How to feed baby breast milk from fridge
Tips for Freezing & Refrigerating Breast Milk
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By: Dina DiMaggio, MD, FAAP
When it comes to breast milk, how you store it depends on how soon you want to use it.
Here are some helpful guidelines for storing your breast milk safely.
Before expressing or pumping: Wash your hands and all storage containers thoroughly. Label the date the breast milk was expressed on each container and include your child's name if you are giving the milk to a child care provider. Talk with your child care provider about how they require breast milk be stored and labeled.
Store breast milk in small batches. 2 to 4 ounces is recommended to prevent waste. Any remaining breast milk left in a bottle after your baby is finished with a feeding should be used within 2 hours, or, if quickly refrigerated, used for the next feeding. You can always thaw an extra container if needed.
Refrigerate or chill milk right after it is expressed. Freshly expressed milk can remain at room temperature (up to 77°F or 25°C) for 4 hours (or up to 6 to 8 hours if very cleanly expressed), but it is best to chill as soon as possible.
Breast milk can be placed in the back of the refrigerator (39°F or 4°C). It is best to use refrigerated breast milk within 4 days, but it can be refrigerated for up to 8 days.
To warm breast milk from the refrigerator: Place the bottle in a bowl of warm water or run it under warm water.
Microwaving breast milk is not safe due to the risk of scalding your baby with hot milk. Freeze breast milk if you will not be using it within 24 hours. Breast milk expands as it freezes, so do not fill the milk all the way to the top of the storage container. Again store the milk in the back of the freezer, not the door.
If freezing the milk inside a refrigerator with a freezer that has a separate door (0°F or −18°C), milk may be frozen for up to 9 months.
If the freezer is a chest or a deep freezer (−4°F or −20°C), milk may be frozen for up to 12 months.
To thaw breast milk from the freezer: Put the bottle or bag in the refrigerator overnight, hold it under warm running water, or set it in a container of warm water. Remember that heating breast milk in microwaves is not safe.
Once breast milk is thawed: It can be stored in a refrigerator and must be used within 24 hours.
The Rule of 4's
We know breast milk storage can be confusing, so here is a more conservative approach that you can also go by (and easily remember): 4 hours at room temperature and 4 days in the refrigerator!
Editor's Note: Although these breast milk storage guidelines are appropriate for babies born premature and those who are hospitalized, hospitals may have their own rules. If you have specific questions, discuss these guidelines with your baby's pediatrician and/or hospital.
Where We Stand:
The American Academy of Pediatrics recommends breastfeeding as the sole source of nutrition for your baby for about 6 months. When you add solid foods to your baby's diet, continue breastfeeding until at least 12 months. You can continue to breastfeed after 12 months if you and your baby desire.
Additional Information & Resources:
- Expressing Breastmilk On the Job
Breastfeeding and the Use of Human Milk (AAP Policy Statement)
Effects of Extended Freezer Storage on the Integrity of Human Milk (The Journal of Pediatrics)
About Dr.
DiMaggio: Dina DiMaggio, MD, FAAP, is a board certified pediatrician at Pediatric Associates of NYC and at NYU Langone Medical Center. She is the co-author of The Pediatrician's Guide to Feeding Babies and Toddlers, a comprehensive manual written by a team of medical, nutrition, and culinary experts. Follow her on Instagram @Pediatriciansguide.
- Author
- Dina DiMaggio, MD, FAAP
- Last Updated
- 9/9/2016
- Source
- American Academy of Pediatrics (Copyright © 2016)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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How to Warm Breast Milk: Safety Tips and More
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Warming stored breast milk before serving it to your baby is a personal choice. Many babies like breast milk warm if they take it from a bottle, since breast milk is warm when babies nurse.
Warming up breast milk also helps the consistency after it’s been stored. When breast milk is frozen or refrigerated, the fat tends to separate in the bottle. Warming breast milk, or at least bringing it to room temperature, can help you more easily mix breast milk back to its original consistency.
