Q&A

The following answers were acquired from my research and some from breastfeeding support groups. If you have any queries, you could also write in to them. They were very helpful and kind.
http://www.mothersdirect.com.au/
http://www.breastfeeding.org.sg/
 
1) I will be going back to work in 2 weeks time. I am wondering if I need to get another sterilizer to be placed in the office as I will be pumping during working hours. I used to sterilize all the pump equipments and bottles everytime before use when I was having my 1st child. A friend told me she would just keep her pumping equipments in the fridge (placed in a container) after every pumping session without washing. Is it okay to do so? What is the standard practice and you advice?

Answer 1 It is ok to keep the equipment in the fridge (kept in air tight container) and sanitise it by washing in hot soapy water at the end of the day
 Answer 2 There's no fixed practice. For myself, I pumped n used boiled water (from my water bottle) to rinse my pump parts. As I pumped in a nursing room, I've colleagues who brought their sterilizers while there are some who simply leave their pump parts (funnel) in the fridge. Occassion when i don't have boiled water, i even used tap water. Acutally, when your baby is <6mths, it's better to be a little cleaner. But it's up to your personal perfernce, how much time you've, the convenience of getting clean water, the space that you've in the frigde and other conditions. Do whatever that's most suitable. Ultimately, it's better to spend more time to pump your milk (eg at least 15min/side). Instead of spend 10min pumping and 10min washing, it's definitely better to pump 15min and wash 5min.

2) Are there any ways to tell when the breast milk is spoilt?
Usually, I'll taste or smell it. if it's v spoilt, you can see curds. But because breastmilk has anti bacterial properties inside, it usually can last quite long. If a thawed breastmilk in its liquid form is sitting around for more than hours, chances are it is starting to spoil. (bacteria action starting). It's going to be real smelly, sour when there's lots of bacteria action. Younger children have more sensitive stomach and a little bacteria may cause them to vomit. If you do want to rescus such milk, it's better to boil them to keep the bacteria. For cases of food poision, usually there's diarrhoea.

Just remember the rule of thumb.. that after pumping, to chill it asap or less than 4hr at room temp. If chill and going to freeze, to move milk from fridge to freezer within 24hr (I sometimes do it within 48hr). Deep freezing can last 4 months to 6 months.

3) Thawing frozen milk. What would be the best way to thaw breast milk so that the nutrients will not diminish as much. I have gathered 3 types of thawing. Which would be the best?

a) Thaw frozen milk in the refrigerator for 24 hours. Consume the thawed
milk within the next 24 hours.
b) Place frozen milk in running water till the milk defrost.
c) Thaw and use milk within 24 hours.

I have tried thawing frozen milk and the milk could not fully defrost within 24 hours .Is it best to wait till it is fully defrost in the fridge before consuming withing the next 24 hours? I've heard from a source that says that as long as there is some crystal ice in the milk, you don't count the next 24 hours of consuming it. Consume within the 24 hours only after it is fully melted.

(a) would be better. If after thawing in fridge n there's still ice crystal, you can put into running water to thaw further to feed. Actually all 3 methods are ok though (b) may consume a lot of water. You can sit it in a pot of warm water for a while. Just DO NOT microwave the milk.

4) If I have a pack of 5oz of thawed milk, could I split it into 2 sessions of feeding?
Depends on your baby's appetite. If you mean once the frozen milk has thawed abt 10am in the fridge, you're going to feed 3oz at 1030am and 2oz at 12nn, it should be ok. It is possible to empty the thawed milk into 2 containers and then use it seperately but not to use any that remains after baby has consumed half.

5) My 3 year old rejects the frozen milk because of its smell and taste. I still breast feed her. Is there any way I could feed her the access frozen milk to avoid wastage?
You can try mixing it w cereals or smash a banana inside. Cook spagetti with it, cooking custards, make yogurt or include it in other recipes.

6) Sometimes, there would be not enough time to warm the milk once baby is hungry. Which would be a better choice to preserve the quality or nutrients in breast milk?

a) leave refrigerated milk in room temperature 1/2 hour before warming and
feeding. This way the milk will take less time to warm up.
b) pre warm refrigerated milk and leave at room temperature before baby
wants milk (consume within 1 hour).
c) warm breast milk straight from the refrigerator. And consume immediately.

Any 3methods are ok. Actually, the milk need not be very warm. Just swirl the bottle milk (not shake it up and down) to dissolve the fats on top and warm a little (for taste) is ok.

7) How long can I keep a freshly expressed breast milk at room temperature before feed?
You can keep breast milk indoor for up to 6 hours. You need not warm freshly expressed breast milk for feed.

8) How long can I leave warmed breast milk at room temperature?
In the shade, best to consume within 1 hour but and not more than 4hours.

9) How long can I leave refrigerated milk (not warmed yet) in room
temperature?
In the shade, not more than 6hours.

10) Milk needs to be transfered from refrigerator to freezer within how many
days?
Within 24hours if you're keeping it for long. If not, try to be within 48 to 72hours. The sooner the better.

11) Can I give my access frozen milk to a younger baby?
If the baby's mum is ok for you to give :)

12) When I defroze my ebm it got a fishy smell and my baby dun want to drink . How do settle with it.

"Odor of Human Milk

Under most circumstances, fresh human milk has a mild, slightly sweet scent. Occasionally, human milk that has been frozen and thawed may smell soapy and may be rejected by the baby. In Breastfeeding: A Guide for the Medical Profession, Ruth Lawrence, MD, postulates that for some mothers, milk stored in a self- defrosting freezer may have had changes in its lipid structure due to the freeze-thaw cycles that occur in such freezers."


Option 1:
It is normal for defrozed milk to have fishy smell. If baby don't take well with the taste, I would try mixing some of my freshly expressed milk to reduce the fishy smell. Fresher = less fishy. As an example, you could try 1oz defrozed milk with 2oz of fresh milk and then work your way up slowly. Hopefully with this transition, your baby will learn to accept the fishy taste.

Option 2:In a few cases, mothers have reported that their milk began to smell soapy as soon as it cooled, regardless of whether it had been frozen. "When these mothers heated their milk to a scald (not boiling) and then quickly cooled and froze it," writes Lawrence, "the effect was not apparent and their infants accepted the heat treated milk. That process inactivated the lipase (fat-digesting enzyme) and halted the process of fat digestion." However, high heating may lower some nutrient levels, including ascorbic acid (vitamin C). If the milk already smells sour, heating will have no effect on flavor or smell. Milk that smells rancid likely is, and should be discarded.

http://www.llli.org/NB/NBJulAug98p109.html