Breastfeeding in The Child Care Setting: Storage and Handling

Breastfeeding inThe Child Care Setting:Storage and Handling

Compiled by: Sarah DeCato, BSN, RN, CLCMSN Graduate Student, New Mexico State University

4/10/2012114/10/2012Collaborators:Maine Roads to Quality & The State of Maine Breastfeeding Stakeholders Committee

4/10/2012224/10/2012How do I store breast milk and how do I prepare the bottle?

4/10/20123We know that breastmilk is the best food for babies through the first 6 months of life and beyond. As a childcare provider, its necessary to understand not only the basics of breastfeeding and how to support breastfeeding within your setting, but also how to prepare and store breast milk. Training staff is instrumental in child care homes and centers to meet the standards of storage and handling of breastmilk. This presentation will give you the basic tools needed to understand how to store and handle breastmilk in your settings. 34/10/2012Preparing and storingWash hands before handling breast milk

Store in clean containers

Label with childs name and date

4/10/20124The first step is to wash your hands before handling breastmilk or any food source for yourself or the children in your care. The breastmilk should be stored in clean containers that can include: screw cap bottles, hard plastic cups with caps, or bags that fit directly into bottles. Each container of breastmilk should have on it the childs name it is intended for as well as the date, making sure to use the oldest expressed breast milk first as breastmilk does have a shelf life. For additonal information access:http://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm

4/10/2012Thawing breastmilk Do not use a microwave

Transfer frozen milk to refrigerator to thaw on ownOr place container of frozen into warm water bath

4/10/20125Microwaves are not recommended to heat up breastmilk as they can unevenly heat the milk leaving hot pocket areas in the milk that could result in burning a babys mouth. You can heat up water in the microwave first and then place the container of frozen milk in the warm water bath to thaw. You can also run the frozen milk under warm water from the faucet to do the same. 4/10/2012CDC recommendationsLocationTemperatureDurationCommentsCounter topRoom temperature (up to 77F or 25C)68 hoursContainers should be covered and kept as cool as possible; covering the container with a cool towel may keep milk cooler.Insulated cooler bag5-39F or -15-4C24 hoursKeep ice packs in contact with milk containers at all times, limit opening cooler bag.Refrigerator39F or 4C5 daysStore milk in the back of the main body of the refrigerator.Freezer compartment of refrigerator5F or -15C2 weeksStore milk toward back of freezer where temp. is constant.Freezer compartment of refrigerator with separate doors0F or -18C36 monthsStore milk toward back of freezer where temp. is constant.

Deep freezer-4F or -20C612 monthsStore milk toward back of freezer where temp. is constant.

Source: Academy of Breastfeeding Medicine. (2004) Clinical Protocol Number #8: Human Milk Storage Information for Home Use for Healthy Full Term Infants[PDF-125k]. Princeton Junction, New Jersey: Academy of Breastfeeding Medicine

4/10/20126According to the Academy of Breastfeeding Medicine (2004): Milk stored for longer durations in the ranges listed is safe, but some of the lipids in the milk undergo degradation resulting in lower quality.Make note that milk stored in the refrigerator will separate. This milk should be shaken prior to heating and giving to baby. 64/10/2012BreastmilkLiquid GoldUse what is neededDo not wasteEncourage mothers to store in small amounts

4/10/20127Breastmilk has often be referred to as Liquid Gold. For mothers who are breastfeeding, especially working mothers who must pump to maintain their breastfeeding, every drop counts! Encouraging storage in 1, 2, or 3 ounce increments allows you, the child care provider to add additional ounces to a bottle if needed versus storage in 5 ounce increments, and baby is only taking 3 ounces, causing you to waste the additional 2 ounces. A good storage methods for breastfeeding mothers is to measure ounce capacity of an ice cube tray and freeze breastmilk in the trays, removing and placing in a freezer bag with date after frozen. Its also good practice to discuss with the breastfeeding parent how she would like to handle late day feeds (i.e. baby is hungry right at pick up time). If you notice a babys feeding pattern is changing, discuss with mom. Some mothers would prefer to feed their baby upon arrival to the child center versus seeing a bag of their breastmilk being thawed to give via bottle at that time. 74/10/2012

4/10/20128To find out where your facility currently stands in regards to infant feeding, I encourage you to take a look at the Lets Move! Childcare Infant Feeding checklist quiz. This is an initiative of First Lady Michelle Obama.

The Lets Move! Childcare initiative has 5 main goals:Get kids moving Reduce screen time Make nutrition fun Offer healthier beverages Support infant feeding

The Lets Move!Childcare infant feeding checklist is available on line at:http://healthykidshealthyfuture.org/welcome.html

84/10/2012Getting started Breastfeeding education Breastfeeding environment Breastfeeding policy

4/10/20129The Lets Move! Childcare infant feeding checklist is a self assessment that covers the following subject areas: breastfeeding education, breastfeeding environment, and breastfeeding policy. Utilizing this checklist is a good starting point for assessing your individual sites on current practices around breastfeeding and can help identify areas of needed improvement.

94/10/2012Caring for Our Children (CFOC), 3rd ed.

4/10/201210Sample nutrition and feeding care plans are available on page 456/457 of the 3rd. Edition of Caring for Our Children. You are encourage to take a closer look at standard 4.3.1.3 specifically addresses the preparation, feeding, and storing of human milk (p. 165).4/10/2012ReferencesAcademy of Breastfeeding Medicine. (2004) Clinical Protocol Number #8: Human Milk Storage Information for Home Use for Healthy Full Term Infants[PDF-125k]. Princeton Junction, New Jersey: Academy of Breastfeeding Medicine

Centers for Disease Control and Prevention. Proper handling and storage of human milk. Retrieved from http://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm

Nemours. Lets Move! Childcare. Retrieved from http://healthykidshealthyfuture.org/welcome.html

United States Department of Agriculture Food and Nutrition Services (2001). Feeding infants; A guide for use in the child nutrition programs. Retrieved from www.fns.usda.gov/tn/resources/feedinginfants-ch3.pdf

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