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Differences in Current Procedures for Handling of Expressed Mother's Milk in Danish Neonatal Care Units

Simonsen, Marie Bendix MD; Hyldig, Nana PhD, MHS; Zachariassen, Gitte MD, PhD

Section Editor(s): Parker, Leslie A.

doi: 10.1097/ANC.0000000000000663
Human Milk Science: Special Series

Background: Mother's own milk (MOM) is preferred when feeding preterm infants. When expressed mother's milk is stored and handled, there is a risk of bacterial contamination, decreased immunological activity, and less nutritional potential.

Purpose: The aim of this study was to investigate current routines when handling MOM in Danish neonatal intensive care units (NICUs).

Methods: A survey was sent to all 17 NICUs in Denmark in which current practices regarding human milk handling, storage, and preparation were evaluated. Furthermore, one question sought to establish when mother's milk was believed to be colostrum. Respondents of the survey were neonatal nurses.

Results: All 17 units responded to the survey. Only 5 of 17 units answered that human colostrum was defined as milk from the first week after birth. Refrigerator storage time varied between 24 and 72 hours. In 6 of 17 units, parents were in charge of mixing milk and fortifier. Heating of human milk was done by using microwave ovens in 4 of 17 of the units.

Implications for Practice: This national survey established that there is significant variability in the way mother's milk is handled. Some of the procedures performed may affect the quality of the milk. It is important to implement evidence-based practice regarding storage and handling of expressed mother's milk to ensure that the quality of the milk is the best possible alternative for all preterm infants.

Implications for Research: Prospective studies are needed to examine the association between handling of human milk and changes in composition and nutritional potential of the milk.

Institute of Clinical Research, University of Southern Denmark, Odense C, Denmark (Drs Simonsen, Hyldig, and Zachariassen); and Hans Christian Andersens Children's Hospital, Odense University Hospital, Odense C, Denmark (Drs Hyldig and Zachariassen).

Correspondence: Gitte Zachariassen, MD, PhD, Hans Christian Andersens Children's Hospital, Odense University Hospital, Kløvervænget 23C, Entrance 60, 5000 Odense C, Denmark (

The authors thank all the neonatal nurses who responded to the survey for their time and expertise, and Signe Haslund Knudsen, master's degree in English, for English proofreading.

None of the authors have conflicting interests.

© 2019 by The National Association of Neonatal Nurses