Breast milk storage can be confusing – especially when it comes to mixing breast milk. Can you mix thawed and fresh milk? What about mixing milk from different sessions? Here’s what you need to know.
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Can you mix milk from the different sides of the same pumping session?
Yes, there are no issues with this.
Just pour from one bottle or bag into the other, and store. Label the milk with the day you pumped it, and use it within the breast milk storage guidelines.
Can you mix milk across pumping sessions?
Yes, you can. You just want to do the following:
- Make sure that the temperature of the milk that you’re combining is all the same. (Usually, this will mean it’s all chilled.)
- Treat the combined milk as if it was all pumped at the time of the first expressed.
Let’s talk a little more about each of these.
Mixing milk across temperatures
The Academy of Breastfeeding Medicine states the following in their Clinical Protocol:
Freshly expressed warm milk should not be added to already cooled or frozen milk, to prevent rewarming of the already stored milk. It is best to cool down the newly expressed first before adding it to older stored milk.
Why is this?
One reason that we have breast milk storage guidelines is to limit the amount of bacterial growth in the milk that we feed to babies.
Keeping milk cold in the refrigerator or freezer slows this bacterial growth down. However, adding warm milk to milk that’s already in the fridge will warm the chilled milk, and allow bacteria to grow more quickly.
Note: If you’re planning on feeding the milk immediately, it’s fine to combine different temperature milk, because the bacteria won’t have any time to grow. This guideline around mixing same temperature breast milk applies to milk you are storing for later.
Treat all the milk as if it was all pumped at the time of the first expressed
This is ensure that bacteria isn’t given too much time to grow in the oldest milk.
Let’s go through an example.
Say that you pump at 10pm on Tuesday, 1am on Wednesday, and 6am on Wednesday, and then you combine all of that milk into one pitcher or bottle.
You’d label the combined milk and treat it as if it was all pumped at 10pm on Tuesday, because you need to use the first date/time that milk was expressed.
More on combining breast milk across days here.
Is mixing frozen breast milk okay?
Yes, you can. Let’s talk about mixing it to freeze, and mixing it to feed.
Mixing breast milk to freeze
Before you freeze breast milk, you can mix milk from different sessions. Just follow the guidelines we discussed above, regarding mixing same temperature milk and labeling with the date of the first expressed.
Then can you freeze it and treat it like any other frozen breast milk.
Mixing frozen breast milk to feed
You can also take thawed frozen milk from multiple containers and combine it for feedings.
Mix thawed milk with fresh milk before feeding is also okay. As discussed above, make sure to either the temperature is the same, or that you’re feeding it immediately.
How does mixing cereal with breast milk work?
When it’s time to start solids, if you want to feed baby rice cereal or oatmeal, you can mix breast milk into the cereal instead of water. Just stir breast milk into the cereal until it’s the desired consistency.
You can also use breast milk to thin out pureed solids.
Breast milk storage guidelines still apply when your milk is added to solid foods.
Per the CDC:
Don’t put cereal in a bottle. Putting infant cereal in your baby’s bottle will not make him or her sleep longer and could increase your baby’s risk of choking.
What about mixing breast milk and whole milk?
This is fine to do. Prep the bottle of breast milk and add the desired amount of cow’s milk.
(I did this to transition my baby off of breast milk. I started with mostly breast milk and just a splash of cow’s milk, and slowly increased the amount of cow’s milk in the bottle.)
Is mixing breast milk and formula okay?
Yes. Prep the formula on its own, and then combine it with breast milk. Don’t mix the formula with breast milk until you’ve already prepared it on it’s own.
When handling the mixed milk, make sure to follow both the timelines on the container of formula in terms of how long it can be out before being discarded, as well as the relevant breast milk storage guidelines for your milk.
More on mixing formula and breast milk here.
Hopefully this answers any questions that you have about mixing breast milk! Let me know if you have any questions in the comments.
References- Anne Eglash, Liliana Simon, The Academy of Breastfeeding Medicine, Wendy Brodribb, Sarah Reece-Stremtan, Larry Noble, Nancy Brent, Maya Bunik, Cadey Harrel, Ruth A. Lawrence, Yvonne LeFort, Kathleen A. Marinelli, Casey Rosen-Carole, Susan Rothenberg, Tomoko Seo, Rose St. Fleur, and Michal Young.Breastfeeding Medicine.Sep 2017.390-395. http://doi.org/10.1089/bfm.2017.29047.aje
- “Feeding from a Bottle.” CDC https://www.cdc.gov/nutrition/infantandtoddlernutrition/bottle-feeding/index.html
Comments & Chitchat
Yaima says
Hi Amanda,
Thank you for this post, I wish I would have come across this information a week ago. I’m panicking a bit, I didn’t know I had to cool fresh milk before mixing it with already cold milk in the fridge. I have a week worth of milk frozen and I wonder if I should just see the milk quality when I need to thaw it or if I should toss all bags up until today. Please advise me what is best.
Thank you for all you do!
Amanda Glenn, CLC says
Hi Yaima! In your situation, assuming all other guidelines were followed, I personally would feed it assuming the milk wasn’t off when it was thawed. Good luck!
Zarah Bocaletti says
If I have already some frozen Milk, can I add some cool-down freshly pump Milk to that same container?
Amanda Glenn, CLC says
Hi Zarah! That could partially thaw the frozen milk so I would say it’s not a best practice.
Molly Summers says
So I have frozen milk from different days ( within 3-4 days of each ) can I mix those together once they’re thawed as my twins are on 5oz and I only have 4oz bag frozen?
Amanda Glenn, CLC says
Yes! no problem mixing frozen milk as long as all the milk is using within 24 hours of thawing.
Emily says
What about freezing the mixed whole milk and breast milk? I will usually add an ounce or so of whole milk to top off what I have pumped (after letting It cool in the fridge) then I put it in the freezer.
Amanda Glenn, CLC says
Hi Emily! I don’t know of any official guidelines on this, but I probably wouldn’t do it. I think it’s fine to prep whole milk/breast milk bottles ahead of time after they are thawed, but I don’t think I would freeze it with the milk.
Lou says
Oops I have been doing this! Did you end up doing this? Also curious why it is not recommended? Thanks!
betsy says
How about mixing your own breastmilk with a donor’s breastmilk
Amanda Glenn, CLC says
Hi Betsy! That’s fine!