ABSTRACT
BACKGROUND: Raw, never stored or pasteurized mother's own milk (MOM) is not always available to feed preterm infants; however, storage and pasteurization of MOM diminishes some bioactive components. It can be difficult to feed raw MOM to preterm infants due to transportation and storage of small volumes that might be pumped away from the infant, and a concern that they might harbor bacteria. However, the higher availability of bioactive components in raw MOM may provide benefits to preterm infants compared to frozen or pasteurized MOM. RESEARCH AIM: To systematically review and summarize the results of studies on feeding raw MOM versus frozen or pasteurized MOM to preterm infants born at less than 37 weeks of gestation. METHODS: Four databases were searched (Cochrane, Embase, Ovid MEDLINE, and Web of Science) for this systematic review. Of 542 studies identified, nine met inclusion criteria and were critically evaluated using the quality assessment tool for quantitative studies by the Effective Public Health Practice Project. Studies were organized using the Breastfeeding Challenges Facing Preterm Mother-Infant Dyads theoretical framework. RESULTS: Included studies evaluated the outcomes of preterm infants fed raw versus pasteurized MOM (n = 7, 77.8%) or raw versus frozen MOM (n = 2, 22.2%). Researchers found that raw MOM did not increase infant infections and may have improved health and growth outcomes for study participants. CONCLUSION: There is laboratory evidence supporting the safety and efficacy of the use of raw MOM for preterm infants. A raw MOM diet is recommended for preterm infants by professional organizations. Despite this, it may not be universally prioritized and could require purposeful implementation by each institution. Further research is needed to pursue the potential benefits of a raw MOM diet for preterm infants.
Subject(s)
Infant, Premature , Milk, Human , Pasteurization , Humans , Infant, Premature/growth & development , Infant, Newborn , Pasteurization/methods , Pasteurization/standards , Female , Infant Nutritional Physiological Phenomena , Breast Feeding/methods , Diet/methods , Diet/standardsABSTRACT
Esta Norma Técnica tem por objetivo estabelecer as orientações necessárias para a determinação da presença de bactérias coliformes totais no leite humano ordenhado pasteurizado, visando a garantia da qualidade em Bancos de Leite Humano e sua certificação.
Esta Norma Técnica tiene por objetivo establecer las orientaciones necesarias para determinar la presencia de bacterias coliformes totales en la leche humana pasteurizada, con el fin de garantizar la calidad de los Bancos de Leche Humana y su certificación.
Subject(s)
Quality Control , Microbiological Techniques/standards , Milk Banks/standards , Coliforms , Breast Milk Expression/methods , Pasteurization/standards , Milk, Human/microbiologyABSTRACT
Esta Norma Técnica tem por objetivo estabelecer as condições necessárias para a estocagem do leite humano ordenhado pasteurizado, visando a garantia da qualidade em Bancos de Leite Humano e sua certificação.
Esta Norma Técnica tiene por objetivo establecer las condiciones necesarias para el almacenamiento de la leche humana extraída pasteurizada con el fin de garantizar la calidad de los Bancos de Leche Humana y su certificación.
Subject(s)
Milk Banks/standards , Food Storage/standards , Breast Milk Expression/methods , Pasteurization/standards , Milk, HumanABSTRACT
Esta Norma Técnica tem por objetivo estabelecer as condições necessárias para o congelamento do leite humano ordenhado pasteurizado, visando a garantia da qualidade em Bancos de Leite Humano e sua certificação.
Esta Norma Técnica tiene por objetivo establecer las condiciones necesarias para la congelación de la leche humana extraída pasteurizada, con el fin de garantizar la calidad de los Bancos de Leche Humana y su certificación.
Subject(s)
Milk Banks/standards , Breast Milk Expression , Pasteurization/standards , Freezing , Milk, HumanABSTRACT
Esta Norma Técnica tem por objetivo estabelecer a determinação do tempo de pré-aquecimento do leite humano ordenhado no processo de pasteurização, visando a garantia da qualidade em Bancos de Leite Humano e sua certificação.
Esta Norma Técnica tiene como objetivo establecer la determinación del tiempo de precalentamiento de la leche humana extraída en el proceso de pasteurización, con el fin de asegurar la calidad en los Bancos de Leche Humana y su certificación.
