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Breast milk and breastfeeding have many advantages over formula milk and bottle-feeding for both the mother and the baby.
Milk expression
 Under no circumstances should breast milk be pooled. Babies should only receive the milk expressed by their own mother. Expressed breast milk should never be diluted and must be kept in the refrigerator.
Milk expression varies from mother to mother. It is a learned skill that involves psychological and physical considerations. A mother’s efficiency in expressing milk will improve with practice and time. During milk expression, hygiene is very important in both collection and storage. This is particularly crucial for the premature infant, who is often hospitalised for a period of time and whose immune system is not yet developed.
Milk can be expressed by:
Manual hand-expression
Manual pumping
Use of a single or double electric pump
Storing and transporting breast milk
All containers, caps and funnels used in the expression and collection of breast milk should be properly sterilised. This can be done either by placing themin boiling water for five to 10 minutes, through steam sterilisation or by sterilisation tablets immersed in clean water. Storage containers for expressed milk include:
- Glass or sterilised bottles
- Disposable sterile breast milk containers
- Disposable storage bags.
The breast milk should be collected in small amounts suitable for feeding. It should be refrigerated at once after expression. Containers should always be labelled with the name, date and time of collection, especially when it is to be transported to the hospital.
To avoid infection, special care should be taken when storing breast milk for premature babies in hospitals. The moving of stored milk from place to place must maintain the cold chain.
Use an insulated bag or an icebox, with an ice pack, to transport properly stored milk. Properly refrigerated milk can be kept for 24 to 48 hours. However, at the Singapore General Hospital’s Department of Neonatal and Development Medicine, the policy is to discard the milk after 24 hours to lower the risk of infection in premature babies.
It is important to note that newly expressed milk should not be added to earlier stored milk and then re-stored. If the stored milk is for home use, it can be frozen for up to three months if it is kept at the back and off the bottom of the freezer.
The milk can be thawed in the refrigerator, by holding the container under lukewarm water for five to 10 minutes or by using an electric warmer. Defrosted milk should never be refrozen. Likewise, newly expressed milk should not be added directly into frozen milk for further freezing. In general, freezing of milk is not encouraged for premature babies who are still hospitalised.
Direct nursing is always encouraged once the baby is able to latch on and suck, and the mother is well.
Ref: W09 |