Read on to learn how to warm up breast milk and safety precautions you should take.
To warm breast milk from the fridge:
- Take breast milk from the fridge and set it aside.
- Heat water using either a teakettle or microwave. Pour very warm (not boiling) water in a mug or bowl.
- Place sealed bag or bottle of breast milk in the bowl of warm water. The milk should be kept in a sealed container for warming.
- Leave the milk in the warm water for 1-2 minutes until breast milk reaches desired temperature.
- With clean hands, pout breast milk into a bottle, or, if it’s already in a bottle, screw on the bottle nipple.
- Swirl breast milk (never shake it) to mix in the fat, if it’s separated.
Before offering the bottle to your baby, test the breast milk temperature. You can do this by pouring a bit on your wrist. It should be warm, but not hot.
To prevent germs getting into the milk, avoid dipping your finger into the bottle.
You can also warm the milk by holding the sealed bag or bottle under very hot running water from the faucet. This takes longer and uses more water. You could also burn or scald your hand.
To warm frozen breast milk, remove the frozen breast milk from the freezer and put it in the fridge to thaw overnight. Then, follow the same instructions for warming breast milk from the fridge.
If you need milk right away and all you have is frozen milk, you can heat the breast milk straight from the freezer using the same method you’d use to heat from the fridge. The only difference is that you’ll need to keep it in the warm water for 10-15 minutes, or longer.
Never put breast milk in a microwave. Microwaves don’t heat food evenly, so they can make hot spots that can burn your baby.
Microwaves are also believed to damage the nutrients and antibodies in breast milk.
You can use a microwave to heat the water used for warming breast milk, however.
Some parents swear by using a bottle warmer to heat breast milk or formula. A bottle warmer is a simple contraption used to help you heat up a bottle.
Manufacturers of bottle warmers claim these devices heat more evenly than a microwave.
However, opinions are mixed if they are actually useful or easier than steeping breast milk in hot water.
The potential disadvantage of a bottle warmer is the increased chance of overheating breast milk and killing beneficial nutrients.
In a 2015 study, researchers tested how warm different portions of breast milk can get in a bottle warmer. They found that the milk can get above 80°F (26.7°C), which could have a negative effect on the nutritional value of the milk.
The study doesn’t state which brand of bottle warmer they used in testing. If you’re interested in the convenience of a bottle warmer, it might be worthwhile to use a thermometer and test breast milk temperatures as you use it.
How to warm breast milk in a bottle warmer
To warm breast milk in a bottle warmer, put the whole bottle in the heating area and follow the manual’s instructions.
Most bottle warmers take a few minutes to reach desired warmth. Keep an eye on the bottle warmer so that it doesn’t overheat, and unplug it when not in use.
Do not reheat or restore breast milk that was previously warmed.
Sometimes babies nibble at their food and don’t quite finish it. But after two hours of sitting out, it’s best to throw out any leftover breast milk. This helps prevent milk from going bad or being introduced to germs in the environment.
If your baby eats on and off, or if you’re traveling, breast milk may end up sitting out for a while. Safety of breast milk left out will vary greatly depending on the overall bacteria levels in the environment.
Breast milk is good at room temperature (up to 77°F or 25°C) for:
- Four hours for fresh breast milk. After four hours you should use, store, or discard it.
- Two hours for previously stored and thawed breast milk. Discard unused, thawed breast milk after two hours. Do not refreeze or reheat breast milk that was frozen and thawed.
Always keep breast milk covered with the lid on or bag zipped while it’s sitting out.
At least one study indicates that you can store breast milk in an insulated cooler with ice packs for up to 24 hours.
Always use bottles and bags specifically designed for freezing human milk.
Plan to store breast milk in 2 to 6 ounces, depending on how much your baby typically takes in a single feeding. That can help reduce the amount of unused breast milk you later have to discard.
