Human Milk Storage Information for Home Use for Full-Term Infants

Publication Date: September 1, 2017

Last Updated: March 14, 2022

Recommendations

Preparation for Human Milk Storage

Washing: Women should wash their hands with soap and water, or a waterless hand cleanser if their hands don’t appear dirty, before milk expression. Unclean hands may transmit viruses and bacteria, some of which can cause illness. Studies show that human milk containing fewer bacteria at the time of expression develops less bacterial growth during storage and has higher protein levels compared to milk that has an abundance of bacteria. Additional hand hygiene and cleaning of the breasts before expression are not necessary. (IIB)

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Hand or Pump: Milk expression can be achieved by hand or by a pump. As long as the appropriate steps are taken for hand cleansing and cleaning of pump parts as per the pump manufacturer’s instructions, there does not seem to be a difference in milk contamination with pumping versus hand expression. ()

(IIB, IV)

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There is no need to discard the first few drops of milk with initiating milk expression. This milk is not more likely to be contaminated than milk that is subsequently expressed. One study found that milk expressed at home appears to have more bacterial contamination than milk expressed at the hospital, possibly related to equipment at home or transport, not related to personal hygiene. (IIB)

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Storage Container Choice: Several studies have been done to evaluate a range of available storage containers. There is a significant reduction in percent of fat and an increase in total protein and carbohydrate concentrations with either glass or polyethylene, polypropylene, polycarbonate, or polyethersulfone bottles or bags. Glass and polypropylene containers appear similar in their effects on adherence of lipid-soluble nutrients to the container surface, the concentration of immunoglobulin A (IgA), and the numbers of viable white blood cells in the stored milk. Use of polyethylene containers was associated with a marked drop (60%) of IgA and milk’s bactericidal effect when compared to Pyrex, a type of tempered glass. Steel containers were associated with a marked decline in cell count and cell viability when compared to polyethylene and glass. (IIB)

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Human milk should not be stored in hospital plastic specimen storage containers such as those used for urine or other bodily fluids because there is insufficient evidence regarding their chemical safety and effects on infants’ health. Only food grade plastic containers should be used for human milk storage. (IV)

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There has been concern about possible contamination of milk stored in polypropylene bags because of the risk of contamination by puncturing the plastic. (IV)

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However, one study showed no difference between contamination and fat loss when comparing hard and soft polypropylene containers. Therefore, plastic bags used for human milk storage should be sturdy, sealed well, and stored in an area of the freezer where damage to the bag would be minimized. (IIB)

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Containers made with bisphenol A, which is found in several plastic containers including baby bottles, should be avoided based on strong evidence of its adverse effects as an endocrine disruptor. There should be caution about the use of bottles with bisphenol S, a bisphenol A alternative, as it may also have deleterious effects, although this is not well established in the literature.

Care of Containers: Containers for human milk storage and breast pump milk collection kits must be completely dismantled, washed in hot soapy water and rinsed or washed in a dishwasher, and should always be thoroughly air dried or dried with paper towels. They do not need to be sterilized. If soap is not available, then boiling water is preferable. (IIB)

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Chemical disinfection is not ideal, as the disinfectant can be easily deactivated and could expose infant to unnecessary risk of both inadequately clean containers and residual chemical disinfectant. (IV)

Human Milk Storage Information for Home Use for Full-Term Infants

Recommendations

Preparation for Human Milk Storage

Overview

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