Human Milk Expression, Storage, and Transport by Women Whose Infants Are Inpatients at a Tertiary Neonatal Unit in Melbourne, Australia

Abstract

Background: Expression and storage of mothers' own milk at home and its transportation to hospital neonatal units are a common practice worldwide when newborns are inpatients. Studies assessing adherence to hospital protocols and guidelines for this are not widely published. Purpose: To explore the advice received and practices followed by mothers when expressing, storing, and transporting their milk from home to the hospital, with a substudy exploring the factors related to temperature maintenance of refrigerated milk at recommended values. Methods: Cross-sectional descriptive study at the neonatal intensive care unit of Mercy Hospital for Women, Melbourne, Australia. Mothers who were discharged home after birth of the infant, but whose infant(s) remained in the neonatal unit for 7 days or more participated. All participants completed a self-administered questionnaire. In the substudy, home refrigerator temperature and surface temperature of milk on arrival to the hospital were recorded. Results:The questionnaire was completed by 100 mothers; 38 participated in the substudy. Median travel time from home to the hospital was 32 minutes (range, 2-135 minutes). Lactation consultants were the largest group providing information, with 44 participants (45%) identifying them as the primary information source. Knowledge about recommended refrigerator storage times for expressed milk was correct in 53 mothers (54%). Coolness of milk was better maintained when transported in an insulated food container than nonuse (surface temperature: mean 9.1°C vs 12.2°C; P = .007). Distance and travel duration were not correlated with temperature. Implications for Practice: More diligent monitoring of conditions under which mothers' own milk is transported to hospital is required, and the use of an insulated food container for refrigerated/frozen milk, even for a short duration, should be strongly recommended. Staff to be trained and better equipped to provide uniform, concise information on expressed human milk management to mothers. Implications for Research: Further research to correlate factors associated with transporting human milk expressed at home and infant health outcome is needed.

Experiences of mothers of NICU preterm infants in milk management out of the hospital: a qualitative study

“…However, how the pump is sterilized is a factor that affects the quality of expressed human milk [ 31 ]. Studies have reported that at least 52% of mothers had one or more experiences of ineffective sterilization of breast pump collection kits [ 32 ] and only 54% of mothers correctly followed the information on the refrigeration times of expressed human milk [ 17 ]. This may increase the risk of bacterial contamination of human milk expressed through a breast pump.…”

“…The main information for 22% of mothers comes from unofficial sources—for example, websites—and these resources may not recommend the same methods as the official guidelines [ 17 ]. The Internet and peer instruction were also other important sources of knowledge for participants in this study, but the scientific nature of the information from these channels was not certain.…”

“…The Sri Lankan Health Agency strongly recommends against the use of pumps for expressing breast milk, a hygiene concern is that pumps are considered a potential source of harmful bacteria [ 16 ]. In a survey in Melbourne, Australia, it was found that only 54% of mothers correctly understood the information on the refrigeration times of expressed human milk [ 17 ]. The study also found that the surface temperature of refrigerated fresh human milk transported to the NICU was higher than the temperature (1 °C–4 °C) recommended by the hospital.…”

“…The study also found that the surface temperature of refrigerated fresh human milk transported to the NICU was higher than the temperature (1 °C–4 °C) recommended by the hospital. Some mothers did not put refrigerated human milk in insulated food containers, resulting in the temperature of these samples of human milk being higher than it would have been in the insulated food container [ 17 ]. Changes in temperature may reduce biologically active factors as well as the nutritional and microbiological value of fresh human milk [ 18 , 19 ].…”

Modern Breastfeeding Options for Preterm Children in Neonatal Hospital

“…/ 2021 / ТОМ 20 / № 6 CURRENT PEDIATRICS / 2021 / V. 20 / № 6 В большинстве развитых стран мира практикуют следующие варианты использования материнского молока в неонатальных стационарах: • кормление свежесцеженным материнским молоком при условии продолжительного/круглосуточного пребывания матери в ОРИТН и достаточном объеме лактации; • кормление материнским молоком, которое матери сцеживают при непродолжительном пребывании в ОРИТН (в дневные часы) и оставляют для ургентного использования или для непродолжительного хранения; • ежедневная транспортировка собранного в домашних условиях в течение суток сцеженного молока (при невозможности пребывания матери в ОРИТН) [67,92,93]. В ОРИТН может быть также использовано замороженное/размороженное материнское молоко; хотя процессы замораживания/размораживания сопряжены с уменьшением нутритивной ценности грудного молока из-за возможной деградации питательных компонентов, прежде всего жира, в результате фотодеградации, окисления на воздухе и оседания на посуде и соединительных трубках при зондовом кормлении [67].…”