Short & Long-term Separation
Short term separation refers to separation of mother and child for one or two feedings in a child that is less than 6 months old.
To prepare for a short-term separation:
Express breastmilk before separation. Ideally feed baby unfrozen milk expressed immediately prior to separation. If this is not possible then feed the milk most recently expressed and stored in the refrigerator. The next best is milk most recently stored in the freezer. This is best because, your body is constantly upgrading, modifying, and balancing the antibodies in your milk to meet the current needs of our baby for that specific day and time. Furthermore, freezing and heating destroy white blood cells, but it is still FAR SUPERIOR TO FORMULA. Store milk in clean container or plastic liner as per below instructions. Practice feeding baby with a bottle of pumped breastmilk. Some infants do better if mom offers the milk and others are more successful if someone other than mother does the feeding. Certainly it is best to teach bottle-feeding to baby when the infant is happy and relaxed versus ravenously hungry; too hungry to learn something new. A good time to try offering pumped breastmilk is shortly after a breastfeeding. A bottle will not cause nipple confusion if baby is at least 3 weeks old and nursing well. If you need to be separated prior to the third week, if nursing is not going well, or infant is not cooperating with bottle-feeding consider feeding with a cup, spoon, eyedropper or finger-feeding (must be taught-see the finger-feeding handout) .
Long term separation refers to separation for a matter of days in an infant who has not been introduced to solids and is under 7 months.
Upon returning, its a good idea to plan spending the first day or two resting in bed with your baby. Nurse frequently, drink to thirst and any decrease in your supply should right itself. If you find that your supply has significantly decreased see the restarting your breastmilk handout. YOU ARE IN CONTROL OF YOUR MILK SUPPLY WHETHER YOU WANT TO INCREASE OR DECREASE IT.
For an older child or partially breastfed child
In an older child or partially nursed baby you will only need to pump both breasts till empty. Pump about as many times as baby is nursing to maintain your supply. So if your 9 month old nurses 2-4 times a day, pump 3 times till empty and as needed while away.
MILK EXPRESSION & STORAGE
Milk expression and storage guidelines in this handout are for moms who have a healthy, full-term baby and are storing their milk for home use.
1. Washing hands.
2. Obtaining containers that have been washed in hot, soapy water and rinsed well. Or you may choose to buy plastic bottle liners.
3. Reading the directions on how to use your pump and/or review how to express by hand.
4. Having a picture of your child handy may help with letdown.
5. Massaging your breasts and/or placing some moist heat on them can be helpful.
1. It sometimes takes practice to get a generous amount. Any amount is precious so save it.
2. Relaxation is key to obtaining a letdown.
3. Some mothers nurse the baby on one side while pumping on the other to help with letdown.
4. Massaging your breasts while pumping can be increase the milk flow.
5. Pumping prior to nursing baby helps to increase supply.
6. If you are pumping because your baby is ill and are having trouble you may find it more effective to think about something else.
Milk storage guidelines
(1). 60o F-24 hours ( 2) 72o F-10 hours (3.) 79o F- 4 to 6 hours.
1. With freezer inside the refrigerator-2 weeks.
2. In self-contained freezer unit 3-4 months. Temp varies because door opens and closes..
3. In separate deep freeze (constant- 0EF) 6 months or longer.
Storage of mature milk or colostrum?
1. Liners-place inside another empty bay to avoid tearing, squeeze out air, roll down to about an inch above the milk, seal, place sealed bag upright in a heavy plastic container with a lid ( and seal it also).
2. Glass-use a solid cap and if milk frozen tighten cap afterward.
3. Any container used to store milk should be clean.
REUSE OF HUMAN MILK
Unlike formula human milk may be reused after feeding from a bottle if:
1. The human milk is immediately refrigerated after feeding.
2. It is used within 24 hours of refrigeration.
3. New milk may not be added to the old milk in the bottle. If must be fed afterward in a new bottle.
This is possible because of the many anti-infective properties contained in breastmilk. Formula begins to spoil the minute the can is opened. If you have any question about safety of your milk simply smell it--human milk smells sour if it has gone bad. If your milk has sediments, a soapy smell, or smells sour within a few hours of expression, call your lactation specialist for advice. We can often easily fix it.
Authored by Christine Betzold, MSN, NP, IBCLC.. May be reproduced without further permission for instructional/educational purpose only. Revised 1/02