If you are unable to breastfeed your baby directly, make sure to pump during the times your baby would normally eat. This will help you to continue making milk.

Before you pump, wash your hands with soap and water. If soap and water are not available, use an alcohol-based hand sanitizer that has at least 60% alcohol. Make sure the area where you are pumping and your pump parts and bottles are clean. You do not need to wash your breasts and nipples before pumping.

If you need help to get your milk to start flowing without your baby there, you can:

• Think about the things you love about your baby. Bring a photo or a blanket or item of clothing that has your baby's scent on it.
• Apply a warm, moist cloth to your breasts.
• Gently massage your breasts.
• Gently rub your nipples.
• Visualize the milk flowing down.
• Sit quietly and think of a relaxing setting.

Following recommended storage and preparation techniques can maintain the safety and quality of expressed breast milk for the baby’s health.

These are general guidelines for storing human milk at different temperatures. Various factors affect how long human milk can be stored safely. Such factors include milk volume, room temperature when milk is expressed, temperature fluctuations in the refrigerator and freezer, and cleanliness of the environment.

Human Milk Storage Guidelines

Safe Storage of Expressed Breast Milk

Before expressing or handling breast milk:

• Wash your hands well with soap and water. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol.
• Mothers can express breast milk by hand or with a manual or electric pump.
• If using a pump, inspect the pump kit and tubing to make sure it is clean. Discard and replace moldy tubing immediately.
• If using a shared pump, clean pump dials, power switch, and countertop with a disinfectant wipe.

Storing breast milk after expressing:

• Use breast milk storage bags or clean, food-grade containers to store expressed breast milk. Make sure the containers are made of glass or plastic and have tight fitting lids.
  • Avoid bottles with the recycle symbol number 7, which indicates that the container may be made of a BPA-containing plastic.
• Never store breast milk in disposable bottle liners or plastic bags that are not intended for storing breast milk.
• Freshly expressed or pumped milk can be stored:
  • At room temperature (77°F or colder) for up to 4 hours.
  • In the refrigerator for up to 4 days.
  • In the freezer for about 6 months is best; up to 12 months is acceptable. Although freezing keeps food safe almost indefinitely, recommended storage times are important to follow for best quality.

Storage tips:

• Clearly label the breast milk with the date it was expressed.

• Do not store breast milk in the door of the refrigerator or freezer. This will help protect the breast milk from temperature changes from the door opening and closing.
• If you don’t think you will use freshly expressed breast milk within 4 days, freeze it right away. This will help to protect the quality of the breast milk.
• When freezing breast milk:
  • Store small amounts to avoid wasting milk that might not be finished. Store in 2 to 4 ounces or the amount offered at one feeding.
  • Leave about one inch of space at the top of the container because breast milk expands as it freezes.
• If you deliver breast milk to a child care provider, clearly label the container with the child’s name. Talk to your child care provider about any other requirements for labeling and storing breast milk.
• Breast milk can be stored in an insulated cooler with frozen ice packs for up to 24 hours when you are traveling. At your destination, use the milk right away, store it in the refrigerator, or freeze it.

Safe Thawing of Breast Milk

• Always thaw the oldest breast milk first. Remember first in, first out. Over time, the quality of breast milk can decrease.

• There are several ways to thaw your breast milk:
  • In the refrigerator overnight.
  • Set in a container of warm or lukewarm water.
  • Under lukewarm running water.
• Never thaw or heat breast milk in a microwave. Microwaving can destroy nutrients in breast milk and create hot spots, which can burn a baby’s mouth.
• If you thaw breast milk in the refrigerator, use it within 24 hours. Start counting the 24 hours when the breast milk is completely thawed, not from the time when you took it out of the freezer.
• Once breast milk is brought to room temperature or warmed, use it within 2 hours.
• Never refreeze breast milk after it has thawed.

Feeding Expressed Breast Milk

• Breast milk does not need to be warmed. It can be served room temperature or cold.
• If you decide to warm the breast milk, here are some tips:
  • Keep the container sealed.
  • Place the sealed container into a bowl of warm water or hold it under warm, but not hot, running water for a few minutes.
  • Test the milk’s temperature before feeding it to your baby by putting a few drops on your wrist.
  • Do not heat breast milk directly on the stove or in the microwave.
• Swirl the breast milk to mix the fat, which may have separated.

• If your baby did not finish the bottle, use the leftover milk within 2 hours after the baby is finished feeding. After 2 hours, leftover breast milk should be discarded.

