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Breastmilk Storage Guide

If for whatever reason your baby needs expressed breast milk (EBM) as part of their feeding routine, here is my guide to storing and transporting EBM. Breastmilk is fresh, living food with many antioxidants, antibacterial, prebiotic, probiotic, and immune-boosting properties in addition to nutrients. It is best to chill or refrigerate expressed breastmilk (EBM) as soon as possible if it will not be used during that time.

Storing & Freezing EBM

EBM should be stored in the back of the fridge or freezer to prevent intermittent rewarming due to door opening.
EBM should be kept away from the walls of self-defrosting freezers.
Space should be left at the top of the container to allow for expansion with freezing.
EBM should be labelled with the date and name of the child if the milk will be used in a health or child-care setting.
Storing EBM in a variety of small increments such as 15–60 mL will reduce the waste of thawed EBM.
All containers with EBM should be well sealed to prevent contamination.
Freshly expressed warm milk should not be added to already cooled or frozen milk. It is best to cool down the new EBM first before adding it to older stored milk.

Transporting EBM

One study has shown that transporting EBM alongside an ice pack in a small cooler (equivalent to 15C) is safe for up to 24 hours.

Storing & Freezing Effects On EBM

The bactericidal (natural bacteria-killing substances found in breastmilk) capacity of stored refrigerated human milk declines significantly by 48–72 hours. Lipid composition and lipase activity remained stable for up to 96 hours in the refrigerator. Lactoferrin levels are stable in the refrigerator for 4–5 days. Immune factors generally won’t diminish for 48 hours.

Fat, protein, and calories decline in human milk when frozen for 90 days compared to freshly expressed breastmilk. Frozen human milk has a significant increase in acidity by three months, likely due to ongoing lipase activity, which increases free fatty acids in the milk.

At the end of the day, fresh is best and then EBM correctly stored in the fridge or freezer is the next best option. And for those babies who will be needing to be stored and frozen EBM, knowing how to do it safely and why is so important.

This knowledge has been adapted by JWP into an easy-to-read guide from the Academy of Breastfeeding Medicine: Human milk storage protocol.

Disclaimer

This knowledge is general in nature, and from Joelleen’s experience as an expert IBCLC Lactation Consultant. This information does not constitute as advice, nor does it replace the advice given by an expert health professional in the confines of a consultation. This content is purely educational to support parents seeking clarity around their newborn, and also helps the reader to decide if Joelleen is the right Lactation Consultant for them.

Breastfeeding & Normal Newborn Behaviour

One of the most important things you can do in preparing for your baby is learn about what normal newborn behaviour is. This way you can prepare yourself for the realities and challenges of early parenthood, and also gain a sense of when things aren’t normal.

Preparing yourself for life with a newborn and your breastfeeding journey can look like a few different things. I recommend that all new parents learn about newborn needs and how to respond to them before their baby is born. Preparation is particularly important when it comes to breastfeeding, as breastfeeding is a learned skill that comes with time, changing with your baby’s needs. If you can have an idea of what normal is, when you hit a challenge such as cluster feeding or a growth spurt, you will be better prepared and less doubtful of your progress.

Breastfeeding is natural, however, that doesn’t necessarily mean it comes naturally.

How often does my baby need to feed?

Research shows 8-12 times or more every 24 hours. Commonly parents are advised every 3-4 hours, which equates to 6-8 times per 24 hours and doesn’t allow for more than this. If you are expecting your baby to feed every 4 hours but they feed every 2-3 hours, you may think something is wrong, or be worried that your baby is not feeding as expected. This frequency is perfectly normal in the early days and is required as their stomachs are small, and the milk supply is still establishing. Also, a baby sucking at the breast is more complex than just calories and growing, they crave nervous system regulation (also achieved by cuddles and skin + skin from their carers), sensory nourishment, warmth and comfort.

Being liberal + flexible with offering the breast allows a frequent stream of nourishment that a baby has been familiar with receiving ‘on tap’ in the womb.

What is cluster feeding?

We can’t talk about breastfeeding without talking about cluster feeding. Cluster feeding is when your baby feeds for extended periods, up to several hours. This is behaviour that is designed to increase the milk supply and calorie intake. It is a normal part of feeding, particularly before the milk has been established. Make sure you have a comfortable breastfeeding technique and posture, and that you have food and fluids on hand. If cluster feeding goes on day after day and is around the clock, seek some guidance from an expert IBCLC Lactation Consultant to make sure everything is on track, and if not, some advice and strategies to get through it.

