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Gumede MIL, Daniels B, Coutsoudis A, Swe Swe-Han K. Postpasteurization Testing of Human Milk Sterility at Human Milk Banks in Resource-Limited Settings: An Alternative to Standard Microbiological Quality Testing. Breastfeed Med 2023; 18:265-271. [PMID: 36856527 DOI: 10.1089/bfm.2022.0215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Introduction: Pasteurized donor human milk provides nutrition and bioactive factors for infant growth and health when a mother's own milk is not available. Bacteriological testing is recommended for each pasteurized batch of donor milk before distribution to ensure that the milk is safe for use. Charm Peel Plates (CPPs) are a simplified, easy-to-use culture method for detecting microorganisms in milk and milk products. This study investigates the feasibility of using CPPs as an alternative test for current standard postpasteurization screening by human milk banks (HMBs), particularly those in resource-limited settings. Aim: The aim of this study was to evaluate the feasibility of using the CPP versus the 5% horse blood agar (HBA) plate (standard South African National Health Laboratory Service method) for detecting bacterial growth in pasteurized human milk samples. Methods: For each of the 50 pasteurized donor milk samples, 100-μL aliquots were cultured on routine HBA and 1 mL on CPPs for the total bacterial colony count. Any positive growth was identified using VITEK® 2 (bioMérieux). To demonstrate the ability of CPPs to support bacterial growth, four spiked samples were tested. Results: Concurrent negative test results were reported for 49/50 (98%) samples with only one positive test with HBA. Conclusions and Recommendations: The CPP is equivalent to HBA for detection of bacterial growth. Additional advantages of CPPs are ease of use and cost-effectiveness. The CPP is therefore recommended as a point-of-care, bacteriological screening method for donor human milk by HMBs, particularly those in resource-limited settings.
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Affiliation(s)
- Maria Itumeleng Lebogang Gumede
- Department of Microbiology, National Health Laboratory Service, KwaZulu-Natal Academic Complex, Inkosi Albert Luthuli Central Hospital, Durban, South Africa.,Department of Medical Microbiology, School of Laboratory Medicine and Medical Science, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Brodie Daniels
- HIV and other Infectious Diseases Research Unit, South African Medical Research Council, Durban, South Africa.,Department of Paediatrics and Child Health, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Anna Coutsoudis
- Department of Paediatrics and Child Health, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Khine Swe Swe-Han
- Department of Microbiology, National Health Laboratory Service, KwaZulu-Natal Academic Complex, Inkosi Albert Luthuli Central Hospital, Durban, South Africa.,Department of Medical Microbiology, School of Laboratory Medicine and Medical Science, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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2
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Salvatori G, De Rose DU, Clemente M, Gentili C, Verardi GP, Amadio P, Reposi MP, Bagolan P, Dotta A. How much does a liter of donor human milk cost? Cost analysis of operating a human milk bank in Italy. Int Breastfeed J 2022; 17:90. [PMID: 36539788 PMCID: PMC9764658 DOI: 10.1186/s13006-022-00530-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To date, 40 Human Milk Banks (HMB) have been established in Italy; however, recent cost analysis data for operating an HMB in Italy are not available in the literature. METHODS This study was a cross-sectional study performed at "Bambino Gesù" Children's Hospital in Rome, Italy in 2019. We assessed the one-year operational costs and, the per liter unit costs at our HMB. RESULTS During the 2019 year we collected 771 l of human milk supplied by 128 donors. The total cost was € 178,287.00 and the average cost was € 231.00 per liter. € 188,716.00 would have been spent had the maximum capacity for 904 l been reached. We found a significant difference (€ 231.00 vs € 209.00 per liter, p = 0.016) comparing the cost for collected liters in the year 2019 and the cost for the maximum capacity of the bank for that year of activity. Analyzing each cost item that determines the charge of donor human milk (DHM), the highest costs are the salaries of medical and paramedical staff, and then the costs related to transporting. If the HMB works at maximum capacity and manages a greater number of liters of milk, this can represent an important saving. Conversely, the price of consumables is modest (i.e., the price of a single-use kit for breast pumps was € 0.22 per unit). CONCLUSION The costs for a liter of DHM are quite high, but they must be related to the benefits, especially for preterm infants. Comparing the cost for collected liters in 2019 and the costs for the 2019 maximum capacity of the HMB, we calculated how much fixed costs of collection and distribution of DHM can be reduced, by increasing the volume of milk collected. To the best of our knowledge, this is the first complete cost analysis for an Italian Milk Bank. A thorough analysis could help to abate fixed costs and reduce the cost of a liter of DHM. The centralization of DHM can allow savings, rather than creating small HMBs scattered throughout the territory that would operate with lower milk volumes.
