Save the Milk, Save the World

1.5 L-CERPs

Rachel O'Brien, MA, IBCLC, PMH-C

Parents get more conflicting advice about milk handling than about almost anything else in infant feeding, and most of it is fear-based. The result is milk poured down the drain, parents afraid to reheat a bottle, and caregivers operating under rules nobody can source. This course replaces that with what the evidence actually supports.

Learners work through current human milk storage and handling guidance, including the differences among the CDC, the Academy of Breastfeeding Medicine, and international guidance bodies, and the reasons those differences exist. The course covers what happens to milk that has been partially consumed, including what the research on infant saliva, bacterial load, and the human milk microbiome actually demonstrates, and what it does not.

The second half of the course is about volumes and patterns. Learners examine the evidence on milk intake in exclusively human-milk-fed infants, which stays remarkably stable across the first six months, and use it to calculate what a caregiver actually needs to be left with. The course distinguishes full feedings from snacking, addresses why frequent practice bottles increase waste and can worsen bottle feeding challenges, and closes with the practical work of getting parents, nannies, and day care providers operating from the same set of instructions.

Rachel O'Brien, MA, IBCLC PMH-C

Rachel O'Brien is an IBCLC with a MA in human lactation who runs a busy private practice in Boston and specializes in bottle refusal. Rachel works 1:1 with families to help their babies learn to eat from the bottle, without tears.

"I love it when the confusion clears and the families I work with realize that they know more than they think they do, and that their instincts are almost always right!"

Rachel began her specialization in bottle refusal in 2019 and when the pandemic hit Rachel realized that bottle refusal had become a much more widespread feeding problem. Rachel developed a method for teaching parents how to re-frame their baby's "bottle refusal" and to work with their baby instead of against them. Rachel does 1:1 bottle refusal visits both in her office and virtually, and has worked with families across the USA and internationally. Rachel has presented on bottle refusal at national conferences and is known among parents and other professionals as a bottle wizard.

Rave Reviews for Rachel

Milk handling guidance reaches families through a long chain of retelling, and the conservatism compounds at every step. A guideline stated as a range becomes a rule stated as a maximum, then becomes a rule stated more strictly than that by the time it reaches a day care handbook. Practitioners are rarely in a position to trace a given instruction back to its source, and so cannot tell a family which rules are evidence-based and which are institutional caution.

The specific area of greatest confusion is partially-consumed milk. The widespread belief that a baby's saliva contaminates a bottle and renders leftover milk unsafe is stated confidently and repeated constantly, and it does not accurately represent the research on the interaction between infant saliva and human milk. Milk is discarded on the strength of it every day.

The volume question is a separate gap. Practitioners regularly advise on how much milk to leave for a caregiver without reference to the intake literature, and families are often working from formula-derived assumptions that intake should rise steadily with age. Overfilled bottles produce waste, feeding pressure, and parental anxiety about supply, and they contribute to the pattern of frequent partial feeds that undermines bottle acceptance.

01

Explain current evidence-based guidelines for human milk storage, handling, and bottle use in language appropriate for parents and non-parent caregivers.

02

Describe what the research demonstrates regarding infant saliva, bacterial load, and the safety of partially-consumed human milk, and correct common misinformation on this topic.

03

Distinguish full feedings from snacking, and explain how frequent practice bottles contribute to milk waste and to bottle feeding difficulty.

04

Guide families in determining appropriate bottle volumes and feeding patterns across home, nanny, and day care settings, using the evidence on human milk intake in the first six months.

05

Support pumping and milk management strategies that reduce waste while maintaining consistent feeding practices across care environments.

I A1. Feeding behaviours at different ages

I A3. Infant anatomy and anatomical/oral challenges

I A7. Normal infant behaviors

1 A11. Term development and growth

Course contents

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Annie Frisbie IBCLC, Inc actively supports the World Health Organization (WHO) International Code of Marketing of Breast-milk Substitutes and subsequent World Health Assembly (WHA) resolutions. Therefore, Annie Frisbie IBCLC, Inc is not a company, inclusive of manufacturers, distributors, or marketers, whose products fall within the scope of the World Health Organization (WHO) International Code of Marketing of Breast-milk Substitutes (1981) and subsequent World Health Assembly (WHA) resolutions (e.g., infant formula, bottles, and teats).

Save the Milk, Save the World

Human Milk Storage and Handling

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CERPs available starting 11/14/2026

Abstract

Meet your instructor

Rachel O'Brien, MA, IBCLC PMH-C

Rave Reviews for Rachel

Rachel shares her knowledge in a clear and understandable way and then provides helpful examples that solidify the information in a “real world” way. 100% recommend!

Rachel is a fantastic educator!

I can not tell you how much I enjoyed this course. Rachel teaches in a way that makes everything so understandable.

Knowledge Gap

Objectives

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VII Development and Nutrition [1.5 L-CERPs]

Course contents