Always label breast milk with the date it was expressed, and use the oldest stored breast milk first in order to keep the rotation fresh.
Breast milk can be stored in the refrigerator for four days and in the freezer for up to 12 months. However, after 90 days, acidity in breast milk can rise and nutrients can decrease. So, for the best quality, plan to use frozen breast milk within six months of when it was expressed.
You can mix and store breast milk that was pumped on different days but always use it based on the first, oldest date. And never add fresh breast milk to already frozen breast milk.
If your baby doesn’t like breast milk that was previously frozen, you can try just refrigerating breast milk and working through your supply faster.
In general, refrigerated breast milk is better than frozen because it’s fresher and the nutrients and antibodies will be most current to the baby’s needs.
However, freezing breast milk is a good technique if you need to have a lot on hand, for example, if you’re returning to work. Frozen breast milk is still considered to have more nutrients than formula.
Warming breast milk is a very common practice, but safety and quality standards cannot be guaranteed due to all of the variables that come with storing and reheating.
More research is needed on optimal use of frozen breast milk since many babies rely on it completely for their nutrition.
In general, though, breast milk stores well in the refrigerator and freezer, and can be warmed to help baby take it easier. Always use storage bags or bottles designed especially for breast milk.
Storing, freezing and thawing breast milk
Expressed breast milk is the best food for your baby when you are not around.
How to store and use breast milk correctly?
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If you go to work, go to the gym or simply ask your partner to feed your baby and you want to get some sleep yourself, you can express breast milk so that the baby can eat even when you are not around. Most of the beneficial properties are retained in expressed breast milk, so if you are forced to skip breastfeeding, it will be a better replacement than any formula. But an important guarantee of the safety of expressed milk for your baby is hygiene. Read the article to learn how to properly store breast milk.
What is the best way to store breast milk?
Any type of breast milk is better for the baby than formula. But freshly expressed breast milk is better than chilled, and chilled breast milk is better than frozen. The fact is that freshly expressed milk fights bacteria better, it contains more antioxidants, vitamins and fats than chilled or frozen milk 4 .
How long expressed breast milk lasts
Once your breast milk is properly collected in a clean container, you can store it at room temperature, in the refrigerator or in the freezer, depending on how soon you plan to use it. Follow the guidelines below:
Recommendations for the storage of expressed breast milk (for healthy term infants) 2, 3
| Storage | Room temperature | Refrigerator | Freezer | Pre-frozen |
| Safe shelf life | Up to four hours Up to six hours for milk expressed under extra clean conditions* | Up to three days Up to five days for milk expressed under extra clean conditions* | Up to six months Up to nine months for milk expressed under extra clean conditions* | Up to two hours at room temperature Up to 24 hours refrigerated Do not freeze again! |
.
0116 . These instructions for storing and thawing breast milk are guidelines only. For more information, contact a lactation consultant or healthcare professional.
If the baby is in the neonatal intensive care unit (NIU) or intensive care unit, stricter cleaning and storage guidelines may apply in accordance with the hospital's internal policies.
Before placing expressed milk in the refrigerator or freezer, be sure to mark the bottles or bags with the amount of milk and the date of expression. This will make it easier to manage your pumped milk supply.
Recommendations for feeding expressed breast milk
During storage, breast milk usually separates into layers and the fat (cream) it contains rises to the top. Shake the bottle lightly to mix the layers before giving it to your baby. Strong stirring and shaking can destroy some of the nutritional and protective components of breast milk 5 .
When a baby is fed expressed breast milk from a cup or bottle, bacteria from the mouth naturally enters the milk.
Therefore, it is best to throw out all the unfinished milk one to two hours after the first feeding. In order to waste as little expressed milk as possible, it is best to store it in small portions and use just enough for one feeding 2 .
How to Store Breast Milk in the Refrigerator
2, 3Follow the guidelines below to safely store expressed milk in the refrigerator.