Sensitive digestive system

It’s also important to recognise that a newborn baby’s gut is very sensitive in the early weeks. A bowel motion and passing gas can be a “full-body” experience for such a tiny person, so they will show their discomfort and seek comfort during the process. Lots of warmth, cuddles, rubbing and patting their back (lower back is ideal), massage, cycling of their legs, and a warm bath can help relax your baby’s tense stomach muscles so they can release wind and move their bowel. You’ll notice after a large poo or fart that they suddenly relax as if nothing was ever the matter. As your baby’s digestive system matures, these symptoms should begin to ease and reduce in frequency.

Newborn sleep

It is very common for sleep to be more abundant during the days (rather than the night) when your baby is first born. And also with the amount of feeding they require, periods of sleep can be short in between frequent feedings. Babies rarely sleep alone in a cot on their own in the early days, they are seeking comfort and protection from the arms of their carers, and this is where they will be most content. Your baby’s night and day clock (circadian rhythm) only starts to develop from about 4 weeks of age, so sleep that feels messy, sporadic and all over the place is especially normal before this time.

Making sure your baby feeds frequently during the day and gets adequate sensory nourishment will help support sleep during the night. It’s also comforting to know that a breastfeeding mother reaches deeper sleep states more quickly, therefore less sleep is required, as it becomes more quality. Holding the perspective that this is normal and for a phase will help. Nap or rest when your baby is sleeping, and make sure you are eating frequently. Getting a balance of protein, healthy fats and wholefood carbohydrates will support your energy levels. This is where a doula, a meal train and meal prep can be a great support.

At the end of the day, the newborn period is a time of immense growth and change for not only the baby but also the parents. If you are feeling lost, or need reassurance that what your baby is doing is normal, seek out a professional who is experienced in newborn behaviour to guide you through. It’s normal to feel like you are struggling, especially if you are trying to do it all on your own. We know it takes a village to raise a child and the newborn period is no exception.

Disclaimer

Burping & Digestion Support

There are generally two camps when it comes to information around burping your newborn… burp always or never. I prefer a more flexible approach in offering digestive support depending on your baby’s cues. While it is true that babies are very capable of bringing up wind on their own, even during feeding at the breast. There are times when offering a break to allow for a burp may support a fuller feed. I often find supporting digestion in this way to be most helpful for babies approximately four weeks and under.

When To Burp

Times your baby may need to be offered a break to burp can look like;

Fussy bobbing on and off the nipple, your baby wants to latch but won’t stay attached
Fast, noisy sucking, you may even hear clicking noises (with no nipple pain) and/ or get the sense your baby is struggling to keep up with your flow
Your baby is ready to change breasts
Sucking really slows down during breastfeeding and you feel your baby still has more to drink
Your baby is about to lay down for a nappy change or tummy time

During Breastfeeding

Sit your baby on your lap (think their ‘sit bones’ on your thigh) with a straight back, leaning slightly forward. Your thumb and finger hold your baby’s jaw, while their ribs rest on your palm. Be mindful to have your baby’s hips, spine and head in alignment to allow air (if any) to travel directly upwards. Pat and or rub up the spine (I don’t find rubbing down helpful to digestion) gently yet firmly to help vibrate and move any wind up (if any). If you are mid-breastfeed or have removed your baby from the breast due to faster milk flow, keep the burp break very short, and return your baby to the breast immediately if they aren’t happy to break and are eager to keep feeding.

After Breastfeeding & Overnight

Your approach and technique will vary with your baby’s needs, and the time of day is always important to consider. Rest your baby over your shoulder so they can snuggle, relax and drift to sleep. Upright time post-feed greatly supports digestion, as babies may be very prone to spilling milk after a feed. You want to be careful to not override their natural sleep reflexes that occur after a feed, and don’t need to do any vigorous or firm patting at this time. If they don’t burp, there is no need to maintain this position until they do, simple settle your baby to sleep when they seem ready.

Bottle Feeding

I always recommend the Paced Bottle Feeding Method which allows your baby to suck when they are ready, and take a break when they need to. This in turn reduces uncoordinated swallows caused by fast flow, and therefore wind accumulation. If your baby is having a larger volume, say over 50ml, you can offer a burp break about halfway. Offer a burp break sooner if you feel they need it, are showing any signs of drinking too fast, or are seeming tired and not sucking and swallowing well. Because bottle feeding isn’t natural, the chances of wind building up are naturally going to be higher, so your baby benefits from a burp break with the bottle, but not so much during breastfeeding.

