Storing human milk

The management of human milk is a major activity for many neonatal intensive care units (NICU). Storage is the critical step after collection for human milk to be used to feed preterm infants. One approach is to have the mother freeze the milk after storage and deliver frozen milk to the NICU. However, the cells in the milk will be destroyed, perhaps along with cytomegalovirus (CMV). Fresh milk is thought to be the preferred food for preterm infants. In this issue of The Journal, Slutzah et al reports that human milk can be refrigerated at 4 °C for up to 96 hours without much change in composition or bacterial counts. The multiple immune functions of the 96 hour-old milk were not tested relative to fresh human milk. Another approach to feeding preterm infants human milk is to use heat-treated (pasteurized) and frozen milk from human milk banks. Some neonatal services use milk purchased from milk banks when the mother does not provide milk for her infant. Whether using fresh, refrigerated, frozen, or pasteurized frozen human milk, storage with careful labeling for each infant is now a time consuming activity in the NICU.