- Refrigerate breast milk as soon as possible after pumping.
- Store milk in clean BPA-free breast milk bottles or breast milk storage bags. Its long-term effects on the human body are not well understood and manufacturers are now moving away from the use of this chemical in plastic containers and coatings.
- After pre-cooling, a small amount of expressed milk can be added to the milk container stored in the refrigerator. Do not add warm breast milk to already chilled milk.
- Store breast milk in the coldest part of the refrigerator, on the back of the shelf above the vegetable drawer.
Do not store milk in the refrigerator door where the temperature is not as constant.
How to store breast milk in the freezer
2, 3The following are recommendations for the safe freezing of breast milk.
- Freeze breast milk as soon as possible after pumping.
- After pre-cooling, expressed milk can be added to a container of already frozen milk. Do not add warm breast milk to already frozen milk.
- To simplify defrosting and reduce waste, store milk in small portions (less than 60 ml). Once thawed, portions can be mixed.
- Make sure the breast milk container is suitable for freezing: some containers (eg glass bottles) may burst at low temperatures. Medela Breast Milk Storage Bags are ideal for storing frozen breast milk: they are ready to use, cold-resistant and easy to label.
- Do not fill bottles or bags more than 3/4 full as milk expands when frozen.
- Store frozen breast milk in the back of the freezer where the temperature is constant.
Do not place it against the walls of freezers with automatic defrosting.
Feeding frozen breast milk
2, 3Follow these guidelines when thawing breast milk to keep it safe for your baby.
- Breast milk can be thawed in the refrigerator, usually takes about 12 hours. You can place the bottle or bag of frozen milk under running warm water (max. 37 °C). Do not thaw breast milk at room temperature.
- Fully thawed breast milk can be stored for up to two hours at room temperature and up to 24 hours in the refrigerator.
- Do not thaw or reheat frozen breast milk in a microwave oven or in boiling water. This can negatively affect the nutritional and protective properties of breast milk, and due to uneven heating, the baby can burn.
- If, after defrosting, you left breast milk at room temperature, but did not feed it to the baby within two hours, the milk must be discarded.
- Do not refreeze breast milk.
How to warm up expressed breast milk
2, 3 Healthy full-term babies can be given breast milk at room temperature or heated to body temperature.
Some children care about the temperature of the milk, while others drink milk at any temperature.
- To warm breast milk, place the bottle or bag in a cup, mug or bowl of warm water for a few minutes until the milk is at body temperature (37°C). You can use a bottle warmer. Do not heat milk above 40°C or microwave it to avoid overheating.
- Slightly shake the milk in the bottle or bag to mix the separated fat (see above). Do not stir or shake the milk too hard.
Why does milk smell strange after storage?
Chilled or thawed breast milk may smell different from fresh
. This is due to the action of lipase, an enzyme that breaks down fats into fatty acids, preventing the growth of dangerous bacteria.
Some mothers report that their milk smells rancid or soapy after storage. But if you followed all the recommendations for safe storage given in this article, such milk is absolutely safe 2 .
Storing breastmilk on the go
If you need to transport your breastmilk from work to home or nursery, use the cool bag with ice packs 2 . For more information on pumping and storing breastmilk on the go, see the article on pumping on the go.
Literature
1 US Food & Drug Administration. Using a breast pump. [Internet]. Silver Spring, MD, USA: US Department of Health and Human Services; 2018 [updated 2018 Feb 04; cited 2018 Apr 12] Available from: www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/HomeHealthandConsumer/ConsumerProducts/BreastPumps/ucm061944.htm
2 US Food and Drug Administration. "Instructions for using the breast pump". [Internet] Silver Spring, Maryland, USA: Department of Health and Human Services; 2018 [updated February 4, 2018; cited April 12, 2018] Article referenced: www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/HomeHealthandConsumer/ConsumerProducts/BreastPumps/ucm061944.htm
3 Eglash,A., Simon,L., & The Academy of Breastfeeding Medicine. ABM clinical protocol #8: human milk storage information for home use for full-term infants, revised 2017.