Safe Cleaning of Infant Feeding Items and Pumping Equipment:

Carefully clean, sanitize, and store pump equipment, baby bottles, and other feeding items to protect your breast milk from contamination. See CDC guidance on how to safely clean and store pump equipment and infant feeding items.

*You can rent an electric pump from a lactation consultant at a local hospital or from a breastfeeding organization. This type of pump works well for creating a milk supply when a new baby can't feed at the breast. Mothers who have struggled with other pumping methods may find that these pumps work well for them.

Most insurance plans must cover the cost of a breast pump. You may be offered a rental or a new one for you to keep. Your plan may provide guidance on whether the covered pump is manual or electric, how long the coverage of a rented pump lasts, and when they'll provide the pump (before or after you have the baby). Learn more about your breastfeedingbenefits at HealthCare.gov and talk to your insurance company to learn their specific policies on breast pumps.

After each pumping, you can:

• Keep milk at room temperature. Breastmilk is OK for up to 4 hours after pumping at room temperature (up to 77°F).
• Refrigerate it. Breastmilk is OK in the refrigerator for up to 4 days.
• Place milk in the freezer. If you're not going to use refrigerated breastmilk within 4 days of pumping, freeze it right after pumping.
• Use cooler packs. You can put breastmilk in a cooler or insulated cooler pack with frozen ice packs for up to 24 hours after pumping. After 24 hours in a cooler the breastmilk should be refrigerated or frozen.

When storing breastmilk, use breastmilk storage bags, which are made for freezing human milk. You can also use clean glass or hard BPA-free plastic bottles with tight-fitting lids. Do not use containers with the recycle number 7, which may contain BPA. Do not use disposable bottle liners or other plastic bags to store breastmilk.

Storage bottles or bags to refrigerate or freeze your breastmilk also qualify as tax-deductible breastfeeding gear. Most insurance plans must cover breastfeeding supplies, such as storage bags, in addition to breast pumps. Call your insurance company to learn more.

• Clearly label milk containers with the date the milk was expressed. Include your child's name if you are giving the milk to a child care provider.
• Freeze in small amounts (2 to 4 ounces, or ¼ to ½ cups) for later feedings.
• Leave an inch or so from the milk to the top of the container, because it will get bigger when freezing.
• Wait to tighten bottle caps or lids until the milk is completely frozen.
• Store milk in the back of the freezer, not on the shelf of the freezer door, so that it doesn't start to thaw out.

• Thaw the oldest breastmilk first.
• Breastmilk does not need to be warmed. Some moms prefer to serve it at room temperature. Some moms serve it cold.
• Thaw the bottle or bag of frozen milk by putting it in the refrigerator overnight.
• If you decide to warm the breastmilk:
  • Keep the container sealed while warming.
  • Hold it under warm, not hot, running water, or set it in a container of water that is warm, not hot.
  • Never put a bottle or bag of breastmilk in the microwave. Microwaving creates hot spots that could burn your baby and damage the milk.
  • Test the temperature before feeding it to your baby by dropping some on your wrist. The milk should feel warm, not hot.
• Swirl the milk to mix the fat, which may have separated. Do not shake the milk.
• Use breastmilk within 24 hours of thawing it in the refrigerator. This means 24 hours from when the breastmilk is no longer frozen, not from when you take it out of the freezer.
• Once breastmilk is thawed to room temperature or warmed after being in the refrigerator or freezer, use it within 2 hours. If you have any leftover milk when the baby is finished feeding, be sure to throw it out within 2 hours.
• Do not refreeze breastmilk after it has been thawed.

Source: Adapted from 7th Edition American Academy of Pediatrics (AAP) Pediatric Nutrition Handbook (2014); 2nd Edition AAP/American College of Obstetricians and Gynecologists (ACOG) Breastfeeding Handbook for Physicians (2014); Academy of Breastfeeding Medicine (ABM) Clinical Protocol #8 Human Milk Storage Information for Home Use for Full-Term Infants(link is external) (2017); CDC Human Milk Storage Guidelines (2018).

Source: Adapted from ABM Clinical Protocol #8 Human Milk Storage Information for Home Use for Full-Term Infants(link is external) (2017).

Despite significant efforts to prevent mix-ups, occasionally, expressed breast milk from a mother is given to another mother’s child in error. If a child is mistakenly fed another child’s bottle of expressed breast milk, such as in a childcare setting, sensitivity should be taken with both families to minimize fear and steps should be taken to appropriately manage the situation in a timely manner.

