Hi Dr. Lei! There's been another comment about the tap water in the Philippines being unclean - I have asked the group for more info but no one has posted. It concerns me. When I lived in Jamaica our water came from a public fountain, unclean, and we took it home to boil. We also boiled it to wash cooking, eating and storage utensils. Can you enlighten me about this? Does soap, and is there a special kind, that would be used to overcome the dirt used to wash breastpumps, storage containers, and dishes?
hi annie! i left a comment on the pinay guideline post for you :) yes, you are right that in some areas, the water is contaminated and the populace should be given instructions and disinfecting methods by the government. for instance, my rural health sanitary inspector was tasked to identify water sources and ensure that the villages regularly cleans up and chlorinates the deep wells. we also teach the people to do SODIS (solar water disinfection).
taking low-resource settings into consideration, breast pumping is not an essential part of breastfeeding education here mainly because 1. manual pumping can be more or as effective 2. quality breast pumps are not easily available, accessible and affordable 3. breast pumps are generally more tedious to clean than storage containers.
as for the containers, we emphasize proper air-drying if they can't rinse them with boiled water. air-drying hopefully dissicates most bacterial contaminants and if they still survive, the antimicrobial properties of milk should work. we also emphasize proper storage - in a cool place, lided, and preferably letting the milk container sit on a water-filled shallow dish to prevent insects from coming into contact with the expressed milk.
My post should appear as Annie Pfeiffer Gower (I am a horticulturist and herbalist as well but we're talking about lactation!) I hope my question about the tap water appears. Something went wrong when I tried to comment. My second question is about item 4. in the blog about milk storage. I'm not looking at it, so I am paraphrasing, but it says something about 'immediately immediate' about using milk. That phrase was unclear for me. I am also confused whether you support earlier recommendations that once the baby's mouth has touched the milk, it must be thrown away. This is why in over 25 years of counselling the people I rely on for information such as La Leche League International, recommend pumping in small quantities like a couple of ounces, and I think you do too. The question is really about whether or not once the baby has touched the milk, and doesn't finish it, should it be thrown out? Thanks very much. Annie
there is no categorical rule as to when milk spoils after touching the baby's mouth. it is dependent on so many factors (e.g. when was the milk collected? was it thawed after being frozen for weeks or was it freshly expressed? how much bacterial contaminants did the baby introduced?).
i think this should be adressed as a matter of principle. if refrigerated thawed milk, whether or not it has touched the baby's mouth should be discarded within 24 hours, it then follows that unfinished milk spoils earlier than that. however, milk doesn't spoil the instant it touches baby's mouth because bacteria still needs to incubate etc. ect. thus, the recommendation to give it on the immediate next feeding. however, when in doubt, it's easier to spill the milk than end up with a poor sick baby. hope it helps annie! thanks for dropping by :)
"immediately immediate" was a typo error, have fixed it already.
Hi Dr. Lei! There's been another comment about the tap water in the Philippines being unclean - I have asked the group for more info but no one has posted. It concerns me. When I lived in Jamaica our water came from a public fountain, unclean, and we took it home to boil. We also boiled it to wash cooking, eating and storage utensils. Can you enlighten me about this? Does soap, and is there a special kind, that would be used to overcome the dirt used to wash breastpumps, storage containers, and dishes?
ReplyDeletehi annie! i left a comment on the pinay guideline post for you :)
Deleteyes, you are right that in some areas, the water is contaminated and the populace should be given instructions and disinfecting methods by the government. for instance, my rural health sanitary inspector was tasked to identify water sources and ensure that the villages regularly cleans up and chlorinates the deep wells. we also teach the people to do SODIS (solar water disinfection).
taking low-resource settings into consideration, breast pumping is not an essential part of breastfeeding education here mainly because 1. manual pumping can be more or as effective 2. quality breast pumps are not easily available, accessible and affordable 3. breast pumps are generally more tedious to clean than storage containers.
as for the containers, we emphasize proper air-drying if they can't rinse them with boiled water. air-drying hopefully dissicates most bacterial contaminants and if they still survive, the antimicrobial properties of milk should work. we also emphasize proper storage - in a cool place, lided, and preferably letting the milk container sit on a water-filled shallow dish to prevent insects from coming into contact with the expressed milk.
-- dessicate
DeleteMy post should appear as Annie Pfeiffer Gower (I am a horticulturist and herbalist as well but we're talking about lactation!) I hope my question about the tap water appears. Something went wrong when I tried to comment.
ReplyDeleteMy second question is about item 4. in the blog about milk storage. I'm not looking at it, so I am paraphrasing, but it says something about 'immediately immediate' about using milk. That phrase was unclear for me. I am also confused whether you support earlier recommendations that once the baby's mouth has touched the milk, it must be thrown away. This is why in over 25 years of counselling the people I rely on for information such as La Leche League International, recommend pumping in small quantities like a couple of ounces, and I think you do too. The question is really about whether or not once the baby has touched the milk, and doesn't finish it, should it be thrown out? Thanks very much. Annie
there is no categorical rule as to when milk spoils after touching the baby's mouth. it is dependent on so many factors (e.g. when was the milk collected? was it thawed after being frozen for weeks or was it freshly expressed? how much bacterial contaminants did the baby introduced?).
Deletei think this should be adressed as a matter of principle. if refrigerated thawed milk, whether or not it has touched the baby's mouth should be discarded within 24 hours, it then follows that unfinished milk spoils earlier than that. however, milk doesn't spoil the instant it touches baby's mouth because bacteria still needs to incubate etc. ect. thus, the recommendation to give it on the immediate next feeding. however, when in doubt, it's easier to spill the milk than end up with a poor sick baby. hope it helps annie! thanks for dropping by :)
"immediately immediate" was a typo error, have fixed it already.
ps: you have such an interesting background! :)
Delete