Breastfeed Med 12, (2017). - Eglash A, Simon L and Academy of Breastfeeding Medicine, AVM Clinical Protocol #8: Home Storage of Milk for Term Infants 2017 Revision. Brestfeed Med (Breastfeeding Medicine) 12 (2917).
4 Human Milk Banking Association of North America. 2011 Best practice for expressing, storing and handling human milk in hospitals, homes, and child care settings. (HMBANA, Fort Worth, 2011).- North American Breast Milk Banks Association. Fort Worth: SABGM; 2011.
5 García-Lara NR et al. Effect of freezing time on macronutrients and energy content of breastmilk. Breastfeeding Medicine. 2012;7(4):295-301. - Garcia-Lara N.R. et al., "Effect of Freezing Duration on Macronutrients and Energy in Breast Milk". Brestfeeding Honey (Breastfeeding Medicine) . 2012;7(4):295-301.
6 Office on Women’s Health.
Pumping and storing breastmilk. [Internet]. Silver Spring, MD, USA: US Department of Health and Human Services; 2018[updated 2018 Jan 12; cited 2018 Apr 12] Available from: www.womenshealth.gov/breastfeeding/pumping-and-storing-breastmilk
7 Office of Women's Health, "Pumping and Storing Breast Milk" [Internet]. Silver Spring, MD, USA: US Department of Health and Human Services, 2018 [updated January 12, 2018; cited April 12, 2018] Article Link: www.womenshealth.gov/breastfeeding/pumping-and-storing-breastmilk
Feeding expressed milk | breastfeeding
When can I start breastfeeding my baby with expressed breast milk? How to do it right? Is it worth worrying that the child will confuse the pacifier with the breast? In this article we will answer your questions.
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When can I start breastfeeding my baby?
If your baby is healthy and breastfeeding well, there is no need to give him expressed milk.
For the first four weeks, you work together to start and increase milk production, and your baby also learns to suckle properly at the breast. There is not enough scientific data on this yet, 1 but there is an opinion that bottle feeding in the first month may adversely affect the process of establishing breastfeeding.
However, if the newborn is unable to latch on or suckle for some reason, start expressing milk as soon as possible after delivery. Read more about this in our articles on coping with problems in the first week, breastfeeding premature babies and babies with special needs, and seeking help from your healthcare provider.
How can I feed my baby with expressed breast milk?
There are many expert feeding solutions that allow you to give your baby expressed milk in a variety of ways, depending on your and your baby's needs.
For example, the innovative Calma smart pacifier only lets milk through when the baby creates a vacuum by suckling.
This means that when feeding from a bottle, he will make the same movements with his tongue and jaws as when sucking at the breast. 2.3 Calma was developed with the help of breastfeeding experts from the University of Western Australia. When using this pacifier, the baby can suck, swallow, pause and breathe in the same way as when breastfeeding. 4 Maintaining natural sucking habits allows baby to transition easily from breast to bottle and back.
In addition, Medela also offers regular bottle teats* in two versions that produce milk at different rates. All Medela* nipples can be placed directly on bottles used for expressing milk, minimizing the risk of spillage.
If you need to feed your baby with expressed milk, but you do not want to bottle feed him until he is learning to breastfeed, you can use a sippy cup* for temporary feeding. The baby will be able to drink milk from such a mug, but you should be careful not to spill the milk. For the first time, it is advisable to feed the child from a drinking cup under the supervision of the attending physician in order to learn how to do it correctly.
If your baby needs to be supplemented with expressed milk in addition to regular breastfeeding, the Supplementary Feeding System (SNS)* can be used. It is equipped with a thin, flexible capillary that can be clipped close to the nipple to give your baby expressed milk while breastfeeding. Thanks to this, the baby suckles the breast for longer, thereby developing sucking skills and stimulating the production of milk from the mother. This can be helpful when there is a shortage of breast milk, as well as when feeding adopted or surrogate children.