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Affiliation(s)
- Guglielmo Salvatori
- grid.414125.70000 0001 0727 6809Neonatal Intensive Care Unit and Human Milk Bank, Medical and Surgical Department of Fetus - Newborn – Infant, “Bambino Gesù” Children’s Hospital IRCCS, Rome, Italy
| | - Domenico Umberto De Rose
- grid.414125.70000 0001 0727 6809Neonatal Intensive Care Unit and Human Milk Bank, Medical and Surgical Department of Fetus - Newborn – Infant, “Bambino Gesù” Children’s Hospital IRCCS, Rome, Italy
| | - Maria Clemente
- Neonatal Intensive Care Unit and Human Milk Bank, Department of Life and Reproductive Sciences, Verona Hospital, Verona, Italy
| | - Cristina Gentili
- grid.414125.70000 0001 0727 6809Finance Control, Internal Control, “Bambino Gesù” Children’s Hospital IRCCS, Rome, Italy
| | - Giovanni Paride Verardi
- grid.414125.70000 0001 0727 6809Finance Control, Internal Control, “Bambino Gesù” Children’s Hospital IRCCS, Rome, Italy
| | - Patrizia Amadio
- grid.414125.70000 0001 0727 6809Neonatal Intensive Care Unit and Human Milk Bank, Medical and Surgical Department of Fetus - Newborn – Infant, “Bambino Gesù” Children’s Hospital IRCCS, Rome, Italy
| | - Maria Paola Reposi
- grid.414125.70000 0001 0727 6809Neonatal Intensive Care Unit and Human Milk Bank, Medical and Surgical Department of Fetus - Newborn – Infant, “Bambino Gesù” Children’s Hospital IRCCS, Rome, Italy
| | - Pietro Bagolan
- grid.414125.70000 0001 0727 6809Neonatal Surgery Unit, Medical and Surgical Department of Fetus - Newborn – Infant, Bambino Gesù Children’s Hospital IRCCS, Rome, Italy
| | - Andrea Dotta
- grid.414125.70000 0001 0727 6809Neonatal Intensive Care Unit and Human Milk Bank, Medical and Surgical Department of Fetus - Newborn – Infant, “Bambino Gesù” Children’s Hospital IRCCS, Rome, Italy
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3
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Effect of pasteurization on melatonin concentration in human breast milk. POSTEP HIG MED DOSW 2022. [DOI: 10.2478/ahem-2022-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction
Women who have problems with lactation can use human milk banks. Mainly this human milk is provided to premature babies and sick newborns. Human milk is the most suitable food for newborns and infants, recommended by WHO (World Health Organization). Human milk has anti-inflammatory, anti-infective, and anti-allergic properties, and also works for immunomodulation. Melatonin has a special, underestimated importance in the composition of breast milk. It is a hormone that has many body functions and, for several decades, its antioxidant potential has been increasingly talked about.
The aim of the study was to examine the effect of Holder pasteurization on melatonin concentration in human milk.
Materials and Methods
18 samples of human milk from donors from the human milk bank were used for the analysis. Melatonin concentration before and after pasteurization was determined by ELISA. In addition, the nutritional content composition of milk was analyzed using MIRIS Human Milk Analyzer and correlations examined.
Results
Melatonin concentration in human milk before pasteurization was 0.65–26.24 pg/mL (Me=9.58, IQR=12.72), while after pasteurization 0.80–29.58 pg/mL (Me=9.98, IQR=11.26). There was a positive correlation between melatonin concentration before and after pasteurization (r=0.797, p<0.001).
Conclusions
The Holder pasteurization process does not affect the concentration of melatonin in milk samples, which may be a recommendation for human milk banks.
