Collection and storage of breast milk

Ideally, mothers who intend to breastfeed their infants should begin pumping by 6 hours after delivery. However, as many of our high-risk mothers are quite ill, initial breast pumping may be delayed, but not beyond the first 24 hours after delivery, if at all possible. When physicians and nurses first meet new mothers, potential breast milk feeding should be addressed; mothers who are willing to provide breast milk for their infants should be encouraged to ask their obstetric nurses for a breast pump. The lactation consultants are also available to assist with this process.

Breast pumps are available for use in the NICU waiting area and at the Ronald McDonald House. Mothers are encouraged to rent a hospital grade electric breast pump for home use after their discharge. The lactation consultants and case managers can assist with this process.

Frequency of pumping is key to stimulating breast milk supply, particularly when the infant is not able to suckle. Mothers should pump at least 8 times in 24 hours (q2 -3 hours by day and no farther apart than q5 hours at night) for ~ 15 minutes at a time. To optimize milk supply and release, mothers should be encouraged to relax as much as possible and use warm compresses and massage to stimulate their breasts.

Glass bottles with an airtight seal are the preferred storage container. The NICU will provide sterile water bottles for this purpose. OB occasionally provides mothers in the early phases of lactation with plastic syringes to collect their colostrum. Although syringes may be easier to collect small volumes in, critical immunoglobulins will adhere to plastic and can be lost if milk is stored this way.

Milk produced at each pumping session should be bottled in fresh containers. Do not combine several pumpings of milk in one container. Mothers who produce > 3 ounces of milk per pumping session will need multiple containers per session. Each container should not be filled with > 3 oz of milk as overfilling may cause bottle breakage during freezing.

The NICU provides mothers with preprinted labels for their baby’s milk. Mom should write on the label the date and time the milk was pumped and any medications she is taking (other than prenatal vitamins.) Each container of breast milk must be labeled separately.

The breast milk should be refrigerated or frozen as soon as possible. Fresh refrigerated breast milk must be fed to the baby within 24 hours. Breast milk brought from home should be transported in an insulated container. Place the milk in the freezer upon arrival in the NICU. Do not re-freeze thawed breast milk or "layer" fresh breast milk onto frozen milk.

Frozen bottles should be thawed in the refrigerator or in a cup of "cool" water. Setting a frozen glass bottle in scalding water will occasionally cause the glass to break

Thawed breast milk should be warmed to room temperature by placing the container in warm water before feeding to the infant. Thawed breast milk left at room temperature is good for only 4 hours. Thawed breast milk left in the refrigerator is good for 24 hours. Containers of breast milk should be labeled with the date and time thawed and opened. Any unlabeled thawed, opened breast milk must be discarded.