I have a lot of pumping questions!
March 9, 2011 3:16 PM   Subscribe

Questions about pumping (breastmilk, not gas or iron)

So I've been back at work for almost a month now, pumping during the day and breastfeeding nights/weekends, and things are going quite well. I actually have about 10oz extra every day that I'm freezing. But, I still have niggling questions about the mechanics of pumping and I'm finding conflicting information, so maybe some MeFite moms can help me out?

Sorry this got way long.

1. Washing/sterilizing: currently I'm washing and sterilizing (boiling for 3 minutes) pump parts and storage bottles (and feeding bottles) every night. Some resources say I don't have to, that washing is good enough. True?

2. During the day: I'm just rinsing the flange assembly with water and drying with a paper towel in between pumping sessions, and (as stated above) washing/sterilizing every night. Some sites say to store the pump parts in the fridge between pumping sessions, but this would be a little more inconvenient (though could be done). Should I store the pump parts in the fridge, or is rinsing between sessions and leaving at room temp OK? From first pumping session to last is never more than eight hours and is usually more like six or seven.

3. Storage: I see two days in the fridge on some sites, and up to 8 days on others. I'm going by the 8 days in general, though I hardly ever need to go out that far now that we've ratched Baby Rabbit's intake needs down and I only leave enough at the sitter's for two days' worth of meals. Also, I see you can freeze milk for 3 months, or six months. There, I would tend to be conservative and say 3 months. Normal kitchen fridge/freezer combo (relatively old).

a. is 8 days in the fridge safe? or should I count on less?
b. is 3 months in the freezer all I get, or can it go longer?
c. when we get near the end of the 8-day fridge thing, can I then freeze, or should I just dump it?
d. sometimes I'll freeze milk that I refrigerated 1-3 days before; is this OK?

4. traveling/appointments/etc.: sometimes I can't get home for a couple hours after I leave work (errands, allergy shots, etc.). I carry the milk from work (where it's been refrigerated in a new fridge) to home in an insulated lunch bag.

a. Is is safe to have it in my car for a couple hours before it goes back into the fridge?
b. How about three hours? (thinking of a meeting I have this friday)
c. Is it better to refrigerate, then maybe let it get back to room temp, then refrigerate again, or leave it at room temp till I get home?
d. Or should I just freeze everything if I have a long time till I get home, and use the refrigerated stash for the following day? (Like I said, I get about 10oz extra every day, which is about half of what I pump, so I basically freeze half of every day's pumped milk, or effectively get two days' worth of milk every day)
e. or should I get an ice pack to put in the insulated bag? I'm afraid it might get too cold that way, and I know you're not supposed to keep thawed milk for more than 24 hours after it's thawed, since freezing kills off the leukocytes which give milk its antibacterial properties, so this seems like it might be the riskiest strategy?
posted by rabbitrabbit to Home & Garden (18 answers total) 8 users marked this as a favorite
 
1. Previously. Quoted from the previous question (however, the link to the Medela site is no longer valid):
Here's what the Medela website says about cleaning...

After each use:
• Disassemble and wash all parts that come in contact with the breast and milk in warm soapy water.
• Rinse in clear water.
• Air-dry on clean towel and cover parts when not in use.

All parts may also be washed in top rack of dishwasher.

Source: Medela Health and Safety Info
2. I do what you do. It never crossed my mind to store parts in the refrigerator.

3. As for storage, I always go with the guidelines at kellymom.com

In my opinion, you're pushing it by storing it in the car. I would not let it get warm and then re-refrigerate. I would definitely use an ice pack, I don't think it will get too cold, and it certainly won't freeze.

My gut says that if you have to choose between going to room temperature or freezing, then freeze it.

OMG, I can't believe you get 10 oz extra! You go girl!
posted by ellenaim at 3:41 PM on March 9, 2011 [1 favorite]


My mom was a LLL leader. I'm nursing my second child. I pump about 3 bottles a week -- not a ton, but some.

1. I don't sterilize, just wash.

2. Rinsing is OK.

3. Your baby will usually refuse the milk long before it becomes unsafe.
a. 8 days is safe.
b. I was taught 5 months in the freezer, 1 year in a deep freeze.
c. I freeze and have never had a problem.
d. Yes.

4a. 2 hours? yes.
b. 3 hours? Yes. I was told 5 hours at room temp if you're going to store it later, and 8 if you're going to feed right away. My son actually got a bottle that had been taken out of the fridge and left at room temp for 12 hours (sleep deprived, we didn't realize) and he gulped it right down and was fine.
c. I think either way you're good.
d. I'd not freeze.
e. I think a freezer pack is fine; my BFF uses an ice pack and has never had any freezing problems. The milk has to actually have ice crystals in it before there's any antileukocytic action, and I think that's unlikely to happen just from a freezer pack.

