Friday, February 28, 2014

Feeding Expressed Breast Milk: Fresh vs. Frozen

     Many moms are automatically freezing their breast milk each time they pump and retrieving frozen milk from their stockpile to feed the baby.  While this is ok for the mom who gives an occasional bottle, working moms should be giving freshly expressed milk whenever possible. 

     Before we list these factors, let us be clear than breast milk, fresh or frozen is immeasurably better for your infant nutritionally than formula; but to use the best at it's very best, we are explaining the changes that happen to frozen breast milk. 

     1.  Levels of pH are effected by freezing which in turn effects lipase which aids in digestion.  Lipase levels vary from woman to woman, so if you notice a soapy smell or metallic taste to your frozen breast milk, it may be especially relevant to you to give freshly expressed breast milk.

     2.  Bactericidal capacity of stored refrigerated human milk is at it's greatest within the first 48 to 72 hours of refrigeration.  (By the way, this is good to know so you can use fresh breast milk on your infants or toddlers hands instead of harmful alcohol based hand sanitizers.)

     3.  Breast milk is age appropriate.  Levels of nutrients, most of which we still do not fully understand change with your baby's age.  One example is magnesium which increases after 4-6 months.  Magnesium aids in bone development which is needed especially in infants as they begin to sit, crawl and pull-up.

     4.  White blood cells in breast milk are living leukocytes and are killed during the freezing process.  These white blood cells are prevalent in freshly expressed breast milk and help prevent infection and disease. 
living blood cells in breast milk before freezing

     5.  Antibodies are another reason freshly expressed milk is best.  If a mother has recently built immunity towards the latest illness going around, this is passed along to her nursling.  So it is especially important to give freshly expressed milk during the cold and flu season.

     6.  Energy density of breast milk varies with the age of the baby.  So giving a 6 month old breast milk expressed at 4 months, is not as beneficial to his energy needs as giving fresh breast milk.

     5.  Nutrients have been shown to decrease when breast milk is frozen over time.  One study showed a decrease in Vitamin C after breast milk had been frozen for 3 months.

     Now that you know some of the reasons that freshly expressed breast milk is best, how can you as a working mother or an exclusively pumping mother manage it. 
  • First know that all breast milk, fresh or frozen is superior to any formula.
  • If you are a M-F working mother, leave frozen milk for your baby on Monday but use the milk you pump Monday to give on Tuesday, Tuesday's milk is for Wednesday, etc.  Then when you come home on Friday, feel free to freeze that milk or save it in the refrigerator for Monday depending on how much stockpile you think you need in the freezer. 
  • Frozen milk is perfect for use as a back-up and if you see you have more than you need, please donate it!
  • If you are an exclusively pumping mom and need to dip into your frozen stockpile, don't beat yourself up about it.  You are doing so much good for your baby in giving breast milk.  To help you have more  fresh milk in the future, make sure to simulate growth spurts by pumping 11-12 times a day during the week your baby turns 3 weeks, 6 weeks and 3 months.  Also, make sure you use stopwatch on your phone or timer app to ensure you are double pumping for a full 10-15 minutes, whether milk is flowing the whole time or not.  This will help you get the stimulation you need to keep up a healthy milk supply.  Also don't forget to change valves, diaphragms or filters on your pump often to get the best performance out of your pump.
  • Many products are dedicated to freezing breast milk, but new products are helping moms label and organize their freshly expressed breast milk.  Breastmilk Bandit is an economical re-usable and fun way of helping moms with this task with their breast milk organizer.  These are day of the week bottle bands that say Mommy's Milk and the day of the week in fun colors.  Also helps identify your baby's bottles in the church nursery or day care.  Breastmilk Bandit Fresh Express Breast Milk Bands fit most 4-8oz breast milk storage and feeding bottles.

Remember, breast milk is best.  Frozen breast milk is great, and FRESH is EVEN BETTER!

