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Pharmamum’s Ultimate Guide: Breastfeeding/Formula Feeding (Part 1 of 2)
When you come home from the hospital with your precious little miracle, just managing to work out how to get them home safely in the baby car seat is a big achievement in itself, let alone working out how you can be polite to your in-laws that you are not ready for visitors the minute you arrive home. You are completely focused on making sure your baby is fed, warm and comfortable. Whether you’re breastfeeding or formula feeding, in this post, I aim to present you with some useful information that hopefully you can keep referring to when issues arise. I will cover how long expressed milk can be kept in the fridge/freezer, how to thaw milk when you and your partner need a night out or have a special function you need to attend. How best to prepare formula. How long does it keep, if we are going out for the day and don’t have access to a fridge. How do I travel with formula? I will discuss all of these scenarios and when you are faced with these situations along your baby journey, you will be able to refer back to this post for the answers.
It is a good idea to express when breastfeeding so that when circumstances arise, eg an important function, you need to go back to work or have a ‘date night’ out with your husband, knowing you can express and your baby can drink from a bottle will give you great peace of mind. It is worth trying to express early on, not in the first two weeks as your body is adjusting to working out how much your baby requires, but when you feel ready to try and you are not dealing with other issues eg mastitis or attachment problems. You may try when your baby is 3 – 6 weeks old as the older they are, the more comfortable they get with breastfeeding and tend to reject a bottle later on. The amount of breast milk produced or stored in your breasts will keep changing as your baby grows. The breast milk will change in quantity and composition, keeping up with the needs of your baby eg when your baby goes through growth spurts, illnesses or when it’s hot outside and your baby is thirsty and requires more fluid. Your body is constantly keeping up with both internal and external environments through lots of different mechanisms. However, when you express, some people can express very well, and obtain a large supply of milk and some people cannot, and only obtain small amounts at a time, and that is perfectly normal. The amount you express is no indication of how much breast milk your baby is getting. Your baby is the best at clearing the breast and achieving a good let down reflex through the chemical reactions that occur when their mouth attaches to the breast. Expressing is the next best thing and what may help to obtain more milk whilst expressing, is thinking about your baby or looking at a photo of them, even imagining large amounts of milk flowing out of your breast. You can express three ways; by hand, a manual pump or with an electric pump. My personal preference was with an electric pump and if you can manage to express from both breasts at the same time you are more likely to obtain a larger volume of breast milk.
When expressing you will need the following:
- 4-6 Baby bottles- which come with teats,rings, caps and lids
- Storage containers or disposable bags specifically designed for breast milk collection and freezing. Many companies make containers that connect directly to the breast pump
- Steriliser: There are 4 different methods you can sterilise:
- Steam/electric steriliser
- Microwave steriliser
- Chemical sterilising tablets eg Milton antibacterial solution/tablets
- You can simply place all your bottles, teats, caps or anything else that requires sterilisation into a large saucepan and cover with water, place the lid on and boil for 5 minutes. My prefered method was using a steam steriliser. It’s very easy to use and will keep everything inside sterilised for up to 6 hours or if you keep it on a cycle setting, can keep your bottles sterilised 24/7.
Everything that comes in contact with breastmilk needs to be sterilised eg. bottles,teats,lids, storage containers that are collecting the milk, and all parts of the breast pump that comes in to contact with the breast and breast milk. It is best to rinse out all of the used bottles and place them in the sink filled with warm soapy water. Get a bottle brush and use it to wash and clear any remnants of milk. Once the bottles, storage containers and parts of the pump have been washed and rinsed, place them in to the steriliser.
If you are expressing using an electric breast pump, the parts that come in contact with the breast and breast milk need to be washed in warm soapy water after each use and sterilised at the end of the day. However, if you place the parts of the breast pump in a container into the fridge after you have expressed, you do not need to wash the parts after each use, only at the end of the day together with sterilising.
Once you have expressed, how long can breast milk keep?
The colder the temperature you store it in, the longer it will last ie
Room temperature (ie < 26 C): 6 hours
Refrigerator: 3 days (no more than 72 hours, kept at the back of the fridge at 4 C)
2 weeks in the freezer section inside a refrigerator: -15 C
3 months in freezer (with a separate door ) -18 C
6 months in a deep freezer -20 C
I would recommend to put expressed breast milk in the coldest part of the fridge ie towards the back of the fridge on the shelf above the draws and when freezing, in the coldest compartment of the freezer.
The best way to thaw breast milk, is to take it out of the freezer and place it in the coldest part of the fridge and allow it to thaw overnight. Thawing in the fridge will take 10-12 hours and must be used within 24 hours of taking it out of the freezer. If you require the breast milk sooner, you can sit the container of breast milk in warm water and it will defrost quickly. Once defrosted in warm water you can place it back in the fridge but must be consumed within 4 hours. What I used to do if I didn’t take the breast milk out of the freezer the night before and the babysitter was arriving soon, was take the breast milk out of the freezer and sit it in warm water, and allow the breast milk to defrost. The breast milk, still very cold, and now in liquid form, would be placed back in the fridge and it would stay there until needed. I would tell the baby sitter, as soon as she hears the baby wake up, take the breastmilk bottle out of the fridge and sit it in some warm water to prepare for feeding. Attend to the baby, change nappy etc Sit the baby in a safe area eg swing, bouncer and check milk temperature.
- When heating up breast milk, sit bottle in warm water, test the breast milk on your wrist before giving it to your baby to ensure temperature is not too hot.
- Never warm up breast milk in a microwave and never sit the bottle of water in a pan of boiling water. This runs the risk of:
- Burning the baby
- Destroying important components of the breast milk
- Never refreeze thawed breast milk
- If your baby drinks only a small amount of milk, I understand how heartbreaking it can be throwing out expressed breast milk especially when it takes so long to express, but it does need to be thrown out at the end of the feed.
- After expressing, always label the container storing the breast milk with the date collected and expiry date. Use the oldest one first as long as it is still in date.
- If collecting small amounts at a time when expressing, you can mix the breastmilks together but only once the last breast milk collected, meets the previous refrigerated breast milk temperature, ie you will have two separate breast milk containers sitting in your fridge and once they are both at fridge temperature ie 4 C, you can mix the two together.
- When breast milk is stored in the fridge, it does separate, so you will see a cloudy liquid at the bottom and a white thicker liquid on top and when placing the bottle in the warm water to heat up the breast milk, give the bottle a swirl to mix the milk together.
- Always give expressed milk a swirl to mix, never shake breast milk vigorously as it can break down important components of breastmilk.