Subject(s)
Milk Banks/standards , Pasteurization/standards , Heating , Milk, HumanABSTRACT
Esta Norma Técnica tem por objetivo estabelecer o processo de pasteurização do leite humano ordenhado, visando a garantia da qualidade em Bancos de Leite Humano e sua certificação.
Esta Norma Técnica tiene como objetivo establecer el proceso de pasteurización de la leche humana extraída para asegurar la calidad de los Bancos de Leche Humana y su certificación.
Subject(s)
Milk Banks/standards , Pasteurization/standards , Milk, HumanABSTRACT
Approximately two billion people lack access to microbiologically safe drinking water globally. Boiling is the most popular household water treatment method and significantly reduces diarrheal disease, but is often practiced inconsistently or ineffectively. The use of low-cost technologies to improve boiling is one approach with potential for increasing access to safe drinking water. We conducted household trials to evaluate the feasibility and acceptability of water pasteurization indicators (WAPIs) in the Peruvian Amazon in 2015. A total of 28 randomly selected households were enrolled from a rural and a peri-urban community. All households trialed two WAPI designs, each for a 2-week period. Ninety-six percent of participants demonstrated the correct use of the WAPIs at the end of each trial, and 88% expressed satisfaction with both WAPI models. Ease of use, short treatment time, knowledge of the association between WAPI use and improved health, and the taste of treated water were among the key factors that influenced acceptability. Ease of use was the key factor that influenced design preference. Participants in both communities preferred a WAPI with a plastic box that floated on the water's surface compared with a WAPI with a wire that was dipped into the pot of drinking water while it was heating (77% versus 15%, P < 0.001); we selected the box design for a subsequent randomized trial of this intervention. The high feasibility and acceptability of the WAPIs in this study suggest that these interventions have potential to increase access to safe water in resource-limited settings.
Subject(s)
Drinking Water/microbiology , Pasteurization/standards , Adolescent , Adult , Aged , Dysentery/prevention & control , Escherichia coli/isolation & purification , Feasibility Studies , Female , Humans , Middle Aged , Pasteurization/instrumentation , Pasteurization/methods , Peru , Water Microbiology , Water Supply , Young AdultABSTRACT
BACKGROUND: During pumping, storage, and pasteurization human milk is exposed to light, which could affect the concentrations of light-sensitive vitamins. Currently, milk banks do not regulate light exposure. RESEARCH AIM: The aim of this paper was to determine the influence of light exposure during pumping, storage, and pasteurization on (1) macronutrients, (2) select water-soluble vitamins, and (3) select fat-soluble vitamins. METHODS: All 13 participants donated 4 milk samples each. Each sample underwent 1 of 4 treatments: raw and light protected, raw and light exposed, pasteurized and light protected, and pasteurized and light exposed. Samples were analyzed for macronutrients and Vitamins B1, B2, retinol, γ-tocopherol, α-tocopherol, and ß-carotene. RESULTS: ß-carotene concentrations were not influenced by light exposure. Vitamin B1 was significantly (p < 0.05) affected by light-exposure (M = 0.23, SD = 0.01mg/L) compared to light-protected (M = 0.27, SD = 0.01mg/L) samples. Vitamin B2 concentrations were reduced (p < 0.05) by light-exposure in raw (M = 62.1, SD = 0.61µg/L) and pasteurized (M = 73.7, SD = 0.72µg/L) samples compared to light-protected raw samples (M = 99.7, SD = 0.66µg/L). No other tested nutrients were affected by light exposure. CONCLUSIONS: If milk is exposed to excessive amounts of light, Vitamins B1 and B2 concentrations may degrade below the current Adequate Intake recommendations for infants 0-6 months of age, increasing the risk of insufficient vitamin supply to the exclusively human milk-fed infant. Thus, pumped or processed human milk should be protected from light to preserve milk vitamin concentrations.
