The Rule of 4 for breastfeeding is a simple guideline from the American Academy of Pediatrics (AAP) for remembering the safe storage durations for freshly expressed breast milk.
The "4-4-4 rule" for breast milk is a simple storage guideline: fresh milk is good for 4 hours at room temperature (up to 77°F/25°C), for 4 days in the refrigerator (39°F/4°C or colder), and up to 4-6 months (or longer) in a standard freezer (0°F/-18°C). It's a handy mnemonic, though some organizations like the CDC recommend up to 6 months in the freezer and the AAP up to 9 months, with deeper freezers offering even longer storage.
I personally used to use masking tape to write on bottles so I could remember which was which… however some of my clients have an order system in their fridge door (eg left to right for newest to oldest). Do whatever works for you. So… the rule of three refers to time - ie 3 hours, 3 days or 3 months.
Breastfeeding mothers who have consumed alcohol can wait 2 hours (per drink) before breastfeeding. This time will allow alcohol levels in her breast milk to go down. If the mother cannot wait to feed her infant, she can feed milk that was previously expressed when the mother was not drinking.
The 4 4 4 rule means breastfeeding or pumping every 4 hours, for at least 4 days, and continuing for about 4 weeks to support milk supply. This steady routine helps signal the body to make more milk.
Rest assured that decreasing your overall pumping sessions, the time spent pumping each day, or gradually delaying pumping will eventually slow breast milk production and allow you to fully wean yourself from the pump.
The CDC and Academy of Breastfeeding Medicine have official guidelines regarding breastmilk handling, but an unofficial approximation is the “Rule of 6”: 6 hours at room temperature, 6 days in refrigerator, and 6 months in the freezer (one year for deep freezer).
You do not have to pump and dump after drinking alcohol when you're breastfeeding, except for comfort. As alcohol leaves the bloodstream, it leaves the breastmilk.
When a lactating woman consumes alcohol, some of that alcohol is transferred into the milk. In general, less than 2 percent of the alcohol dose consumed by the mother reaches her milk and blood. Alcohol is not stored in breast milk, however, but its level parallels that found in the maternal blood.
Alcohol moves freely from your blood into your breastmilk (and back out again) and will usually be in your milk about 30 to 60 minutes after you start drinking. A number of factors affect how much alcohol gets into your breastmilk, including: The strength and amount of alcohol in your drink.
It is particularly important that you express at least once during the night. This is because the levels of the hormone prolactin, which drives milk production, are higher overnight. Prolactin levels seem to be highest between 2-6am.
Coco Austin defended her choice to breastfeed her and husband Ice-T's daughter Chanel, now 9, until she was 6 years old, saying it was an opportunity to bond.
The American Academy of Pediatrics and the World Health Organization recommend continued breastfeeding along with introducing appropriate complementary foods for up to 2 years or longer.
At around 6 weeks, many moms introduce the pump and follow the Magic 8 method — pumping 8 times in 24 hours to help build and maintain milk supply.
As newborns get older, they'll nurse less often, and may have a more predictable schedule. Some might feed every 90 minutes, whereas others might go 2–3 hours between feedings. Newborns should not go more than about 4 hours without feeding, even overnight.
Common Breast Milk Storage Mistakes to Avoid
Alcohol and your breast milk
It takes your body an average of 1 to 2 hours to get rid of 1 standard drink. The alcohol level in your breast milk is highest at about 1 hour after drinking a standard drink. Wait 2 hours before feeding your baby. If you have more than 1 drink, you will need to wait longer.
When a person drinks, a small amount of alcohol passes through the blood into breast milk. Regular exposure to too much alcohol can affect a baby's growth, development and sleep. The baby might seem drowsy and weak and have unhealthy weight gain. Alcohol also can affect the ability to safely care for a baby.
The consumption of beer, unlike other alcoholic beverages, increases serum prolactin, a hormone necessary for milk production (Carlson, Wasser, & Reidelberger, 1985; De Rosa, Corsello, Ruffilli, Della Casa, & Pasargiklian, 1981; Grossman, 1987).
If your baby has already fed from the bottle, it's safest not to put leftover milk back in the fridge, as bacteria from your baby's mouth can transfer into the milk. However, if the milk was warmed but your baby hasn't fed from it yet, you can store it in the fridge and use it within 2 hours.
Alcohol can pass into your breastmilk and then into your baby when you feed them. An occasional drink is unlikely to harm your baby especially if you wait at least 2 hours after having a drink before feeding.. Regularly drinking above the recommended limits can be harmful for you and your baby.
Lactation 101
Simply put, lactating parents need some way to maintain their breast milk supply even while temporarily unable to breastfeed, and that's how the pump and dump technique came to be. Furthermore, when nursing parents don't express their breast milk, they can experience swelling, soreness, and even mastitis.
“The first four to six weeks are the toughest, then it starts to settle down,” says Cathy. “And when you get to three months, breastfeeding gets really easy – way easier than cleaning and making up a bottle.
Breast milk does not need to be warmed. It can be served room temperature or cold.
If you have lower levels of progesterone, you're likely to get your periods back earlier than people with higher levels (Ingram et al 2004). So it's possible that you could be breastfeeding around the clock, but still become fertile and start your periods again.