Breastmilk storage and handling

Expressing and storing breast milk allows parents to sustain breastfeeding for a longer period of time.

However, different storage practices may alter the composition of breast milk, such as variations in fat content, antioxidants, lactoferrin, and immune components.

Further, improper handling and storage may increase bacterial growth in breast milk which makes it unsafe for consumption.

The World Health Organization (WHO), UNICEF, and the American Academy of Pediatrics (AAP) recommend exclusive breastfeeding for infants up to 6 months, and continuing to breastfeed along with the introduction of safe complementary foods for up to 2 years or beyond, as desired by parent and child.

[2] Breastfeeding parents can also experience lower rates of diabetes, high blood pressure, and breast, ovarian, and endometrial cancers.

[4] The practice of feeding infants expressed milk is common in NICU (Neonatal Intensive Care Unit) settings, where it is challenging for parents to breastfeed, but it has also expanded to other contexts and situations which allow parents to be able to offer breastmilk for more sustained periods, especially given the increased prevalence of commercial manual and electric breast pumps.

[5][6] In the United States about 85% of birthing parents express milk at some point during the first four months of the infant's life.

[6] Parents report a broad range of factors that contribute to their desire to express breast milk, including experiencing difficulties with latch, embarrassment of breastfeeding in public, the desire to have other caregivers help with feeding, return to paid work, concerns about over or under supply, and body weight considerations.

One study found that educating parents on how to clean equipment reduced presence of bacteria, and that the main sources of contamination were containers for storage and the pump parts.

[4] In the United States the FDA (Food and Drug Administration) recommends that all equipment that comes into contact with breast milk should be cleaned after each use.

[4] Further, there is no evidence to support discarding the first few drops of expressed breast milk to reduce the risk of bacterial contamination.

[16] Manual pumps require a handle or lever be squeezed by the user which creates a vacuum that extracts the breast milk.

[5] Further, when refrigerating instead of freezing, pyrex bottles preserved expressed breast milk's bactericidal activity better.

[5] In terms of nutritional components, antioxidants and fat content are not significantly impacted by storage at 6.8°C for 96 hours[5] or at -20°C for (non-specified) short durations.

[10] However, storing milk at -80°C has been demonstrated to decrease antioxidant activity and fat content considerably and is not recommended for longer than 1-2 months.

[18] Further, the proportion of triglycerides to free fatty acids in the expressed breastmilk also vary, which is likely to enzymatic activity.