Basically, remember that like I said above, your baby will probably refuse "old" milk long, LONG before it becomes unsafe. My son did once refuse a bottle that seemed perfectly fine to me, but we later figured out it had been in the fridge for two weeks hiding behind a jar of capers. It still smelled and tasted fine to me, but he sucked down a much newer bottle so the age was definitely the issue.
posted by KathrynT at 3:45 PM on March 9, 2011 [2 favorites]


I agree with previous posters ESPECIALLY: I never sterilized only washed, and I just rinsed (no soap) the components while at work but washed them when I got home.

I did not have access to a fridge at my job, and always used an insulated bag with an ice pack. I would then transfer to the fridge at home. On two occasions I forgot the ice pack - The milk smelled off and I dumped it. I am certain that due to being sleep deprived we accidentally gave him old bottles rather than fresh ones on more than one occasion - nothing bad ever happened.
posted by lodie6 at 3:53 PM on March 9, 2011


Congrats on being back at work and maintaining your supply! It's great that you have extra to freeze. As an additional resource for these questions I recommend you join the Yahoo mailing list PumpMoms, which is full of really experienced moms.

1) True, UNLESS your baby is immunocompromised. If you have a premie or special circumstances then you may want to keep everything sterile. If not, then scrubbing with hot water and soap should be enough. Your pediatrician can guide you if you're not sure. Make sure you are getting to every part of the flange when cleaning. The tiny brushes that come with Dr. Brown's bottles, or pipe cleaners, are the right size. You can also run your pump parts through the dishwasher on the top rack. Do not run the white membranes through the dishwasher as that will wear them out quickly.

2) I'd rinse, then store in the fridge, if you can't wash them with soap and hot water after you're done.

3) I have actually seen as long as 10 days in the fridge from some resources.
a. I've heard it said that the baby won't drink it if it's bad, so the biggest risk is having to dump it down the drain. Still, I wouldn't leave it 8 days. That's a long time. I've gone 6.
b. The guidelines are 3 months for a freezer that's attached to your fridge, 6 months for a stand alone deep freezer. I'd experiment with your milk BEFORE you build up a huge stash, because sometimes milk that is within the guidelines acquires an 'off' taste in the freezer and the baby rejects it. Thaw some and offer it to baby when it's a month old and see if he'll take it. Try again at 2 months. Try again at 3 months. You may find you have more or less leeway, and you'll find out if you have a problem before you're face with dumping gallons of milk.
c. Up to you - but probably the baby is more likely to reject it if it's frozen when it's older.
d. See above. Also, if you freeze milk that has been stored in the fridge a couple of days, it separates and looks weird. It's still OK to drink when thawed.

4.
a, b, e - I would get an ice pack, or, easier, just throw a bunch of ice cubes in a baggie in the lunch bag. I transported a lot of milk like this and none of it froze. It did stay nice and cold.
c. It's NOT better to let it get to room temperature. You want to keep it cold and outside of the temperature ranges that are conducive to bacterial growth. Which means that,
d. it's better to freeze it than to let it go to room temperature. Since you're producing so much, that's what I'd do.

Other notes: it's AWESOME that you are building up a nice stash. You will probably see your baby's consumption vary due to growth spurts, so it'll be great to have that resource to draw on.

I've heard of people buying a separate chest freezer just for breastmilk and then quitting once they have enough in the freezer to get the baby to a year.

If you end up with a large surplus of milk, please consider donating it to a milk bank or a mother in need. There are a lot of avenues for this, so you never need to toss milk down the drain. Even if you have a picky eater who rejects your older frozen milk, if it's been stored correctly then milk banks will probably accept it.
posted by bq at 3:55 PM on March 9, 2011


Strongly seconding PumpMoms, it was fantastic for me. It is a very high-volume mailing list, but there is a lot of awesome info to learn!
1. No need to sterilise unless you baby is immunocompromised in some way.
2. I did the fridge thing, I think its fine to leave it out of the fridge if you rinse, and keep it in a cooler with an icepack.
3. I dont think there are any hard and fast numbers, it depends on your milk (lipase content) and your fridge and freezer. I personally went with 5 days in the fridge (and then I would freeze it, figuring if it was bad, my sons would notice), 6 months for the attached freezer, and 1 year for a deep freeze. All these numbers are estimates, and when you go to serve the milk, just smell it. If it smells rotten, then its probably bad. Do a couple of test batches to see.
4. As long as you have an icepack in there keeping it cool, then that's fine, otherwise you are just reducing the lifespan of the milk, since it will then be at room temperature. Personally i think refrigerating > freezing, since freezing kills off many of the antibodies. But obviously freezing > dumping. so
a) yes, if you have an icepack in there. Otherwise no, IMHO.
b) yes, if you have an icepack in there. Otherwise no, IMHO.
c) Not ideal either way, but the former is preferable.
d) Freezing is OK, but I think using an icepack in your cooler negates this need.
e) Yes, icepack! Don't worry about it getting too cold, this is fine. I'm slightly confused by the wording of this bit, but an icepack with your freshly pumped, refrigerated (during the day at work) milk is fine. Don't freeze it unless you need to keep it for long term storage.
posted by Joh at 4:29 PM on March 9, 2011


When asked about sterilizing, our pediatrician said: "mom's nipples aren't sterile either"
posted by kenliu at 4:59 PM on March 9, 2011 [1 favorite]


We used the microwave sterilization bags that came with the Medela pump, and that was extremely convenient.

