How long do you hang your breastmilk when a baby is on continuous feedings? Is it different when the breastmilk has fortifier added? Do you have any references? Thanks!

Three hours, pretty sure it's the same with HMF. We just changed our policy annd can't remember if EBM with HMF is only good for 3 or 4 hours now. I think that was the recommendation of Ross labs

I think this is unit policy specific. Are you trying to write one?

That is a good point donnuchi because I have been attending breastfeeding study days but I have never heard how long can we hang breastmilk for continuous feeding.In my unit it is based on pure assumption that the length of time you can hang it on is the same time you can keep it at room temperature(max4hours-UK Association for Milk Banking,Apr.01)w or w/o fortifier.`Could be nice to have evidence-based practice.Try:http://www.lalecheleague.org

http://www.breastfeeding.org

http://www.breastfeedingonline.com

http://www.peach.ease.lsoft.com/archives/lactnet.html

http://www.ukamb.org

http://www.babyfriendly.org.uk :)

4 hours here... :)

The first hospital I worked at would let it hang for 3 hours. When I find out the answer for the new hospital where I'm working now, I'll let you know. Wish I had some literature references for you... I'll keep an eye out for some...

4 hours here...and we hang the syringe upside down so that when it separates, the fats go in :)

After adding fortifier, it is good for 8 hours in the container.

We do four hours as well. As for the fortifier, I just saw a flier about that at work; will make a copy and bring it home and type it for you (if it's relevant- I think it is) on Monday morning (have to work this weekend).

We do four hours, too.

Mixed with fortifier, it can be stored up to 24 hours. Usually, it's a lot less than that. More like 8-12 hours.

Do other hospitals charge for the fortifier?

We don't.

We hang the brst milk for up to 4 hours, and when using the HMF it's ok for 12 hours. We also tilt the syringe up when delivering the milk.

No charge for the HMF it's a floor stock item.

We hang BM for 4 hours with or without HMF. We hang prepared bottle formula 8 hours. If we have to mix the formula from powder or concentrate, or if we add any type of additives, then it only hangs for 4 hours. Our policy comes from infection control

okay, so it's thursday and not monday, but i had to work ot.

the flier i found wasn't exactly what i thought it was, but it was partially relevant to this discussion (and interesting, imo), so i'll post it here for those who haven't seen this yet (don't know if everyone got this or not on their units). here it is:

powdered fortifier effects on preterm human milk's antibacterial action:

background: human milk has cellular and hormonal factors that protect infants against various virus, fungus, and bacteria. however, the nutritional content of hm is not suffecient to meet the nutritional needs of preterm infants. human milk fortifiers have been designed to meet these nutritional needs. in the united states, there are two commercially available powdered fortifiers, enfamil and similac hm fortifiers, that increase the nutrients in hm for the preterm infant. a major difference between these two fortifiers is that enfamil contains iron that may decrease hm's lactoferrin antibacterial property. (my note: fyi, enfamil contains 1.44mg iron per 4 packets, and similac contains 0.35mg iron per 4 packets).

study objectives: evaluate the effects of human milk mixed with commerciallya vailable powdered human milk fortifiers (hmf) on the bacterial inhibition against e. coli, staph aureus, gbs, and e. sakazakii compared to human milk alone.

study design: human milk was collected from mothers who delivered prematurely after the 1st week postpartum. human milk was used as a control and with each of the powedered commercial fortifiers. bacterial inhibition of human milk (hm) alone, hm+ similac hmf, and hm + enfamil hmf was tested by a filter paper method. after 36 hours of incubation, the diameter of the clear zone around the filter paper disk was measured as an indicator of the bacterial inhibition of the milk samples.

results: human milk alone and in combination with similac hmf were similar in their inhibitory activity. the diameter of the zone of inhibition of samples of hm + enfamil hmf were significantly different from hm or hm + similac hmf.

conclusion:[/b} human milk has antibacterial activity against e. coli, staph, gbs, and e. sakazakii. it was not adversely affected by similac human milk foritifier.

resource:

chan, gm. powdered fortifier effects on perterm human milk's antibacterial action. pediatr res 2003;53:421a (abstract) and in press, j. perinatol.

--end article--

so, basically, preterm human milk has antibacterial properties alone. with low-iron fortifier preparations, these properties are not disturbed. with higher iron preparations, these antibacterial properties are weakened significantly.

i thought that was interesting; sorry to get sort of off topic there.