LC Learning

After watching a lecture about climate change and reproductive justice, I wonder how prepared folks are for the effects of climate change where they are living. I wonder about the downstream effects for birth workers and lactation consultants when the power goes out because of hurricanes, tornadoes, or extreme flooding. I presume that the inequities in health care will be exacerbated, and it falls to health care workers and birth workers to know of resources to support pregnant and postpartum folks... to know where to access clean water for formula, to know how to pump milk without an electric pump, etc. Where I live, the main climate concern would be heat waves both affecting women and babies by virtue of dehydration, but also the power going down due to too much cooling power being generated in homes and institutions - or whatever else would cause the grid to go down. For this reason, one takeaway for me on this topic is to teach every one of my lactating clients to know how to hand express their breast milk - regardless on if they have a working electric breast pump. For obvious reasons, milk not coming out is an issue for both mom and baby...clogged ducts, mastitis, abcesses, hungry baby...  It is essential to have a plan in place as a lactation consultant and knowing what supports are in your community for breastfeeding moms in the case of a climate change related disaster or disruption. For one, knowing who and where to access pump rentals, and secondly, knowing where moms can access milk substitutes would be a good place to start.

Most parents are familiar with the basic breastmilk storage guidelines, like how long milk can sit at room temperature, how many days it can stay in the refrigerator, and when it should be frozen. Organizations like La Leche League and The Breastfeeding Network provide excellent foundational guidance on this and they are resources I personally rely on. Where families often need more support, however, is in the grey areas- the real life situations that don’t always fit neatly into a chart. This post focuses on those nuances, so you can make (and so that I can remember) more informed, confident decisions about handling and storing human milk. 🥛 Temperature Stability Matters More Than the Exact Hour One of the most overlooked aspects of milk storage is temperature consistency. → Breastmilk should be stored toward the back of the refrigerator, not on the door → The refrigerator door experiences frequent temperature fluctuations due to opening and closing → Repeated warming and cooling can impact milk quality over time
 → Best practice:
Store milk on a middle or back shelf, as close to the cooling element as possible, where temperatures are most stable. 🥛 Ice Crystals = Milk Is Still Frozen A common source of anxiety is partially thawed milk. But even I was surprised to learn that if frozen breastmilk: → Still contains ice crystals → Is cold to the touch → Has not fully thawed
 🙌 It is considered frozen and can be safely refrozen This guidance is supported by both La Leche League and The Breastfeeding Network, and it’s especially relevant during: → Power outages → Cooler transport → Freezer door openings
 Once milk has fully thawed (no ice crystals remain), it should be treated as refrigerated milk and not refrozen. Ideally if it has experienced a power outage and the milk has experienced a drop (even if it still has ice crystals), that it be used sooner rather than later regardless. Use the first-in-first-out method strictly for these cases. 🥛 Thawed Milk Smell and Appearance Can Vary Milk doesn’t always look or smell the same after freezing and that alone DOESN’T mean it’s unsafe. Normal changes include: → Separation of fat (this is expected) → Slightly soapy or metallic smell (often related to lipase activity) → Color variation depending on diet and stage of lactation
 What matters most: → Milk does not smell rancid or sour → Milk was handled and stored appropriately prior to freezing
 🤔 When in doubt, trust both your senses and the storage history. 🥛 Warming Milk: Gentle Is Better Overheating breastmilk can damage some of its protective properties and cause hot pockets. Avoid using microwaves or boiling water to heat the milk as it can result in uneven heating or over-heating. Instead, warm milk slowly in warm-hot water either in a bowl on your countertop or in a bottle warmer. Milk does not need to be “hot” to be safe or effective; body-temperature or even cool milk is acceptable for many babies. I’m an advocate for getting your babe to take cool milk so that it is less of a fuss overall. 🥛 Clean Handling Reduces Risk More Than Sterility Obsession You do not need a sterile environment to safely handle milk. You need clean hands and containers. Focus on: → Handwashing before pumping or transferring milk → Clean pump parts according to manufacturer guidelines → Using containers designed for human milk storage
 Over-sanitizing can add stress without significantly improving safety for healthy, term infants in home settings. 🥛 Transporting Milk With Cold Packs When transporting expressed milk: → Use an insulated cooler → Add ice packs → Keep milk cold consistently
 Milk stored in a properly packed cooler with ice packs can often remain safely chilled for up to 24 hours, depending on conditions - but again, temperature stability is the key here. 🥛 When Extra Caution Is Needed Some situations require STRICTER handling guidelines, including: → Premature infants → Medically fragile or immunocompromised babies → NICU or hospital settings
 In these cases, follow guidance provided by your healthcare team or institution, which may differ from home-use recommendations. 🥛 A Note on Guidelines Milk storage guidelines are designed to be protective, not punitive. They assume worst-case scenarios to keep babies safe. Please remember that real life is often more nuanced. Understanding why guidelines exist allows families to make thoughtful decisions without unnecessary anxiety or waste. 🙌 Information like this should build confidence, not fear. References & Further Reading Primary references used in this post: → La Leche League International - Human Milk Storage Guidelines
 → The Breastfeeding Network (UK) - Expressing and Storing Breastmilk
 Additional evidence-based resources: → Academy of Breastfeeding Medicine (ABM) Clinical Protocol #8: Human Milk Storage
 → Centers for Disease Control and Prevention (CDC) - Proper Storage and Preparation of Breast Milk
 → Health Canada - Safe Storage of Expressed Breast Milk
 → World Health Organization (WHO) - Breastfeeding and Milk Handling Guidance

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