The Why

Your baby may not need to burp however, may benefit from the break in drinking, particularly when milk flow is very fast. It’s not just about getting out a burp, it’s also allowing your baby to have a break, catch their breath, look around and have a stretch during a feed. It can also be a great way to introduce some age-appropriate play as your baby develops week by week. As adults, we don’t eat constantly until our food is done (well we shouldn’t!), and for newborn babies, their feeding process isn’t linear either. By offering breaks, you are allowing your baby to rest/digest a bit between each course of milk – approaching each feeding from the breast like an unrestricted degustation.

Disclaimer

Tips For Reducing Nipple Pain During Breastfeeding

Sore nipples are common but not normal. I encourage you to experiment with positioning your baby during breastfeeding to explore what feels most comfortable using these tips. When the breastfeeding technique becomes comfortable, it will be more enjoyable and sustainable for both mum and baby.

I have helped a multitude of mothers find the right breastfeeding technique, and they have come to me in tears thinking breastfeeding wasn’t working for them. Often to their delight and surprise, they have a much more comfortable feeding session with my guidance, and their baby is so relaxed because they know their mum is being taken care of!

These are my top tips for tweaking your breastfeeding technique, and it’s all based on how your baby fits your unique body (your baby’s position can differ on each side, just as your breasts do). It’s also important to know that just because the latch isnt feeling quite right, it doesn’t mean you have to take your baby off and start again. Use these tips while your baby is at the breast, so you can avoid that unlatching and relatching process which is often the worst part when nipples are feeling tender and/or sore.

During breastfeeding, press your baby in closer so that both of their cheeks are evenly touching your breast. (Lips should not be visible, flanged lips are a myth!). Their nose should be flush against your breast – your baby will be breathing if they are drinking milk. You can also watch your baby’s body breathing, and listen for their inhales and exhales.
Hold your baby slightly lower, and see if this feels more comfortable. Holding your baby higher than the natural level of your nipple can cause nipple drag and discomfort. Holding your baby’s mouth opposite to where the nipple naturally falls is so key, as your baby won’t have to work too hard to keep the nipple deep in their mouth.
Gently yet firmly wrap your baby further around to the opposite breast he/she is feeding from, see if this makes the latch feel less “pinchy” and sharp. Reinforce firm pressure over their back and hips – this will allow their nose to remain free.
If tips 2. & 3. reduce the discomfort, you are getting close to your optimal breastfeeding position! If nipple discomfort feels worse, work towards moving your baby in the opposite directions.
If your nipple pain does not resolve within three days or pain is more than a 4/10 throughout the breastfeeding seek help from an IBCLC Lactation Consultant to get support with finding your optimal breastfeeding position.

As mentioned in tip 5, it is so essential to get help sooner rather than later if you are experiencing nipple pain. In my experiment, many mothers suffer unnecessarily with intense pain that can be corrected with the right support. Ongoing pain makes breastfeeding tense and stressful, which has a negative effect on a mum’s mental health and baby bonding. Sometimes determination alone is not enough to get you through, and unfortunately, the statistics in Australia show that the majority of mums do start out breastfeeding, however at 3 months of age only around one-third of babies are still being breastfed. We know nipple pain is common, we know it’s not normal and the majority of the time it is related to how your baby is fitting your body. If unresolved, nipple pain can turn into more complex issues, so act promptly so you and your baby can get into the swing of things in a more relaxed way.

I have helped many mums both in their homes and in clinics and virtually achieved a comfortable breastfeeding technique during my time as an IBCLC Lactation Consultant in Naarm Melbourne. See my booking page to choose an offering that feels right for you or someone you know that is struggling with nipple pain.

Disclaimer

Calming Chamomile Latte Recipe

Chamomile (a nervine herb) calms the nervous system and also contributes to overall digestive health. This latte recipe is a great alternative to coffee, chai or hot chocolate when you want a less stimulating and more grounding effect. Chamomile blends well with milk and is a great option for people who are new to incorporating herbs into their diet.

Enjoy this latte in the morning, after a meal to support digestion. In the evening to support sleep I would suggest drinking the latte 2-3 hours before bed to soak up all of its benefits, and avoid going to sleep with a full bladder. It can be enjoyed hot or chilled.

Ingredients

1-2 tea bags of organic chamomile flowers
1 cup of your choice of milk (I love organic oat milk)
Optional
1 tbsp unflavoured collagen powder
1 teaspoon honey or maple syrup

Method

Bring your choice of milk to a simmer in a small saucepan
Add the tea bags and simmer for 2-5 minutes
Remove from the heat, stir in the sweetener as desired
For a frothy texture, blend for 30 seconds

I have been enjoying this recipe for years, and when you are trying to have a low caffeine intake, having a yummy hot drink to cherish is so key.

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