If the baby is unable to breastfeed because he is too weak or has a congenital disease, you can use the Special Needs Cup*, which releases milk with gentle pressure, making it suitable for feeding these babies.
How to teach a child to bottle feed?
If your breastfeeding is going well and you decide to start bottle feeding your baby with expressed milk, follow these guidelines.
Start early and take your time
Don't wait until the first day of work or the first time you leave the house to start bottle feeding your baby.
Start accustoming your baby to small portions of expressed milk a couple of weeks before the desired date, calmly and without haste. Gradually build up to one full serving of pumped milk from a bottle.
Choose a time
Ideally, at the first bottle feeding, the baby should be hungry, but not too hungry - in this state, he is as relaxed as possible.
Let others feed
Your baby is used to feeding from your breast, so when you offer him a bottle it can be confusing. The process can go faster if the first time the baby is bottle-fed by someone else while you are not in the room, so that your sight and smell do not embarrass the baby.
Maintain optimal temperature
Your baby will be more willing to eat expressed milk if the temperature is around 37°C, close to body temperature.
Dip a nipple in milk
Try dipping a nipple in expressed milk before offering it to your baby.
This way it will taste and smell like your breast milk. Lightly touch the baby's upper lip with the nipple to open the mouth.
Choose the right position for bottle feeding
Feed your baby on demand and keep him reclining during feeding. Never bottle feed your baby when he is lying or sitting, otherwise he may choke. Listen to the wishes of the child - take as many pauses as he needs. You can even try to shift it from one hand to another during feeding.
Be patient
Don't worry if your baby doesn't take the bottle right away - it may take several tries. If he pushes the bottle away or starts crying, calm him down, wait a few minutes and try again. If he still doesn't want to bottle feed, wait a few more minutes and breastfeed him as usual. Repeat the bottle experiment at a different time of day.
How much expressed milk should I give my baby?
All children are different. Research shows that between the ages of one and six months, a baby can consume between 50 and 230 ml of milk per feeding.
To start, prepare about 60 ml and observe how much your baby needs - more or less. You will soon realize how much milk he usually eats. Just never force him to finish the cooked portion.
How can I keep my baby safe when bottle feeding?
Always clean and sterilize your breast pump and bottles according to the manufacturer's instructions. Wash your hands before expressing, pouring milk, and feeding your baby. Follow our instructions for safely storing and thawing your expressed milk.
If breastmilk needs to be warmed, place the bottle or bag in a bowl of warm water or a heater or under running water at a maximum of 37°C. Never heat breast milk in the microwave or on the stove.
Will the baby be able to transition from breast to bottle?
Some mothers worry that if they start bottle feeding too early, they will get used to the artificial nipple and not want to breastfeed. Others, on the contrary, are worried that if the child is not immediately accustomed to the bottle, then he will no longer eat from it.
In general, in these cases, they say that the child confuses the nipple with the breast.
Experts disagree on whether such confusion is a problem. 1 Without a doubt, it is easier for a baby to suckle milk from a regular bottle with a nipple, which does not require a vacuum, than from the breast, since the milk flows faster, also under the influence of gravity. And some babies really have clear preferences: only the breast or only the nipple. However, many babies are comfortable suckling both the breast and the pacifier.
If you are unable to feed your baby with expressed breast milk, seek help from a lactation consultant or specialist.
Literature
1 Zimmerman E, Thompson K. Clarifying nipple confusion. J. Perinatol. 2015;35(11):895-899. - Zimmerman I., Thompson K., "On the issue of breastfeeding." J Perinatol (Journal of Perinatology). 2015;35(11):895-899.
2 Geddes DT et al. Tongue movement and intra-oral vacuum of term infants during breastfeeding and feeding from an experimental teat that released milk under vacuum only.
