Storage of breastmilk during power outages or loadshedding - by Lactation Consultant Niyati Naik

A lot of energy, time, dedication, and money goes into the process of expressing precious breastmilk so that it can be given to your baby, whilst you are separated from him or her for any amount of time.

Here are a few practical guidelines on the storage of breastmilk and how to care for, and store your liquid gold, whilst if there is a power outage or when we experience load-shedding.

BREASTMILK STORAGE GUIDELINES (CDC, 2019)

• If breastmilk is thawed at room temperature, it can be used within 2 hours
• If there is leftover breastmilk from a feeding- it must be used within 1 hour of that feed.
• If your baby is premature or sick, stick to more stringent guidelines, such as:

POWER OUTAGE & LOADSHEDDING TIPS

• Check that your pump is ready- consider using a car adaptor or a battery pack for your electric pump. Check if your pump is able to be converted to manual use. If so, practice how to do this. Consider getting a hand pump as a back-up. Learn how to use your hands to express your milk.
• If you are intending to store breastmilk for the future, place it in the fridge or freezer as soon as you can after expressing.
• Use storage containers that have a solid wall and can be sealed airtight.
• If you have breastmilk in the fridge or freezer that has experienced load shedding mark the container with a dot (eg. Red dot etc) so that you use that breastmilk first.
• Keep checking apps regarding when you can expect load shedding so you can take out what you need in time and avoid opening the fridge/freezer during load shedding - Plan ahead.
• The colder the temperature of the breastmilk is, to begin with - the less likely it is for the breastmilk to degrade.
• On the same token, if the breastmilk is in the freezer, it will take it longer to thaw to room temperature during load shedding, than it would take for breastmilk that is stored in the fridge to reach room temperature. Your aim is to try and PREVENT THE MILK FROM COMPLETELY THAWING.
• To homogenise breastmilk that has separated (this is 100% normal), gently roll the bottle with the milk in it, in the palm of your hands for 30 seconds. Alternatively, gently swirl the bottle of breastmilk. Do not shake!
• Once breastmilk is completely thawed or warmed, do not refreeze.
• If storing your milk in a cooler - try to pack it as full as possible to slow thawing. A newspaper that is crumpled is a good insulator and can be used to fill empty spaces. You can even cover the cooler with blankets to help keep it cold. Alternatively, dry ice, containers of water or ice or snow can be used. Unfortunately, the last suggestion isn’t an option in South Africa.
• Do the sniff test - if your breastmilk smells or tastes bad, it is likely that it is. Do not feed this to your baby. If it smells fine, it is likely to be fine.

BREASTMILK THAT IS STORED IN THE REFRIGERATOR

• Use a fridge thermometer to give you the temperature so you can monitor changes in the temperature more accurately, rather than subjectively.
• Open the refrigerator as minimal times as possible whilst there is no electricity
• Store the bottle of breastmilk at the back of the fridge, in the coldest part (usually the bottom shelves) Do not store bottles in the door.

BREASTMILK THAT IS STORED IN THE FREEZER

• Pack frozen breastmilk at the bottom of the freezer (where it is the coldest or check your freezer manual where this may be in your freezer).
• Stack additional ice packs on top of the frozen breastmilk to try and maintain the frozen state.
• Open the freezer as minimal times as possible to conserve the cold temperature as much as possible.
• If you have a generator - connect it to your freezer during a power outage.
• If your neighbour has power ask if you can store your milk in their freezer - be sure to label it with your name and number!
• Fill empty spaces in your freezer with containers of water so that if there is an outage, there are more ice packs surrounding the contents of the freezer rather than empty space.
• Store your breastmilk in the middle of the freezer and away from the walls.
• A full freezer will hold the temperature for approximately 48 hours (24 hours if it is half full) if the door remains closed.

CONCLUSION

Power outages are not ideal, but they do happen. Whether your frozen breastmilk will be salvaged after the power outage will depend on the frequency and duration of the power outage, and the state and temperature that your milk is at, after this time. The conditions and storage of your breastmilk will also affect the rate at which the breastmilk will thaw. If you are in doubt, seek help, as sometimes the decision to use or discard your stored breastmilk may not be clear.

Breastmilk is a living fluid with live cells and immune factors that can be damaged during heating and freezing processes. The best way to feed your baby breastmilk is fresh. This is when the nutritional and immune content is at its highest. Use power outages to spend down-time with your little one and avoid using frozen milk, when proper heating is not available.

REFERENCES

• CDC (2019) Storage of human milk.
• https://kellymom.com/bf/pumpingmoms/milkstorage/frozen-milk-power-outage/
• Rechtman DJ, Lee ML, Berg H. Effect of environmental conditions on unpasteurized donor human milk. Breastfeed Med.
• 2006 Spring;1(1):24-6. Also available here. Commentary here: Study results about frozen breastmilk. Also discussed in
• Breastfeeding Answers Made Simple (Mohrbacher, 2010, p. 461-2)
• Weathering a storm with a freezer stash of breastmilk by Katy Linda, IBCLC
• Packaging Frozen Breastmilk from Breastfeeding in Combat Boots
• Using Dry Ice Safely when Traveling with Breastmilk from the Children’s Hospital of Philadelphia
• Keeping Food Safe During an Emergency from the US Department of Agriculture
• Frozen Food and Power Outages: When to Save and When to Throw Out from FoodSafety.gov
• Keep Food and Water Safe after a Natural Disaster or Power Outage from the US Centers for Disease Control
• Storing Human Milk from La Leche League International