Few illnesses are transmitted via breast milk, and in fact, the unique properties of breast milk help protect infants from colds and other typical childhood viruses. Nonetheless, both families need to be notified when there is a milk mix-up, and they should be informed that the risk of transmission of infectious diseases via breast milk is small.

CDC’s experts recommend health care and childcare providers take specific actions as soon as possible after this kind of error to prevent adverse health consequences. If a child is mistakenly fed another child’s bottle of expressed breast milk, follow these steps:

• Inform the mother whose breast milk was given to another child, and ask her:
  • When was the breast milk expressed and how was it handled prior to being delivered to the caretaker or facility?
  • Would she be willing to share information about her current medication use, recent infectious disease history, and presence of cracked or bleeding nipples during milk expression with the other family or the child’s pediatrician?
• Discuss the event with the parent(s) or guardian(s) of the child who was given another mother’s milk:
  • Inform them that their child was given another mother’s expressed breast milk.
  • Inform them that the risk of transmission of infectious diseases is small.
  • If possible, provide the family with information on when the milk was expressed and how the milk was handled prior to its being delivered to the caretaker.
  • Encourage the parent(s) or guardian(s) to notify the child’s physician of the situation and share any specific details known.

When a milk mix-up occurs, any decisions about medical management and diagnostic testing of the infant who received another mother’s milk should be based on the details of the individual situation and be determined collaboratively between the infant’s physician and parent(s) or guardian(s).

Potential Concerns Related to Breast Milk Mix-Ups

Concerns about potential exposure to human immunodeficiency virus (HIV)

Routine prenatal care in the United States includes laboratory testing for sexually transmitted infections (STIs) and HIV. Most HIV-positive women are identified prior to or during their maternity hospital stay. In the United States, women who are HIV-positive are advised NOT to breastfeed their infants. As such, it is unlikely that a mother living with HIV would be providing expressed milk for her own child at a child care center. In addition, the risk of mother-to-child transmission for whom a single bottle of another mother’s milk was fed is very low. The CDC is unaware of any evidence of transmission of HIV to a child via a single exposure to another mother’s milk.

Concerns about potential exposure to hepatitis B and C viruses

Hepatitis B and C cannot be spread from a woman to a child through breastfeeding or close contact unless there is exposure to blood. It is very unlikely that a child would be at risk for hepatitis B or C by receiving another mother’s breast milk. Furthermore, with regard to hepatitis B (there is no vaccine for hepatitis C), most infants have already received at least one dose of the hepatitis B vaccine shortly after birth, the second dose between 1-2 months of age, and the third dose between 6-18 months of age. However, infants who have not been vaccinated, or infants whose vaccine schedule was interrupted, should be vaccinated according to the Advisory Committee on Immunization Practices’ hepatitis B vaccine recommendations as soon as possible.

There is no evidence that breastfeeding spreads hepatitis C virus.

Concerns about potential exposure to medications

Although many medications do pass into breast milk, most have little or no effect on infant well-being. Few medications are contraindicated while breastfeeding and risk of adverse effects from a single exposure to a medication through breast milk is very low.

Prevent Milk Mix-Ups

To help prevent milk mix-ups, childcare facilities should review and update their policies and practices for storing and handling breast milk, as well as training (or retraining) all childcare facility staff in safe storage and handling of breast milk. In addition to clearly labeling expressed breast milk with the child’s name, some facilities use strategies such as putting different colored rubber bands around the bottles for different infants and using separate bins for each infant’s bottles of milk.

Why have I seen different recommendations for storing breast milk?

Many factors can affect how long breast milk can be stored in various locations, such as storage temperature, temperature fluctuations, and cleanliness while expressing and handling breast milk. These factors make it difficult to recommend exact times for storing breast milk in various locations.

Does the temperature of the room matter if I plan to leave breast milk on the counter until I use it?

Yes. If you live in a warmer climate or keep your home at a warmer temperature, you should place breast milk in the refrigerator if it will not be used within a few hours. Breast milk does not spoil as quickly at cooler temperatures.

What is the recommended method to store and serve breast milk that is leftover from a feeding?

If your baby did not finish the bottle, the leftover breast milk can still be used within 2 hours after the baby is finished feeding. After 2 hours, leftover breast milk should be thrown away. To avoid wasting unfed milk, consider storing, thawing, and warming milk in smaller amounts.

How can I determine the temperature of my refrigerator and freezer?

