title: Pooling expressed breastmilk to provide a consistent feeding composition for premature infants.
abstract: OBJECTIVE
  We hypothesized that pooling a mother's expressed breastmilk for 24 hours compared with individual pump session collection of milk would provide a more consistent caloric product without increasing bacterial contamination.
  
  
  METHODS
  We investigated 24-hour pooled breastmilk collection by enrolling 19 mothers who were expressing milk for their infants. Mothers followed a standardized milk collection protocol for 4 study days: daily milk was pooled in a sterile 1-L bottle on Day 1, and on Day 2 milk was aliquoted for each pump session into a sterile 120-mL container. The next week the order of collection was reversed. Milk samples were plated, incubated, and evaluated for bacteria colonization. Milk samples were analyzed for protein, fat, and carbohydrate content.
  
  
  RESULTS
  There was inherently less variability in the caloric and nutrient content of pooled milk compared with individual samples, in which caloric density varied by as much as 29%. Mother's milk had highly variable bacterial counts ranging from 0 to greater than 100,000 colonies/mL. High bacteria counts (>100,000 colonies/mL) occurred in 14.7% (31 of 211) of individual samples compared with 8.6% (three of 35) of pooled samples (p=0.39).
  
  
  CONCLUSIONS
  Twenty-four-hour pooling of human milk reduces nutrient and caloric variability without increasing bacterial counts.
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of California San Diego Medical Center, San Diego, California 92103-8774, USA. lstellwagen@ucsd.edu
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Stellwagen
authors.forename: Yvonne E
authors.initials: YE
authors.lastname: Vaucher
authors.forename: Christina S
authors.initials: CS
authors.lastname: Chan
authors.forename: Taylor D
authors.initials: TD
authors.lastname: Montminy
authors.forename: Jae H
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001942:Breast Feeding; D061186:Breast Milk Expression / Q000379:methods*; D002140:California / Q000453:epidemiology; D002149:Energy Intake; D005260:Female; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature; D008895:Milk, Human / Q000737:chemistry* / Q000382:microbiology; D009035:Mothers; D009753:Nutritive Value; D017060:Patient Satisfaction; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D013997:Time Factors