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Affiliation(s)
- Penny Reimers
- 56394 Department of Child Health and Paediatrics, University of KwaZulu-Natal, Durban, South Africa
| | - Anna Coutsoudis
- 56394 Department of Child Health and Paediatrics, University of KwaZulu-Natal, Durban, South Africa
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Fogliano RRF, Bohomol E, Schveitzer MC, Coca KP, Abrão ACFDV. Quality management in Human Milk Banks: a scope review. Rev Bras Enferm 2020. [DOI: 10.1590/0034-7167-2019-0640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objectives: to identify the main quality management interventions used by professionals working at Human Milk Banks. Methods: a scope review conducted at PubMed, VHL, Scopus, SciELO, CAPES thesis and Google Scholar databases. Primary studies were included that address quality improvement strategies to improve Milk Bank processes in Portuguese, English and Spanish. Results: search totaled 192 scientific studies, 17 of which met the objective of the study and inclusion criteria. The main quality management interventions used in the Human Milk Bank addressed tools for continuous improvement. Six were aimed at improving processes, one to prevent errors and failures and two to achieve continuous monitoring. Final Considerations: the tools used by professionals working in Human Milk Banks have demonstrated effectiveness in managing the quality of services.
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Palmquist AEL, Perrin MT, Cassar-Uhl D, Gribble KD, Bond AB, Cassidy T. Current Trends in Research on Human Milk Exchange for Infant Feeding. J Hum Lact 2019; 35:453-477. [PMID: 31206310 DOI: 10.1177/0890334419850820] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Breastfeeding is critical for the healthy growth and development of infants. A diverse range of infant-feeding methods are used around the world today. Many methods involve feeding infants with expressed human milk obtained through human milk exchange. Human milk exchange includes human milk banking, human milk sharing, and markets in which human milk may be purchased or sold by individuals or commercial entities. In this review, we examine peer-reviewed scholarly literature pertaining to human milk exchange in the social sciences and basic human milk sciences. We also examine current position and policy statements for human milk sharing. Our review highlights areas in need of future research. This review is a valuable resource for healthcare professionals and others who provide evidence-based care to families about infant feeding.
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Affiliation(s)
- Aunchalee E L Palmquist
- 1 Department of Maternal and Child Health, Carolina Global Breastfeeding Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Maryanne T Perrin
- 2 Department of Nutrition, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Diana Cassar-Uhl
- 3 Maternal and Child Health Program, School of Public Health, University of Maryland, Cornwall, NY, USA
| | - Karleen D Gribble
- 4 School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, AUS
| | - Angela B Bond
- 5 Center for Evolution and Medicine, Arizona State University, Phoenix, AZ, USA
| | - Tanya Cassidy
- 6 Dublin City University, School of Nursing and Human Sciences, Glasnevin Campus, Dublin 9, Ireland
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Wesolowska A, Sinkiewicz-Darol E, Barbarska O, Bernatowicz-Lojko U, Borszewska-Kornacka MK, van Goudoever JB. Innovative Techniques of Processing Human Milk to Preserve Key Components. Nutrients 2019; 11:E1169. [PMID: 31137691 PMCID: PMC6566440 DOI: 10.3390/nu11051169] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/15/2019] [Accepted: 05/20/2019] [Indexed: 12/25/2022] Open
Abstract
Human milk not only contains all nutritional elements that an infant requires, but is also the source of components whose regulatory role was confirmed by demonstrating health-related deficiencies in formula-fed children. A human milk diet is especially important for premature babies in the neonatal intensive care unit (NICU). In cases where breastfeeding is not possible and the mother's own milk is insufficient in volume, the most preferred food is pasteurized donor milk. The number of human milk banks has increased recently but their technical infrastructure is continuously developing. Heat treatment at a low temperature and long time, also known as holder pasteurization (62.5 °C, 30 min), is the most widespread method of human milk processing, whose effects on the quality of donor milk is well documented. Holder pasteurization destroys vegetative forms of bacteria and most viruses including human immunodeficiency virus (HIV) herpes and cytomegalovirus (CMV). The macronutrients remain relatively intact but various beneficial components are destroyed completely or compromised. Enzymes and immune cells are the most heat sensitive elements. The bactericidal capacity of heat-pasteurized milk is lower than that of untreated milk. The aim of the study was for a comprehensive comparison of currently tested methods of improving the preservation stage. Innovative techniques of milk processing should minimize the risk of milk-borne infections and preserve the bioactivity of this complex biological fluid better than the holder method. In the present paper, the most promising thermal pasteurization condition (72 °C-75 °C,) and a few non-thermal processes were discussed (high pressure processing, microwave irradiation). This narrative review presents an overview of methods of human milk preservation that have been explored to improve the safety and quality of donor milk.
