Childcare and the Breastfed Baby FAQs…including Breastmilk Storing and Feeding

Are you going back to work soon and you are wondering how many bottles your baby will need while you are gone?

Do you have breastmilk in your freezer and you want to know how long it’s good for?

Check out the links below and find your answer!  If you don’t see what you are looking for, post up a comment and I will answer you as soon as I can and I will update this post whenever new questions need answers!

Q. How long is my breast milk good for in the fridge?  the freezer?  the deep freezer?

Kellymom.com is my go to source for all things breastfeeding.  They have an awesome chart that you can print out here: http://www.kellymom.com/store/freehandouts/milkstorage01.pdf.

breastmilk storage and handling guidlines from kellymom.com

The La Leche League (LLLI) provides these guidelines:

All milk should be dated before storing. Storing milk in 2-4 ounce amounts may reduce waste. Refrigerated milk has more anti-infective properties than frozen milk. Cool fresh milk in the refrigerator before adding it to previously frozen milk.

Preferably, human milk should be refrigerated or chilled right after it is expressed. Acceptable guidelines for storing human milk are as follows. Store milk:

  • at room temperature (66-78°F, 19-26°C) for 4 hours (ideal), up to 6 hours (acceptable) (Some sources use 8 hours)
  • in a refrigerator (<39°F, <4°C) for 72 hours (ideal), up to 8 days (acceptable if collected in a very clean, careful way)
  • in a freezer (-0.4 to -4°F, -18 to -20°C) for 6 months (ideal) up to 12 months (acceptable)

Q.  Why am I told to swirl the milk?  I’ve been shaking my breastmilk to mix it.  Why is that bad?

from http://www.bflrc.com/ljs/breastfeeding/shakenot.htm

Linda J. Smith, BSE, FACCE, IBCLC writes:

Because shaking expressed mothers’ milk (or boiling or freezing it) denatures the shaped molecules of the protective proteins, leaving only the pieces – the amino acids – the parts. Lactoferrin, lysozyme, and other protective components work their protection magic when they are in their original shaped molecular structure. Some components remain intact, even during freezing, shaking or heating. They not only protect the gut from many kinds of infection, but also prevent inflammation of the gut lining. Even broken up, the separate amino acids are still really good stuff and are digested by the baby as nutrients.

Imagine a set of pop-beads assembled into a necklace or bracelet. When the beads are acting as a bracelet or necklace, they are doing their job as protective elements. When you break apart the beads, you have in your hand many individual chunks of amino acids which are then digested.

Cellular components are also susceptible to damage by physical stress. After all, they are living cells.

With mother’s milk, you get at least two functions for the price of one. With manufactured formula, you only get the individual beads, never the necklace or bracelet. And never the living cells.

So, please handle human milk gently, respectfully and kindly. It’s far more than perfect food for babies – it’s a living tissue and protective shield too.

Q.  How many bottles will my baby need while I’m gone?

from workandpump.com

In an 8-9 hour day at childcare, most breastfed babies will take between 8 and 15 oz of milk.

Many people suggest that you go by the “One Ounce per Hour Rule”.  That is because research has shown that the average breastfed baby consumes about 25oz a day.  So if you divide the day up, that means that babies will take 1-1.25 oz. per hour.  I always figured that my babies will want to eat every 2-3 hours, so I always sent four 3-4 oz. bottles with a few packages of frozen breastmilk in 2-4oz. servings, in case the childcare provider needed more.  They usually kept those in their freezer at all times for back up.

Another thing to know is that you should be using the slowest flowing nipples you can get for your bottles.  Breastmilk flows much slower from a breast than it does from a bottle.  Babies can over eat if they are fed using a faster nipple.  This could then result in them blowing through your milk stash quickly.

Please read more at these sources:

http://kellymom.com/bf/pumpingmoms/pumping/milkcalc/

https://breastfeedingusa.org/content/article/breast-versus-bottle-how-much-milk-should-baby-take

http://nurshable.com/2011/12/29/the-one-ounce-per-hour-rule-of-bottle-feeding/

http://www.workandpump.com/bottlesize.htm

Q. My childcare provider has never watched a breastfed baby.  Is there anything important I should tell her?

Again…head on over to kellymom.com and check out their amazing resource on “How to Bottle-feed the Breastfed Baby”  they have a .pdf version of the article and I always printed it out, along with the storage guidelines above, and gave those to my babysitter/nanny.

from their article:

Babies should be bottle-fed:

  1. When their cues indicate hunger, rather than on a schedule.
  2. Held in an upright position; it is especially important to avoid letting the baby drink from a bottle when lying down. Such a position is associated with bottle caries and an increased frequency of ear infections. Note also that babies should be held often at times when they arenot being fed, to avoid the baby being trained to eat in order to be held.
  3. With a switch from one side to the other side midway through a feed; this provides for eye stimulation and development, and thwarts the development of a side preference which could impact the breastfeeding mother.
  4. For 10-20 minutes at a time, to mimic the usual breastfeeding experience. Care providers should be encouraged to make appropriate quantities last the average length of a feeding, rather than trying to feed as much as they can in as short a time as possible. This time element is significant because the infant’s system needs time to recognize satiety, long before the stomach has a chance to get over-filled.
  5. Gently, allowing the infant to draw nipple into mouth rather than pushing the nipple into the infant’s mouth, so that baby controls when the feed begins. Stroke baby’s lips from top to bottom with the nipple to illicit a rooting response of a wide open mouth, and then allow the baby to “accept” the nipple rather than poking it in.
  6. Consistent with a breastfed rhythm; the caregiver should encourage frequent pauses while the baby drinks from the bottle to mimic the breastfeeding mother’s let-down patterns. This discourages the baby from guzzling the bottle and can mitigate nipple confusion or preference.
  7. To satiation, so that baby is not aggressively encouraged to finish the last bit of milk in the bottle by such measures as forcing the nipple into the mouth, massaging the infant’s jaw or throat, or rattling the nipple around in the infant’s mouth. If baby is drowsing off and releasing the bottle nipple before the bottle is empty that means baby is done; don’t reawaken the baby to “finish.” See Bottlefeeding tips from AskDrSears.com.

The benefits of bottle-feeding in this manner:

  1. The infant will consume a volume appropriate to their size and age, rather than over- or under-eating. This can support the working and pumping mom who then has an increased likelihood of pumping a daily volume equivalent to the baby’s demand.
  2. This can minimize colic-like symptoms in the baby whose stomach is distended or over-fed.
  3. It supports the breastfeeding relationship, hopefully leading to longer durations and increased success at breastfeeding particularly for mothers who are separated from their nurslings either intermittently or recurrently.

Other awesome info on from Kellymom: http://kellymom.com/bf/pumpingmoms/employed-moms/childcare-breastfed-baby/

If you have any other questions, feel free to leave me a comment here or visit our facebook page https://www.facebook.com/unlatched!

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