When asked about sterilizing, our pediatrician said: "mom's nipples aren't sterile either"

There is a qualitative difference between the bacteria your kid is going to get from nipples versus those cultured in the bottle and pumping equipment. There's some good emerging research that says that breast feeding is a key way that gut flora colonizes the digestive system, and I would be somewhat concerned about bad bacteria versus good ones. But I'm absolutely not quibbling with the overall point that the ped was probably making, which is that it's not going to help much in getting obsessive about the issue.
posted by norm at 5:06 PM on March 9, 2011


The Medela bag is, indeed, really convenient. A woman I babysit for sterilizes the equipment that is harder to clean (the tubing, etc.) but not the bottles.

I suggest thawing out a frozen batch and seeing if your baby likes it; she had to scald her milk or her baby wouldn't drink it. Which was frustrating when we were trying to give him all the frozen milk that hadn't been scalded!
posted by the young rope-rider at 6:09 PM on March 9, 2011


Advice I have seen is to sterilise up until 6 months old.
The Medela bags are indeed awesome.

Re freezing, I have seen that the length of time in a fridge freezer depends on whether the freezer has a separate door. If you have to open the main door to get to the freezer compartment, you shouldnt store for 3 months. I can't remember the length of time, it was maybe 1 - 2 months.
posted by 8k at 11:20 PM on March 9, 2011


We used a microwave steriliser which was very convenient. Pop everything in, zap for 2 minutes (or however long it was), done!
posted by pharm at 2:06 AM on March 10, 2011


Kellymom dot com and mothering dot org have heaps and heaps of info on this topic.
posted by heigh-hothederryo at 6:38 AM on March 10, 2011


Thanks everyone.

It looks like people are divided about whether or not sterilization is required. I would just go with washing, since my boy is not immunocompromised in the least, but I'm going to be donating a lot of my frozen milk so I think I'll continue sterilizing.

I do have a couple of the sterilizer bags that came with my milk storage bottles, and I've used one of them once in a pinch -- maybe I'll keep one at work so I can sterilize my pump parts at work and not have to bring them home every night and back to work every morning.

I'll get an ice pack to put in the lunch bag for days when I can't go directly home from work.

I thought kellymom would have info like this, too, but was surprised that I couldn't find anything beyond basic milk storage guidelines. There are other sites that have more info, but their provenance is a little questionable, which is why I thought I'd ask here.

I'll have to check out PumpMoms.
posted by rabbitrabbit at 7:31 AM on March 10, 2011


Oh, and it's also really good to know that babies will likely refuse old milk. That makes it so much easier to not worry too much about it.
posted by rabbitrabbit at 8:43 AM on March 10, 2011


I'm going to be donating a lot of my frozen milk so I think I'll continue sterilizing.
In case you haven't already - do go and read up on the rules for donating milk at HMBNA (assuming that is where you plan to donate). The requirements are stringent to say the least, and I think it is almost impossible to fulfill them without forethought (i.e. can't donate milk expressed after you took an advil or NSAID, can't donate milk at all if you take certain medications, or have lived in the UK etc). So you probably need to adjust your routine to fulfill their requirements, and mark bags that you express which don't meet the requirements, so you can still feed those to your baby.
posted by Joh at 9:01 AM on March 10, 2011


Thanks. I'm going to be donating more informally, to a local woman who can't breastfeed. I have looked at milk bank requirements for meds, etc., just to get guidelines, and should be fine. (I know how lucky I am to have such a great supply and my stash has built up so fast, it makes no sense not to donate!)
posted by rabbitrabbit at 10:48 AM on March 10, 2011


Just coming back in to say, do not put the tubing in one of those sterilizer bags. I just did and ruined the tubing -- it's all melted and fused together now. Probably also shouldn't use the bag again, even though that was only its second use. Phuck.
posted by rabbitrabbit at 5:27 PM on March 13, 2011


rabbitrabbit: if you don't have extra tubing, let me spare you the aggravation of going to Babies R Us or Target and finding out you can't buy it there. As far as I know you can only buy replacement tubing online or directly from Medela (I don't know about other brands).
posted by ellenaim at 5:40 PM on March 13, 2011


Thanks. I thought I was getting off easy and bought some tubing from Home Depot, but it seems to be only just like one milimeter too large so it doesn't stay on the pump well enough. Luckily I had some spare tubing that came with the [used] pump, I didn't really want to use used pump parts but I will until I can get my hands on some new tubing.

By the way, I noticed last night after I posted that I may just be an idiot. There are instructions on the left side of the bag about how to use the bag, and that's what I went by, without noticing there are also instructions on the right side of the bag about how to use the bag to sterilize the tubing. Which are different. So, um. If you try sterilizing the tubing, make sure you use the right set of instructions.
posted by rabbitrabbit at 9:13 AM on March 14, 2011


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