back. Thanks to all the support, I was able to feed my baby breast milk for 18 months.”