Do I only take it out from the fridge when I want to feed baby? Can I take it out earlier and leave it at room temperature?

Yes, you should take the milk out of the fridge only when you want to feed baby, then warm it. It is not recommended that you take the milk from the fridge and leave it at room temperature for some time. Similarly, thawing breast milk at room temperature is also not recommended.

Excerpt from Answering breastfeeding questions ( Thots N Tots & SusuIbu.Com )

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