Subject(s)
Dietary Exposure/analysis , Milk, Human/chemistry , Ultraviolet Rays/adverse effects , Adult , Breast Milk Expression/instrumentation , Breast Milk Expression/methods , Female , Humans , Longitudinal Studies , North Carolina , Nutrients/analysis , Pasteurization/methods , Pasteurization/standards , Prospective Studies , Ultraviolet Rays/classification , Vitamins/analysisABSTRACT
A chemiluminescence assay using a handheld luminometer to measure the activity of alkaline phosphatase was developed that can detect 0.002% or more of unpasteurized milk in various milk products. Evaluation of the assay followed an National Conference on Interstate Milk Shipments (NCIMS)-approved protocol in which aliquots of pasteurized milk products were spiked with raw milk at various levels. Milk products evaluated included skim white milk, 1 and 2% fat content white milk, whole white milk, strawberry-flavored 1% fat content milk, chocolate-flavored 1% fat content milk, half-and-half, and heavy cream. Split samples were prepared, and alkaline phosphatase activities were determined in triplicate on 4 days by three NCIMS-accredited laboratories by the chemiluminescent method and NCIMS-approved reference methods. Equivalence of the chemiluminescent method to the approved reference methods was demonstrated for all eight products evaluated over a range of raw milk concentration from 0 to 0.5%, using criteria established by NCIMS, in which mean results obtained by the three laboratories by the chemiluminescent method were within 1 standard deviation of the mean results obtained by the NCIMS-approved reference methods at each alkaline phosphatase concentration. Procedures for measurement of microbial and reactivated alkaline phosphatase were also established for the method.
Subject(s)
Alkaline Phosphatase , Food Microbiology , Luminescent Measurements , Milk , Pasteurization , Alkaline Phosphatase/metabolism , Animals , Food Microbiology/methods , Luminescence , Luminescent Measurements/instrumentation , Milk/standards , Pasteurization/standardsABSTRACT
OBJECTIVE: To increase exclusive breastfeeding by offering pasteurized donor human milk (PDHM) to newborns with hypoglycemia. DESIGN: Quality improvement project. SETTING/LOCAL PROBLEM: A Baby-Friendly Hospital Initiative-designated urban academic medical center in the northeastern United States serving a diverse population where, by policy, virtually all newborns with hypoglycemia received supplemental infant formula. Approximately 85% of women cared for at this center initiate breastfeeding, but many struggle with exclusive breastfeeding during the hospital stay. PARTICIPANTS: All staff members in the labor and delivery unit and the mother/baby unit, including registered nurses, unit clerks, patient care technicians, and lactation consultants. Term, breastfed newborns identified as being hypoglycemic per our guidelines were eligible to receive PDHM. INTERVENTION/MEASUREMENTS: Registered nurses provided education about PDHM to parents of newborns who were hypoglycemic, obtained consent, and initiated the order. We offered PDHM instead of infant formula when mother's own milk was not available in sufficient quantity per our hypoglycemia guidelines. We measured newborns' glucose levels and monitored breastfeeding outcomes, including continued breastfeeding. RESULTS: During the 4-month trial, 83 newborns were eligible for PDHM. Of those, 76% of parents opted for PDHM rather than formula. Most newborns in both groups were still breastfeeding at discharge, and 53% of those who received PDHM were fed human milk exclusively during their hospital stays. CONCLUSION: A nurse-driven protocol offering PDHM to otherwise healthy newborns with hypoglycemia is a viable option for increasing exclusive breast milk feeding during the hospital stay.
Subject(s)
Hypoglycemia/therapy , Milk, Human , Pasteurization/methods , Female , Humans , Hypoglycemia/physiopathology , Hypoglycemic Agents/therapeutic use , Infant Care/methods , Infant, Newborn , Male , Pasteurization/standards , Quality ImprovementABSTRACT
Pasteurization of dairy products is plagued by fouling, which induces significant economic, environmental and microbiological safety concerns. Herein, an amphiphilic silicone coating was evaluated for its efficacy against fouling by a model dairy fluid in a pilot pasteurizer and against foodborne bacterial adhesion. The coating was formed by modifying an RTV silicone with a PEO-silane amphiphile comprised of a PEO segment and flexible siloxane tether ([(EtO)3Si-(CH2)2-oligodimethylsiloxanem-block-(OCH2CH2)n-OCH3]). Contact angle analysis of the coating revealed that the PEO segments were able to migrate to the aqueous interface. The PEO-modified silicone coating applied to pretreated stainless steel was exceptionally resistant to fouling. After five cycles of pasteurization, these coated substrata were subjected to a standard clean-in-place process and exhibited a minor reduction in fouling resistance in subsequent tests. However, the lack of fouling prior to cleaning indicates that harsh cleaning is not necessary. PEO-modified silicone coatings also showed exceptional resistance to adhesion by foodborne pathogenic bacteria.
