Human Milk Composition and Storage (Nursing)

00:01 So let's talk about what's in milk, both in colostrum and in mature milk.

00:06 So colostrum, liquid gold.

00:09 Because it is gold, it looks yellow and thick.

00:13 And what's in it? Proteins, minerals, immunoglobulins.

00:17 It has a lot less fat than mature milk, but it's really thick and sticky.

00:22 Mature milk is going to come in around day 3 or 4.

00:26 It's going to take about a week or so more before we don't have a mix of colostrum and mature milk.

00:31 But this is what we have that's going to really meet baby's needs over the long term.

00:37 So if we have a preemie baby, it's going to have everything a preemie baby needs.

00:41 If we have a term baby, it's going to have everything a term baby needs.

00:45 So it's like, "Hmm, you can have it your way at Mom's." Right, it's great.

00:51 Mature milk is perfect for a baby anytime.

00:54 Now there are two components of mature milk, there's foremilk that comes at the beginning of the feeding, and then there's hindmilk at the end.

01:01 Now the importance of the hindmilk and the importance of getting to the end of the feeding.

01:05 So that's why we don't want a baby that eats like two minutes and then stops, because they don't get to the hindmilk.

01:11 The hindmilk is where all the fat is.

01:13 And that's going to hold them over to the next feeding.

01:16 So one of the things that you'll learn if you get into a deeper dive about breastfeeding is that if the baby doesn't get that hindmilk, then they're constantly hungry, because they're not getting that really bang at the end that good, strong, fat laden hindmilk.

01:32 Now let's talk about how we store milk.

01:34 So in the cases where we actually are maybe pumping breast milk, because we don't need all of it or maybe because we have a birthing person that's going back to work.

01:43 Or maybe they just decided that this is how they want to feed their baby in general where they pump and they give the baby the bottle.

01:50 We need to know how to give them recommendations for storing.

01:53 So first of all, it has to be in the appropriate container.

01:57 So we need a hard container.

01:59 So something made of glass or food grade plastic.

02:02 You can also use little bags, so you'll find them at the store.

02:05 And they are made specifically for breast milk storage, they both work.

02:10 When you put them in the room and you have it out, let's say you're pumping and you bring the milk home, it can stay at room temperature for up to 8 hours.

02:20 So that's perfectly safe.

02:22 So up to 8 hours, and it's okay to give to the baby.

02:25 If you put it in the refrigerator.

02:27 Again, in those containers, it can stay for up to five days.

02:32 But these are important numbers.

02:34 Because I can tell you as an instructor, these are questions we always ask on an exam.

02:39 If you put it in a freezer, like a side by side freezer, it can stay in the side by side freezer for up to six months.

02:47 And then if you have a deep freezer, and deep freezers are always scary to me.

02:50 I don't know why, like I think there are too many horror movies made about what's in the deep freezer.

02:55 However, we can put breast milk, which is not scary into the deep freezer, and that can stay in there up to 12 months.

03:02 And I will tell you a beautiful thing is if you can open up a deep freezer and it's full of breast milk.

03:07 That's awesome thing of beauty.

03:11 So let's talk about thawing breast milk.

03:14 So we go into that freezer and we take out that liquid gold, what do we do? Well, we have a couple of options, we can put it in the refrigerator and let it thaw out over a day or so that works perfectly well.

03:25 But let's say maybe you need it right now, you can actually put it into warm water, not going to boil it, we don't have to do that.

03:33 And then we can shake it.

03:35 So we want to allow that breast milk just sort of thought out in the water.

03:39 What we can never ever ever do is put it in the microwave.

03:44 And we can't put it in the microwave because it actually breaks down the human enzymes, which really defeat the purpose of giving them the breast milk in the first place.

03:52 So refrigerator or putting it in a warm water bath.

03:55 So keep it in the container and put it in the warm water.

03:58 But never ever ever ever ever put it in the microwave.

04:04 We've established that breastfeeding is best.

04:06 We've talked about the benefits and all the good things.

04:09 So what do we do to encourage hospitals to encourage their birthing persons to breastfeed? Well there's actually something called Baby-Friendly Hospital Standards that lets us know how we can encourage breastfeeding.

04:21 They include things like having a written breastfeeding policy or training the staff to actually use the policy and making sure that all of the pregnant women that come pregnant families, everybody knows about the benefits and how to manage breastfeeding, that we initiate that breastfeeding within the first 30 minutes.

04:40 Now we know why that's important.

04:42 And that we actually show the birthing persons how to maintain lactation when separated.

04:47 So using the pump or donor milk or whatever needs to happen.

04:53 We want to encourage breastfeeding by making sure that the baby doesn't have any other options for things to eat except the breast milk.

05:01 If they only have breast milk, they will choose breast milk.

05:04 It works out really well.

05:06 We also want to practice rooming in.

05:07 Keeping the birthing person and the baby together will increase the chances that breastfeeding will happen.

05:14 We want to encourage the birthing person to feed the baby whenever they want to eat.

05:18 Because remember, the suckling releases prolactin, which produces milk.

05:24 Yeah, okay, no pacifiers, no artificial nipples, or anything else like that.

05:29 Because suckling on a nipple is a little more challenging than suckling on a pacifier.

05:35 So we want to make sure, again, there are no other options except breastfeeding, and the baby will actually pick it up a lot faster.

05:42 We also want to foster breastfeeding support groups, and actually encourage support that extends beyond the time the client is in the hospital.

05:50 Because often the trouble we have with breastfeeding happens when there's nobody around.

05:55 So we want to make sure we set up those systems.

05:58 So we've just talked about a whole lot of things when it comes to breastfeeding.

06:02 So I have a question for you in the form of a case study.

06:06 Here we go.

06:07 For a birthing person who is not breastfeeding her newborn, which measure would be the most appropriate to alleviate engorgement? So breast engorgement.

06:19 What do you think? Our options are A. warm showers B. Nipple stimulation C. Ice to the breast, or D. Manually expressing milk.

06:31 So this is going to pull on some of your knowledge from postpartum complications.

06:35 So hopefully, you're able to put this together.

06:37 So this is somebody who is not choosing to breastfeed.

06:41 How are we going to stop milk production? You got it.

06:49 The answer is C. Ice to the breast.

06:51 If we use warm showers or nipple stimulation, or we manually express the breast, we're going to have that same sort of release of oxytocin and prolactin.

07:00 So we're going to have more milk, which is going to do exactly the opposite of what we want to do when we are experiencing engorgement.

07:07 Great job.