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Sunday, March 9, 2014
Stored breast milk or formula?
Because certain nutrients/antibodies are lost during the freezing and reheating of breast milk, is it recommended to use formula vice stored breast milk? If so, what brand is closest to mother`s milk?
When considering infant feeding, direct breastfeeding is most beneficial in terms of nutrients and other properties, such as anti-infective properties. However, breast-milk-feeding of a mother`s expressed breast milk is second, human milk from a reputable milk bank is third, and infant formulas would be fourth-ahead of pasteurized milk from a goat, cow or other mammals. (There are a few milk banks in the USA and elsewhere. Because of limited amounts available, banked milk usually is reserved for babies/children with special health issues.)
The nutrients in expressed milk, including vitamins and minerals, are considered stable when expressed milk is handled properly. Many babies have grown and developed well when fully breast-milk-fed their mother`s own milk, which has been pumped and stored in a refrigerator or freezer, for their first several months. Expressed human milk still is better designed for the human infant than other substitutes. It is the easiest option for baby`s system to digest and is the least likely to provoke an allergic response or food sensitivity.
In addition, properly handled breast milk provides babies with a large percentage of the anti-infective properties available through direct breastfeeding. Although a percentage of these properties may be lost as a result of freezing or heating, properly handled expressed breast milk is still much better when considering that infant formulas contain no anti-infective properties at all.
Occasionally, a mother finds her expressed milk develops a rancid or soapy smell. See a recent question about "spoiled frozen milk" for an explanation of, and solution for, this. Also, storing milk in polyethylene containers may contribute to a "soapy" smell.
Proper handling of expressed breast milk for a full-term, healthy baby includes: · Washing hands prior to readying a breast pump and expressing milk · Cleaning pump (collection kit) parts according to manufacturer directions · Pumping directly into the clean/sterile polypropylene (hard plastic or special collection bags) or glass containers milk is to be stored in · Refrigerating the milk at the appropriate temperature-up to 8 days at 32-39° F/0-4° C or freezing at less than 32° F/0°C (type of freezer affects length milk can be frozen) · Thawing containers overnight in a refrigerator or in a pan of warm (not hot) water and then gently swirling contents to remix (expressed milk is not homogenized and it is normal for "cream" to rise to the top) · Using thawed milk within 24 hours and discarding leftovers. Do NOT microwave expressed breast milk, as this can cause a loss of nutrients and anti-infective properties.
If also using an infant formula, it is best to ask a baby`s pediatric care provider for a recommendation most suited to a particular baby`s growth and developmental needs.
Lawrence RA & Lawrence RM (1999). Breastfeeding: A guide for the medical profession (5th ed.). St. Louis: Mosby.
Riordan J & Auerbach KG (1999). Breastfeeding and human lactation (2nd ed.). Sudbury, MA: Jones and Bartlett.
Karen Kerkhoff Gromada, MSN, RN, IBCLC
Adjunct Clinical Instructor
College of Nursing
University of Cincinnati