Subject(s)
Biofouling/prevention & control , Dairying/standards , Pasteurization/standards , Silicones/chemistry , Stainless Steel/chemistry , Surface-Active Agents/chemistry , Bacterial Adhesion , Biofilms/growth & development , Silanes/chemistry , Siloxanes/chemistry , Surface PropertiesABSTRACT
Industrialising edible insects goes along with quality control and hazard analysis and critical control points. One of those steps is assessing heat treatment. For the present contribution, the potential of enzymatic heat assessment tests used in the dairy industry (alkaline phosphatase and lactoperoxidase) to detect heat treatment in several insect species ( Acheta domesticus, Gryllus assimilis, Gryllus bimaculatus, Locusta migratoria, Schistocerca gregaria, Chilecomadia moorei, Galleria mellonella, Bombyx mori, Pachnoda marginata, Tenebrio molitor, Zophobas atratus, Apis mellifera, and Hermetia illucens) was evaluated. Insect material was homogenised, diluted, and the enzymatic tests (Lactognost®, Peroxtesmo®) were carried with these liquids as if they were milk. All species but C. moorei, B. mori, P. marginata, and A. mellifera showed alkaline phosphatase activity in raw samples and none in heated (10 min at 100 â) ones, while only G. mellonella, T. molitor, and Z. atratus reacted accordingly with lactoperoxidase. In trial 2 focusing only on alkaline phosphatase activity, inactivation of the enzyme after 5, 10, and 15 min of heating occurred species specific within a range of 60-86 â, i.e. within ordinary pasteurisation schemes. Thus and for the time being, heat treatment in many edible insect species can be assessed using alkaline phosphatase activity test kits. In contrast to milk samples, positive results may display bluish or greenish colours, and the time until a reliable reading is possible is extended to 1-1.5 h (24 h in the case of Gryllidae).
Subject(s)
Alkaline Phosphatase/analysis , Diet , Food Preservation , Insecta , Lactoperoxidase/analysis , Pasteurization , Animals , Bees/enzymology , Bombyx/enzymology , Food Preservation/standards , Gryllidae/enzymology , Humans , Insecta/enzymology , Locusta migratoria/enzymology , Milk/enzymology , Pasteurization/standards , Tenebrio/enzymologyABSTRACT
RESUMEN Objetivo Determinar y cuantificar residuos de pesticidas organoclorados en leche de vaca pasteurizada distribuida en la ciudad de Montería, Colombia. Materiales y Métodos Se colectaron y analizaron 144 muestras durante seis meses (junio-diciembre 2013) de ocho marcas comerciales identificadas como A, B, C, D, E, F, G, H. Mensualmente se realizó un muestreo simple por atributo. Los POCs (puntos de contacto) fueron determinados usando un cromatógrafo de gas con detector captura de electrones, columna capilar RTX-5 (30.0 m longitud x 0.25 mm diámetro interno, 0.25 µÎ¹τι espesor de película). Resultados En las muestras analizadas se observó la presencia de pesticidas organoclorados, excediendo el Límite Máximo Residual establecido por el Codex Alimentarius. Las concentraciones encontradas fueron: 0.53; 0.15; 0.57; 0.40; 0.22; 0.20; 0.014; 0.002 y 0.028 mg/Kg de Σα-HCH/ß-HCH, γ-HCH, δ-HCH, ΣAldrín/Dieldrín, ΣHeptacloro/Heptacloro epóxido, Endrín, α-Clordano, γ-Clordano y Endosulfán I, respectivamente. La marca con mayor número de residuos de pesticidas detectados durante el estudio fue la A. La marca G presentó mayor concentración de residuos de pesticidas totales con 1.46 mg/Kg. Las marcas C y D presentaron, concentraciones menores de 0.72 y 0.0016 mg/Kg, δ-HCH y γ-Clordano respectivamente. Conclusiones Las muestras de leche pasteurizada bajo estudio, presentan residuales de pesticidas organoclorados por encima del límite máximo residual establecidos por el Codex Alimentarius, indicando un riesgo para la salud pública especialmente para los niños que es un subgrupo de la población más vulnerable.(AU)
ABSTRACT Objectives To determine and quantify organochlorine pesticide residues in pasteurized cow's milk distributed in the city of Monteria, Colombia. Materials and Methods 144 samples were collected and analyzed for six months (June-December 2013) from eight commercial brands identified as A, B, C, D, E, F, G, H. Simple sampling by attribute was carried out monthly. The POC (points of contact) were determined using a gas chromatograph with electron capture detector, with a capillary column RTX-5 (30.0 m long x 0.25 mm internal diameter, 0.25 pm film thickness). Results The samples analyzed showed organochlorine pesticides, exceeding the maximum residue limit established by the Codex Alimentarius. The concentrations found