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H UMAN MILK FOR HOSPITALized infants in the neonatal intensive care unit (NICU) is often stored frozen and must be thawed before use. Frozenmilkmust be properly thawed, ensuring that no ice crystals remain, while minimizing overheating, to reduce risk of microbial growth and prevent nutrient loss. Although frozen milk may be thawed in the refrigerator over 8 to 12 hours, such a process may not be as effective for thawing large volumes for multiple patients or may result in human milk waste if orders change frequently. Therefore, some facilities may require a more rapid thawing method. Such methods include holding the bottle under lukewarm running water or placing it in a container of warmwater with the water level below the lid to prevent contamination. However, research has shown that hospital tapwater is one potential source of pathogenic organisms in the patient care environment and can cause nosocomial infections. Commercial bottle warmers that use tap water also have been reportedly linkedwith Pseudomonas aeruginosa infections in one NICU. Such data have consequently led some experts to recommend that hospitalized patients at high risk for infection avoid all exposure to hospital tap water. Human milk bottle warmers that do not use tap water are commercially available in the United States. Such warmers are able to thaw 120to 270mL volumes in approximately 12 to 25 minutes and allow for a regulated temperature. However, each warmer only accommodates up to 270 mL at a time. For hospitals that use centralized human milk preparation and prepare feedings for large numbers of patients, thawing such small volumes at a time would not be feasible, nor would having an individual warmer for each patient’s milk to be thawed. The Children’s Hospital of Orange County (CHOC) has high rates of human milk use, with more than 80% of very-low-birth-weight infants discharging home still on human milk. To ensure proper handling and tracking, CHOC employs centralized human milk handling in its Nutrition Lab. Mothers are provided with 2-oz human milk storage containers for milk collection. The Nutrition Lab receives all human milk brought to the facility and tracks it using a bar code scanning system. Human milk feedings are prepared per physician order (including the addition of fortifiers or other additives) and unit dosed into individual feeding syringes or bottles twice daily with 12-hour volumes prepared at each preparation time. Typically, the Nutrition Lab prepares human milk feeds for 45 to 50 individual patients at a time. Depending on the patient’s clinical status and ability to initiate or advance feedings, much of the milk may be frozen, necessitating thawing of approximately 8,500 mL breast milk daily. The number of 2-oz bottles per patient at each preparation time varies from one to six bottles, depending on the volume ordered and the volume per container. In an attempt to reduce potential exposure to tap water within the NICU, CHOC converted from human milk