Saving expressed breast milk

Question

How long does expressed breast milk last? Should it be kept in a refrigerator?

Priyankara C D Atapattu, registered medical officer, Wlasmull, Sri Lanka

Answer

The Breastfeeding Network (BfN) recently investigated this issue (Hands A. Safe storage of expressed breast milk in the home. MIDIRS Midwifery Digest, 2003;13: 378-85).

“Current guidelines for the safe storage of expressed breast milk (EBM) were found to be inconsistent and confusing, ranging from 24 hours to 8 days in the fridge. Primary research showed EBM could delay bacterial growth, keeping it safer for longer than processed milk. Freezing affects these antibacterial properties.

Careful handling during collection and accurate storage temperature is stressed to prevent bacterial contamination and minimise bacterial growth. Studies showed EBM to be safe for up to 8 days below 4°C and up to 3 days at 4-10°C. It has not been shown if milk is safe (or unsafe) at either refrigeration temperature. There is evidence to suggest that contaminated milk is safer stored at 4°C for 8 days than frozen; and that previously frozen breast milk should be kept for as short a time as possible before use.”

Anabel H Hands, former dairy microbiologist and BfN trustee, Paisley

Answer

The following guidance is taken from Guidelines for the Collection, Storage and Handling of Breastmilk for a Mother's Own Baby in Hospital, published by the UK Association for Milk Banking, 2nd edition, 2001. As it is intended for use with babies who have been born preterm or are unwell, it incorporates a margin of safety. The storage times are therefore less generous than those sometimes used for well babies at home.

“Breastmilk should be kept at room temperature for as short a time as possible and refrigerated immediately after expression. If a mother is expressing at home and has no access to a fridge, the milk can be kept at room temperature for up to 6 hours. If milk is to be used within 48 hours it should be stored in a refrigerator at a temperature of 2-4°C. Milk which has not been used after 48 hours should be stored frozen (-20°C) for a maximum of 3 months if it is to be fed to sick preterm infants.”

Gillian A Weaver, chair of the United Kingdom Association for Milk Banking, Queen Charlotte's and Chelsea Hospital, London

Answer

Searching the web using Google and the phrase “storing expressed breast milk” gives a good set of results. Quality of information is obviously an issue; however, a quick scan shows that there seems to be a degree of consistency among the guidelines and some are published by well respected organisations. See www.ich.ucl.ac.uk/factsheets/misc/breastfeeding_and_expressing/

John C Platt, senior nurse lecturer, Northern General Hospital, Sheffield