Happy Nurturing,
Tanya




References:
Lawrence R. A., and Lawrence R. Breastfeeding: A Guide for the Medical Profession. 6th ed. Philadelphia, Pennsylvania: Mosby, 2005: pp. 106-129
Per Gaskin, Ina May. “Soapy-, Metallic- or Rancid-tasting Milk that You Have Thawed.” Ina May’s Guide to Breastfeeding. New York: Bantam, 2009. p.165.
A few studies have found a significant decrease in vitamin C levels in frozen milk after 3 months Buss et al., 2001; Bank et al., 1985
Martínez-Costa et al., 2007
EFSA Journal 2013;11(7):3331
Goldman AS. The immune system of human milk: antimicrobial, anti-inflammatory and immunomodulating properties. Pediatr Infect Dis J 1993 Aug;12(8):664-71

Note:  Breastmilk Bandit breastmilk storage organizer systems for retail and resale wholesale accounts can be purchased through Amamante.

9 comments:

  1. Thanks so much for the info. Helped lot

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  2. Thank you so much. I am a working mother. I try to express two bottles at night and freeze overnight. Then another bottle in the morning which is refridgerated. My daughter takes them at her creche. I go during lunch to breastfeed and express somemore so that she is getting mostly fresh milk... I love being a mother.

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    1. Thank you for your comments. If the two bottles that you are expressing at night will be fed during the same week, you can just refrigerate them to preserve more of the living cells. Being a mom is great!

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  3. Thank you for this info! I'm exclusively pumping and have worked hard to build up a stockpile. I have 4 days worth stored in the refrigerator that we have been cycling through. If I continue to pump a little more than my baby eats, when will it be better to start freezing the milk instead of refrigerating it? Within how many days should refrigerated milk be consumed before it becomes inferior to frozen milk?

    Thank you!

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    1. Once you have more than one week in your refrigerator, then the next pumped milk should be frozen. Milk may be refrigerated for only 24 hours before freezing in order to maintain the full life in the freezer which is 3-6 mo in freezer, 6-12 in deep freeze. Best wishes!

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  4. Hi Tanya,
    I found your blog when searching on google to find out more about using fresh vs frozen milk. I'm wondering if I could ask your opinion on my situation. I had my daughter when I was 30+5 weeks pregnant via emergency c-section and she spent the first 5 weeks in the NICU. She is now almost 8 weeks home and we are blessed with a healthy girl and a fantastic milk supply. Her current diet is that she breastfeeds 4x/day and has 4 bottles per day of breastmilk with formula added for extra calories as we continue to work on her gaining weight. This means I pump 4x/day and generally get about 6oz each time. She generally eats 2-2.5oz per bottle now, but it has take a long time to work up to this amount so I have a huge freezer stash already. I am considering donating once we get a little further into a good routine and I feel more confident in my surplus. M question is, should I basically ignore my freezer stash and only make her bottles from my fresh milk? Or should I try to use up some of my old, frozen milk supply from when she was first born? I don't have colostrum left so should I follow your advicethat fresh is best? Sorry for the wall of text, I hope it's okay to post my situation and question here. Thanks!

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    1. Although fresh is best, any breastmilk is better than formula. Human milk has 22 kcal per ounce vs 20 for formula. I am confused why you are using formula to boost her weight gain. My advice is that you switch to using up some of your frozen milk instead of the formula and move to pumping eight times per day. While right now, you are getting a lot pumping only 4 times per day, your body will decide your baby is older than she is and will begin to reduce that amount since it is not getting the stimulation appropriate for an eight week old infant. Keep up the good work!

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  5. Hi Tanya,

    Very informative post. I wanted your opinion about my situation . I have a frozen stash of about 3 days worth of breast milk. I pump at work and while I am away my baby gets pumped milk from the refrigerator ( from my morning pump cycle ) plus one bottle of frozen milk. I generally freeze what I pump at work and breastfeed while home with the baby. I could just give her refrigerated milk but then my freezer stash is just sitting there and getting older . I would probably need to discard milk pumped 3 months ago if I don't rotate this stash. What do you suggest? Thanks !

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    1. Unfrozen milk will give your baby the best defense against illness, which is especially important during the cold and flu season. I would suggest giving regrigerated milk expressed on Friday on the following Monday, and the rest of the week give what you pump on Monday to the baby on Tuesday, etc. But frozen milk is still far superior than formula, so please do not discard the older milk. Find a Milk Bank where you can donate your excess. Keep enough for emergencies, but donate the rest. Here is a link to locate local milk banks: https://www.hmbana.org/locations

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