were: 0.53; 0.15; 0.57; 0.40; 0.22; 0.20; 0.014; 0.002 and 0.028 mg/Kg of Σα-HCH/ß-HCH, γ-HCH, δ-HCH, ΣAldrin/Dieldrin, ΣHeptachlor/Heptachlor epoxide, Endrin, α-chlordane, γ- chlordane and Endosulfan I, respectively. The brand with the highest number of pesticide residues detected during the study was A. The G brand had the highest concentration of total pesticide residues with 1.46mg/Kg. The C and D brands had lower concentrations with 0.72 and 0.0016mg/Kg, and δ-HCH and γ- chlordane, respectively. Conclusions The samples of pasteurized milk under study had organochlorine pesticides residue levels above the maximum residue limit established by the Codex Alimentarius, indicating a risk to public health, especially in children, which the most vulnerable sub-group.(AU)
Subject(s)
Food Contamination/analysis , Breast-Milk Substitutes , Insecticides, Organochlorine/analysis , Pasteurization/standards , Food Samples , Epidemiology, Descriptive , ColombiaABSTRACT
BACKGROUND: Environmental contaminants ranging from legacy chemicals like p,p'-dichlorodiphenyltrichloroethane (DDT) to emerging chemicals like phthalates are ubiquitous. Research aims/questions: This research aims to examine the presence and co-occurrence of contaminants in human milk and effects of pasteurization on human milk chemical contaminants. METHODS: We analyzed human milk donated by 21 women to a milk bank for 23 chemicals, including the persistent organic pollutants (POPs) polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), dichlorodiphenyltrichloroethane (DDT), and dichlorodiphenyldichloroethylene (DDE) isomers that are known to sequester in adipose tissue, along with the current-use and nonpersistent pesticides chlorpyrifos and permethrin, phthalates, and bisphenol A (BPA). Human milk was analyzed raw and pasteurized for these chemicals using gas chromatography-tandem mass spectrometry for the POPs and high-performance liquid chromatography-tandem mass spectrometry for non-POPs. RESULTS: Within the different chemical classes, PBDE47, PCB153, ppDDE, and MEHHP (phthalate metabolite) had the highest median concentrations and were observed in all samples. We also observed chlorpyrifos and BPA in all samples and permethrin in 90% of the samples tested. Only two chemicals, chlorpyrifos and permethrin, were susceptible to substantial degradation from pasteurization, a standard method for processing donated human milk. CONCLUSION: We detected 19 of 23 chemicals in all of our prepasteurized milk and 18 of 23 chemicals in all of our pasteurized milk. Pasteurization did not affect the presence of most of the chemicals. Future research should continue to explore human milk for potential chemical contamination and as a means to surveil exposures among women and children.
Subject(s)
Food Contamination/analysis , Milk, Human/chemistry , Adult , California , Cross-Sectional Studies , DDT/adverse effects , DDT/chemistry , Environmental Monitoring/methods , Environmental Pollutants/adverse effects , Environmental Pollutants/chemistry , Female , Food Contamination/statistics & numerical data , Humans , Pasteurization/standardsABSTRACT
OBJECTIVES: To describe the use of pasteurised human donor milk (pHDM) in England and the influence of a human milk bank in the network. DESIGN: Prospective observational study SETTING: All 163 neonatal units (23 networks) in England 2012-2013. PATIENTS: Preterm infants born at <32â¯weeks gestational age (GA). MAIN OUTCOME MEASURES: Proportion of infants and care-days fed pHDM during the first 30 postnatal days by network METHODS: We extracted daily patient-level data from the National Neonatal Research Database (NNRD). We fitted a logistic regression of pHDM exposure on the presence of a pHDM bank within the network, with GA, BW z score and network as covariates. Significance was assessed by the likelihood ratio (chi-squared) test. RESULTS: Data for 13,463 infants were included in the study. Across the networks, the proportion (95%CI) of infants ranged from 2.0% (1.0, 3.0) to 61.0% (57.4%, 64.6%), and the proportion of care-days in which pHDM was fed from 0.08% (0.04%, 0.10%) to 21.9% (19.9%, 24.0%). In three networks <5%, and in seven networks >30% of infants received any pHDM. Variation in the use of pHDM across networks remained significant after adjustment for presence of a human milk bank within the network and all covariates (pâ¯<â¯0.001). CONCLUSIONS: Wide variation of pHDM use in England is not fully explained by presence of a pHDM bank or patient characteristics. This suggests clinical uncertainty about the use of pHDM.
