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Bottle Feeding Safely - Expressed Breast Milk or Formula

Expressed breast milk

Breastfeeding supports optimum growth, development and health, and also ensures a better future health for infants and their mothers.  Mothers often express their breast milk so that their babies and toddlers can continue to drink it even if they are away from their mother – for example, when mums go back to work.
When expressing breast milk, and feeding breast milk from a bottle, it’s important to use clean, sterilised equipment and to store the expressed milk safely. Our guide Best Practice for Infant Feeding in Ireland gives advice on expressing breast milk and storing it safely.

Sharing expressed breast milk

Some mothers who have surplus breast milk may wish to share it. The FSAI strongly urges that breast milk is not shared through unregulated sources such as websites or social media. Instead, mothers with surplus milk could donate it to a registered milk bank.
See also the European Milk Bank Association’s statement on sharing breast milk

Milk banks

Milk banks supply maternity and children’s hospitals with donated breast milk. Infants that have a very low birth weight, who are premature, or sick have a much better chance of survival if they are fed breast milk. When babies are born prematurely, their mothers may not be able to provide enough breast milk, especially in the early days after birth. Therefore, milk banks provide a critical service for these infants.
Milk banks follow strict protocols to ensure that the donated breast milk fed to these infants is safe:

  • Donors’ blood is screened for infectious diseases
  • Donors follow strict guidelines on how to hygienically express their milk and how to store and transport it at the correct temperature
  • Donated milk is tested for microorganisms – contaminated milk is rejected
  • Donated milk is pasteurised
  • Pasteurised milk is stored and transported to the hospitals hygienically and at the correct temperature.

Mothers who donate their milk to milk banks do so out of good will. They do not receive payment. Access information on becoming a donor

Sharing expressed breast milk outside milk banks

Some mothers choose to share or sell their expressed breast milk on websites or social media. The FSAI strongly advises that you do not obtain breast milk from these sources. Unlike breast milk from milk banks, there are no controls in place for informal breast milk sharing. This means there is no guarantee that the milk is safe to drink. The milk may:

  • come from a mother who has an infection
  • be contaminated with harmful microorganisms, medications, alcohol, nicotine, drugs or other contaminants
  • not have been expressed hygienically
  • have been shipped at the wrong temperature, allowing bacteria to multiply
  • have been diluted to increase profit for the seller
  • not be human breast milk

One study (1), found that 74% (74/101) of breast milk samples purchased online failed the Human Milk Banking Association of North America (HMBANA) criteria for feeding without pasteurisation as they contained a pathogen or large numbers of bacteria (>104 cfu/ml total aerobic count). Salmonella was found in three of the samples purchased online.
In another study (2), 10% (10/102) of breast milk samples purchased online were found to be diluted with at least 10% cow’s milk. This is harmful as an infant fed with diluted milk will not get the correct balance of nutrients they require. The infant may also have a cow’s milk protein allergy or intolerance.

(1) Sarah Keim and colleagues (2013). Microbiological contamination of human milk purchased via the internet. Pediatrics Volume 132, Number 5, November 2013
(2) Sarah Keim and colleagues (2015). Cow’s milk contamination of human milk purchased via the internet. Pediatrics Volume 135, number 5, May 2015

Infant formula

Breast milk is the best and most natural food for babies, it’s ready to feed and it’s free. However, if you have made an informed decision to feed your baby infant formula, you need to know how to prepare and store it safely – just follow the steps in safefood’s booklet:  How to Prepare your Baby’s Bottle  

Last reviewed: 18/11/2015

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