Your refrigerator should be 40°F or below, and your freezer should be 0°F or below. If your refrigerator/freezer thermostats do not show the temperatures, use inexpensive freestanding appliance thermometers. Even if your refrigerator/freezer do show the temperatures, appliance thermometers may be important if you lose power or have mechanical problems.

If I move stored breast milk that has been in a kitchen freezer to a deep/chest freezer or vice versa, do the storage recommendations change?

No. You can count the age of the milk from the first time that it was frozen, regardless of when it was moved. As long as the temperature of the freezer is 0°F or below, it does not matter whether it is a kitchen freezer or a deep freezer. Breast milk can be stored in the freezer (at 0° F or colder) for up to 12 months, although using it within 6 months is best. The temperature of kitchen freezers is typically 0° F and although deep freezers or chest freezers may be able to operate at a temperature colder than 0° F, both types of freezers fall within the guideline of keeping frozen milk at a temperature of 0° F.

Moving frozen breast milk between freezer locations should be done quickly to ensure that the milk stays frozen. It may be useful to pack the frozen breast milk on ice packs while transporting the milk from one location to another.

If I don’t use breast milk stored in the refrigerator within a few days, can I still freeze it to use later?

After 4 days of refrigeration, your breast milk should be used or thrown away. Breast milk has properties that slow the growth of bad bacteria. These properties begin to decline after a few days of refrigeration. If you think you won’t use breast milk within a few days, the sooner you freeze it, the better.

Can I mix freshly expressed breast milk with older breast milk?

Mixing freshly expressed breast milk with already cooled or frozen milk is not advised because it can rewarm the older stored milk. It is best to cool freshly expressed milk before combining it with older, previously cooled or frozen milk. It is also important to consider storage duration guidelines for breast milk. For example, if combining cooled milk pumped on different days, the duration of storage should be based on when the older milk was first stored.

The power went out! Do I have to throw out all of my stored frozen breast milk?

Your breast milk may still be safe, but it depends on how long the power is out and how defrosted or warm the breast milk becomes. Freezers, if left unopened and full during a power outage, will keep food safe for about 48 hours (about 24 hours if half full). When freezers are full, the other frozen items help keep the freezer colder longer. The refrigerator will keep food cold for about 4 hours if it is unopened. While the power is out, keep the freezer and refrigerator doors closed as much as possible.

Once the power is back on, check the condition of your stored breast milk. Frozen breast milk that has started to thaw but still contains ice crystals can be refrozen. If your breast milk has completely thawed but still feels cold, put it in the refrigerator and use it within the next day or throw it away.

Where can I store my breast milk at work?

Expressed breast milk is a food and may be stored alongside other foods in any refrigerator that is appropriate for food storage. Employers, coworkers, cleaning staff, other family members, and childcare providers should not consider or treat breast milk as a biohazard. Storing breast milk in a shared refrigerator and washing pump parts in community break rooms are unlikely to pose health risks (sanitary or safety issues); however, it is important that the breast pump equipment be cleaned, dried, and stored in a sanitary (clean) environment to protect the equipment (and expressed breast milk) from contamination.

What are the recommendations for properly storing expressed breast milk while traveling?

Expressed breast milk may be stored and transported in an insulated cooler bag with frozen ice packs for up to 24 hours, or else frozen in dry ice (follow safety precautions when handling dry ice). Once breast milk is cooled, it should remain cool until it is consumed. Breast milk that has been transported in an insulated cooler bag with frozen ice packs can then be refrigerated or frozen.

Depending on the destination, if no reliable breast milk storage is available, a mother traveling with expressed breast milk could consider using temperature-controlled shipping to transport breast milk or discarding her expressed breast milk. Continuing to express breast milk regularly will help a mother to maintain her breast milk supply until she and her nursing infant or child can be reunited.

Traveling by air?

• You are allowed to carry more than 3.4 ounces of breast milk in your carry-on bag, as well as ice and gel packs.
• The Transportation Security Administration (TSA) has specific screening procedures for anyone traveling with breast milk.
• Consider keeping a copy of the TSA regulations in your carry-on bag.

Traveling with a Breastfeeding Baby

The thought of traveling with your breastfeeding baby can feel overwhelming, but breastfeeding provides several benefits to parents and children traveling together. Breastfeeding can provide a source of comfort for babies whose normal routine is disrupted due to travel. In addition to providing the ideal nutrition for your baby, breast milk keeps babies hydrated. Breastfed babies under 6 months do not need to drink water or any other liquids, even in hot weather.