Subject(s)
Infant, Premature/physiology , Milk Banks/statistics & numerical data , Milk, Human , England , Female , Humans , Infant Nutritional Physiological Phenomena/standards , Infant, Newborn , Male , Milk Banks/standards , Pasteurization/standardsABSTRACT
Sterilised food products undergo chemical changes during processing that ultimately determine the product quality. To provide detailed information on the chemistry of each stage of a pet-food sterilisation process, a laboratory-scale system was developed, which allowed sampling under the high temperatures and pressures associated with sterilisation. Products from the laboratory-scale system were representative of the factory process. Sample extracts were analysed by Fourier Transform-Ion Cyclotron Resonance-Mass Spectrometry (FT-ICR-MS), which delivered the molecular formulae and ion intensities of the compounds present. Data were examined to determine the coverage of this method, the degree of chemical change occurring during pet food thermal processing, and the level of identification possible with FT-ICR-MS. Data visualisation and statistical analysis identified significant chemical changes in pet food as a result of processing, and allowed tentative identification of the compounds involved. Insights generated using FT-ICR-MS analysis can be confirmed and further explored using conventional, targeted analyses.
Subject(s)
Mass Spectrometry/methods , Pasteurization/methods , Fourier Analysis , Pasteurization/standards , Sterilization/methods , Sterilization/standardsABSTRACT
BACKGROUND: When feeding preterm infants, donor milk is preferred if the mother's own milk is unavailable. Pasteurization may have detrimental effects on bioactivity, but more information is needed about its effects on the immunological compounds. Research aim: This work has two main aims: evaluate the antibody profile of colostrum and study the quantitative variations in the antibodies' level and specific reactivity after undergoing Holder pasteurization. The authors focused on immunoregulatory components of colostrum (antidietary antibodies and TGF-ß2) in the neonatal gut. METHODS: This is a descriptive cross-sectional study of a convenience sample of 67 donated colostrum samples at different days after delivery, both raw and pasteurized. Antibody profiles were analyzed at different times during breastfeeding, and total and specific antibodies (IgM, IgA, and IgG subclasses) were compared with tetanus toxoid and ovalbumin using enzyme-linked immunosorbent assay. The processing effect on total and specific antibodies, as well as TGF-ß2, was evaluated by paired analyses. RESULTS: No variations in immunological compounds were observed throughout the colostrum stage. The TGF-ß2, antibodies' concentrations, and antibodies' specific reactivity after pasteurization did not vary significantly as days of lactation varied. Changes in antibody levels were dependent on isotype and IgG subclass, and IgG4 showed remarkable resistance to heating. Moreover, the effect of the pasteurization on specific reactivity was antigen dependent. CONCLUSION: The supply of relevant immunological components is stable throughout the colostrum stage. The effects of pasteurization on antibodies depend on isotype, subclass, and specificity. This information is relevant to improving the immunological quality of colostrum, especially for preterm newborns.
