Freezing breastmilk

Gompers, BSN, RN · Mar 26, 2006

We have to freeze our breastmilk. The majority of our babies are NPO for at least the first few days of life, and the micropreemies never eat as much as the mother produces so we freeze the remainder. Most of the moms produce lots more milk than their preemies need.

Do some units only give fresh milk?

TiffyRN, BSN, PhD · Mar 26, 2006

I give whatever's available. If the kid is NPO we freeze it, if mom brings too much fresh for the kid to consume in the next 48hrs (from pumping time) we freeze it. We have many moms that come from long distances and can only come every few days, they bring their milk frozen packed in ice. It's not a big deal.

Of course, I would rather use fresh because I don't have to wait for the thawing process to mix it (pretty much every kid has some fancy mixture). The occasional mom will prefer her kid get fresh and will work hard to always have fresh available.

Our donor milk is only available frozen.

I've never heard of anything about CMV, that could be interesting to find more about.

twallingrn · Mar 26, 2006

Thanks for replying. We also freeze milk because a lot of premies & sick babies are NPO and mothers also have an over abundance of milk as well. But the reason I was asking was to see who freezes their milk for CMV. So the milk after the 1st week has to be frozen for 24 hours at least prior to administration of that milk for premies that are 34 weeks can be given fresh breast milk when they are fed). Because freezing is supposed to kill CMV. But we have some doctors that believe the only way to kill CMV is to freeze it and some doctors that don't. And, feel that the only way to kill CMV would be to pasteurize it. I haven't seen the new studies. I was asked to see if any other NICU's froze their milk for CMV. So my homework from a committee that I am on is to see what other NICU's were doing.

Gompers, BSN, RN · Mar 26, 2006

Oooops! Sorry about that!

I've never heard of freezing breastmilk to kill CMV. Is this a new thing?

Anyone else doing that?

We always try to feed fresh, not frozen, whenever possible.

fergus51 · Mar 26, 2006

I've never heard about that either. We freeze for practicality, not because of CMV.

dawngloves, BSN, RN · Mar 26, 2006

Nope, never heard that. Wouldn't it have to be irraidiated to kill CMV?

NicuNightRN · Mar 26, 2006

We also freeze for practicality. While some moms have a hard time keeping up, most produce more than the baby needs, since they all start off NPO. Because freezing breaks down some of the components (so I was told in orientation, I don't know all the details), we prefer to give fresh first, then frozen. Donor is also only available frozen, and a lot of it can go to waste if the baby is only getting a few mL's per feeding (it comes in 3-4 oz bottles, and milk is good only for 24 hours after thawing or mixing).

I've also never heard of freezing for CMV.

EricJRN, MSN, RN · Mar 27, 2006

Here's a link to an article that examined freezing EBM to prevent CMV. Unfortunately in this study there was still CMV transmission. Heat treatment is mentioned as a possible alternative.

http://www.pedresearch.org/cgi/content/full/56/4/529

BittyBabyGrower, MSN, RN · Mar 27, 2006

Never heard of it....heat will kill it,but you'll also kill off the proteins, that is why you don't microwave MBM. If we know a mom is CMV pos. she doesn't breastfeed. Do you have a huge amount of people who have CMV?

EricJRN, MSN, RN · Mar 27, 2006

Never heard of it....heat will kill it,but you'll also kill off the proteins, that is why you don't microwave MBM. If we know a mom is CMV pos. she doesn't breastfeed. Do you have a huge amount of people who have CMV?

CMV is something that has infected most adults in the US. According to the CDC it affects 50-80% of adults by age 40. The CDC also says that the highest risk of passing the infection to the infant is when an unexposed mom acquires CMV during the pregnancy.

I always thought the main reason for not microwaving the milk was to avoid 'hot spots' that could burn the baby.

BittyBabyGrower, MSN, RN · Mar 27, 2006

Our nutritionist told us that microwaving, besides the hot spots, breaks down the proteins and also some of the antibodies, that is why warm water or room temperature is preferred for thawing frozen MBM.

I've been at this for over 20 years now, and I can honestly say that I have never seen a kid get CMV from it's mom by BFing. Most people are exposed early on in life, there are the few that aren't.