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august 2012

Nutritional Aspects Of Stored Breast Milk

Nitika Sharma & Dr Vindhya Tirumalareddy
Breast-feeding we know is the simplest and assured means of clean, warm and bacteria-free milk for a newborn or a growing infant, besides the emotional and psychological benefits it has for the mother and child. The composition of human breast milk is also ideally suited for the requirements of human life at the tender newborn age

Mother’s milk is the best food for a baby and mothers should be encouraged to breastfeed completely and as long as possible. Working mothers, or mothers who are separated from the newborns or infants for varying hours or days, can express their milk and assure their babies of an unbroken supply or availability of breast milk.

The point is for mothers to know the right and hygienic way of expressing and storing breast milk. Many mothers are able to express 400 - 500 ml of milk even just after a round of breast-feeding. The cup of the expressed breast milk (EBM) must be covered and left in a cool place. EBM keeps well for up to 10 hours without refrigeration. EBM can be a source of infection if it is not collected, stored and administered safely.

There is no doubt that any hitch in breastfeeding, robs a mother and her child their unique bonding factor. It holds true also in cases where work-life balance forces mothers to serve the needs of their infants by pumping or expressing breast milk. The point is, from purely nutritional point of view, breast milk in any form bottled or otherwise, is still beneficial to a child

Quality Facts Of EBM
Storing EBM for a long duration causes loss of Vitamin C. Also, bactericidal properties of EBM reduce when stored for more than two days. Freezing destroys the substances in EBM that fight infection. Thawed EBM may have different colour, odour and consistency as compared to fresh breast milk but it is still safe to be fed to the baby.

Breast milk has important health benefits. When handled properly, expressed breast milk serves well the needs of an infant and the post-natal work-life balance of a woman.

Gynaecological Aspects
Apart from the obvious nutritional benefits to the infant, breastfeeding provides a unique bonding opportunity for the mother and child. Women who breastfeed their children have lesser chances of contracting breast cancer than those who don’t. However, if themother is undergoing treatment for some condition that requires potent medication, then breastfeeding should be avoided. Routine medication does not require cessation of breastfeeding. It is always best to heed your doctor’s advice regarding breastfeeding while on medication. A common myth associated with breastfeeding is that lactating helps in losing pregnancy weight. This leads some women to indulge in high calorie food post-delivery. While lactation does require a certain amount of extra nutrition, it should not be an excuse to gorge on sweets, ghee or fatty foods. A maximum of extra 600 calories in the form of nutritious healthy food is enough to supplement milk production. Working mothers, who pump out breast milk, do miss out on the mother-child bonding factor. But, most of these women have no choice, and breast milk in any form, bottled or directly from source, is more beneficial to the child in any case. To point at the other side of the case, prolonged breastfeeding can lead to calcium depletion. Osteoporosis has been observed in women who have breastfed several children for long periods of time. Normally, babies should be weaned when they are at the end of the first year and completely weaned at one and a half year of age.

How To Handle, Store And Use EBM?
  • Freshly expressed breast milk should be used or refrigerated within 4 hours.
  • EBM should be refrigerated at 4° C in a refrigerator and away from other foods.
  • Refrigerated EBM must be used within 48 hours, if it is fresh and has no additives.
  • It must be used within 24 hours, if it is thawed or contains additives.
  • Frozen EBM may be kept for not more than 3 to 4 months. Once thawed, EBM should be used within 24 hours.
  • Milk should be stored/frozen in quantities appropriate for the infant’s age (30-60 ml for newborns and larger quantities for infants) to minimize waste and for easier thawing.
  • EBM can be kept in deep freeze, for up to 6 months. t Thaw frozen EBM by placing it in the refrigerator the previous night.
  • If required immediately, frozen EBM may be thawed by placing the container in warm water until the required volume has thawed. The warmed milk is to be used within an hour.
  • Thawed EBM must never be refrozen or reheated. t Microwaves are not to be used to thaw or heat EBM, as it may heat the EBM unevenly.
  • Milk that has separated into layers should be rotated gently to recombine it.
  • Never thaw frozen EBM at room temperature.
Nitika Sharma Dietician, Apollo Health City, Hyderabad. and
Dr Vindhya Tirumalareddy
is Senior Consultant Gynaecologist, Apollo Health City, Hyderabad