Subject(s)
Colostrum/immunology , Milk, Human/immunology , Pasteurization/statistics & numerical data , Colostrum/chemistry , Cross-Sectional Studies , Enzyme-Linked Immunosorbent Assay/methods , Humans , Immunoglobulin A/analysis , Immunoglobulin G/analysis , Immunoglobulin M/analysis , Milk Banks/organization & administration , Milk, Human/chemistry , Pasteurization/methods , Pasteurization/standards , Statistics, Nonparametric , UruguayABSTRACT
BACKGROUND: Holder pasteurization is the most commonly used technique in milk banks worldwide, but higher temperatures and longer pasteurization time have been associated with damage to the immune components of human milk. Research aim: This study aimed to assess the detailed pattern of pasteurization temperature using two water pasteurizers (WP1 and WP2) and one air pasteurizer (AP). METHODS: The milk temperature during each phase of the pasteurization cycle was recorded using 6 to 9 probes, depending on the number of bottles, in the pasteurizers. We used 90 to 200 ml bottles to assess the effect of volume on milk temperature. RESULTS: The time to heat the milk from room temperature to 58°C was 12.4, 12.9, and 64.5 min, respectively, for WP1, WP2, and the AP ( p < .0001). The duration of the plateau was 35.5, 35.2, and 45.8 min ( p < .0001). The duration of exposure to a temperature above 58°C was 49.6, 40.7, and 76.2 min ( p < .0001). The total duration of a full cycle was 79, 66, and 182 min ( p < .0001). The duration of exposure above 58°C for the different volumes of milk treated showed no difference when using WP1 but was significantly longer in small volumes when using WP2. CONCLUSION: Human milk treated using the air pasteurizer in our study was exposed to higher temperatures and for longer periods of time than the water pasteurizers we employed. Regular qualification of pasteurizers is requested when evaluating the effect of pasteurization on milk components and for routine treatment of human milk in milk banks.
Subject(s)
Immunologic Factors/analysis , Milk Banks , Milk, Human , Pasteurization/methods , Pasteurization/standards , France , Humans , Longitudinal Studies , Quality Control , Temperature , Tissue DonorsABSTRACT
Growing evidence supporting the health benefits of human milk, particularly in the preterm population, has led to rising demand for donor human milk in NICUs and pediatric hospitals. There are no previous reports describing the use of unpasteurized shared human milk (USHM) in the hospital setting, but the use of USHM solicited from community donors through social networks appears to be common. Many pediatric hospitals permit inpatients to receive breast milk that has been screened and pasteurized by a human milk banking organization and will provide pasteurized donor human milk (PDHM) only to infants who are preterm or have specific medical conditions. These policies are designed to minimize potential adverse effects from improperly handled or screened donor milk and to target patients who would experience the greatest benefit in health outcomes with donor milk use. We explore the ethical and health implications of 2 cases of medically complex infants who did not meet criteria in our tertiary care hospital for the use of PDHM from a regulated human milk bank and were incidentally found to be using USHM. These cases raise questions about how best to balance the ethical principles of beneficence, nonmaleficence, justice, and patient autonomy in the provision of PDHM, a limited resource. Health care staff should ask about USHM use to provide adequate counseling about the risks and benefits of various feeding options in the context of an infant's medical condition.
Subject(s)
Feeding Methods , Food Safety/methods , Infant Nutrition Disorders , Infant, Newborn, Diseases/therapy , Milk, Human , Pasteurization , Donor Selection/ethics , Donor Selection/organization & administration , Donor Selection/standards , Feeding Methods/adverse effects , Feeding Methods/ethics , Feeding Methods/standards , Female , Humans , Infant , Infant Food/adverse effects , Infant Food/analysis , Infant Food/standards , Infant Nutrition Disorders/etiology , Infant Nutrition Disorders/prevention & control , Infant, Newborn , Infant, Newborn, Diseases/diagnosis , Infant, Premature/physiology , Milk Banks , Needs Assessment , Pasteurization/methods , Pasteurization/standards , Risk Assessment , Social NetworkingABSTRACT
BACKGROUND: Potential donors of human milk are screened for Ebola virus (EBOV) using standard questions, but testing for EBOV and Marburg virus (MARV) is not part of routine serological testing performed by milk banks. Research aim: This study tested the hypothesis that EBOV would be inactivated in donor human milk (DHM) by standard pasteurization techniques (Holder) used in all North American nonprofit milk banks. METHODS: Milk samples were obtained from a nonprofit milk bank. They were inoculated with EBOV (Zaire strain) and MARV (Angola strain) and processed by standard Holder pasteurization technique. Plaque assays for EBOV and MARV were performed to detect the presence of virus after pasteurization. RESULTS: Neither EBOV nor MARV was detectable by viral plaque assay in DHM or culture media samples, which were pasteurized by the Holder process. CONCLUSION: EBOV and MARV are safely inactivated in human milk by standard Holder pasteurization technique. Screening for EBOV or MARV beyond questionnaire and self-deferral is not needed to ensure safety of DHM for high-risk infants.