By planning ahead, you can successfully continue to breastfeed and/or express milk for your baby.

• Breastfeed your baby during takeoff and landing when traveling by airplane. This will help to protect your child from ear pain due to cabin pressure changes.
• Feed your baby on demand. The best way to maintain your milk supply is to breastfeed whenever your baby is hungry.

Traveling Without a Breastfeeding Child

If you are traveling without your child and plan on continuing breastfeeding, you will need to take certain steps to maintain your milk supply. Working with a lactation consultant or pediatrician may also be helpful to plan for your specific situation.

Prior to departure

• Express breast milk in advance so that your child may continue to have your milk while you are apart.
• Babies who have never drank milk from a bottle or cup should practice with another caregiver.

While Traveling

• You have many options for what to do with your milk while traveling. You can express milk and store it, send it home, or “pump and dump” (throw it out).
• If storing and/or shipping breast milk is not possible, “pumping and dumping” can allow you to maintain your milk supply so that you can continue breastfeeding when reunited with your baby.

Expressing Milk

Maintaining a full milk supply can be a concern for many traveling parents. Here are some tips for preserving your milk supply while traveling:

• Take regular breaks to express your milk, as frequently as you would normally feed your baby, if possible.
• To maintain an abundant milk supply over a long period of time, you may have greater success using an electric breast pump.
  • If you plan to use an electric breast pump, consider whether you will need an electrical adapter and converter.
  • Plan for a back-up option (such as hand expression or a portable manual pump) to express milk if needed.
• Before expressing milk make sure to wash your hands with soap and water. When soap and water are not available, an alcohol-based hand sanitizer with at least 60% alcohol can be used.
• It is important to keep your breast pump parts clean while traveling. Plan in advance how to best keep your pump kit parts clean given your specific travel settings.
• Know your rights. The Friendly Airports for Mothers (FAM) Act requires all medium and large airports in the U.S. to have clean, private, non-bathroom lactation spaces in each terminal for expressing breast milk.
• If you need to pump milk while traveling by car, plane or other transportation, a manual or battery powered breast pump may be the best option. Some pumps can also be powered with car adapters.

Storing Milk

• Check with your hotel or lodging accommodations in advance to request a compact refrigerator for your room if needed.
• Store expressed milk in milk storage bags or clean food-grade containers with tight fitting lids made of glass or BPA-free plastic.
• Store milk in the back of the refrigerator or freezer where the temperature is more likely to stay constant.

Transporting Milk

• If you expect to have expressed milk with you during travel, carefully plan how you will transport the milk. The type of transportation (e.g., airplane, car, train, bus) you take may influence what policies you need to be aware of and follow.
  • You can carry freshly expressed milk in an insulated cooler bag with frozen ice packs for up to 24 hours. After arriving at your destination, use the milk right away, store it in the refrigerator, or freeze it.
• If you carry frozen milk in a cooler with frozen gel packs or ice, check your milk when you get to your destination. Upon arrival, if the milk has ice crystals, you can refreeze it.
  • Keep in mind that previously frozen milk should be kept cold and used within 24 hours from the time it thaws completely. This will depend on the time spent traveling and the temperature of the cooler. If possible, check the milk after a few hours in the cooler to see if it has thawed.

Considerations for Air Travel

• In the United States, expressed milk and related baby and child feeding items are exempt from Transportation Security Administration (TSA) regulations limiting quantities of liquids and gels.
• Passengers are allowed to carry with them all expressed milk, ice, gel packs (frozen or unfrozen), and other items required to transport expressed milk through airport security checkpoints and onboard flights.
• You do not have to be traveling with a baby to be able to carry milk and supplies.
• At the beginning of the screening process, inform the TSA officer that you are carrying expressed milk or related accessories, and separate them from other liquids, gels, and aerosols that are limited to 3.4 oz. (100 mL) each, subject to TSA’s Liquids Rule.
• Having a printed copy of the TSA regulations for expressed milk may help the screening process.
• For more information on breastfeeding and international travel visit CDC’s Yellowbook (Chapter 7).

Getting Back to Your Breastfeeding Routine After Traveling

• Even if your milk supply begins to decrease while you are away from your breastfeeding child, you can continue breastfeeding when you return and in most cases your milk supply will return to normal after several days.
• Occasionally, during long separations, babies who have adapted to using a bottle or cup may find it difficult to go back to breastfeeding. Support from a lactation provider may be helpful if you experience breastfeeding challenges after reuniting with your baby.