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Affiliation(s)
- Aleksandra Wesolowska
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Hospital, Medical University of Warsaw, Department of Neonatology, 63A Zwirki i Wigury St., 02-091 Warsaw, Poland.
| | - Elena Sinkiewicz-Darol
- Human Milk Bank, Ludwik Rydygier' Provincial Polyclinical Hospital in Torun, Torun, 53-59 St. Jozef St., 87-100 Torun, Poland.
| | - Olga Barbarska
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Hospital, Medical University of Warsaw, Department of Neonatology, 63A Zwirki i Wigury St., 02-091 Warsaw, Poland.
| | - Urszula Bernatowicz-Lojko
- Human Milk Bank, Ludwik Rydygier' Provincial Polyclinical Hospital in Torun, Torun, 53-59 St. Jozef St., 87-100 Torun, Poland.
| | | | - Johannes B van Goudoever
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
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8
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Sparks H, Linley L, Beaumont JL, Robinson DT. Donor milk intake and infant growth in a South African neonatal unit: a cohort study. Int Breastfeed J 2018; 13:41. [PMID: 30202424 PMCID: PMC6124008 DOI: 10.1186/s13006-018-0183-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 08/22/2018] [Indexed: 05/29/2023] Open
Abstract
Background Implications of donor milk feedings on infant growth in resource limited settings remain uncertain. This knowledge gap includes the impact of donor milk availability on infant intake of mother’s own milk. Therefore, this investigation aimed to measure intake and growth in infants receiving donor milk when born to women from resource limited backgrounds with high rates of human immunodeficiency virus (HIV). Methods A retrospective cohort study enrolled eligible infants admitted to a South African combined neonatal intensive and secondary high care unit, within a one year admission period during 2015, with signed consent for donor milk feedings. A certified milk bank provided donor milk. Daily nutritional intake during the first month was recorded. Details included proportional intake of donor milk, mother’s own milk and infant formula. The primary outcome of infant growth velocity from day back to birth weight to discharge was calculated when length of stay was ≥14 days. Analyses primarily used T-tests; mixed effects models compared weekly calorie intake. Results One hundred five infants with donor milk consent were born at 30.9 ± 3.6 weeks of gestation, weighing 1389 ± 708 g. Forty percent of mothers had HIV. Infant growth velocity did not differ based on percent of feedings as donor milk (≥ 50%: 11.8 ± 4.9 g/kg/d; < 50%: 13.5 ± 5.3 g/kg/d; p = 0.3). Percent of feedings from donor milk was similar based on maternal HIV status (positive: 31 ± 25%; negative: 36 ± 29%; p = 0.4), as was percent of feedings as mother’s milk (positive: 53 ± 35%; negative: 58 ± 30%; p = 0.4). Calorie intake increased markedly during the first two weeks and then plateaued (p < 0.0001). Conclusions Donor milk feedings in higher proportions did not further impair growth of infants managed in a South African combined neonatal intensive and secondary high care unit with growth rates already below reference ranges. The provision of donor milk contributed to feedings being composed of primarily human milk during the first month. Increasing early calorie intake may improve infant growth in this center.
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Affiliation(s)
- Hayley Sparks
- 1Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Lucy Linley
- 2Division of Neonatology, School of Child and Adolescent Health, University of Cape Town and Mowbray Maternity Hospital, Cape Town, South Africa
| | - Jennifer L Beaumont
- 3Terasaki Research Institute, Los Angeles, CA USA.,4Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Daniel T Robinson
- 5Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL USA.,6Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL USA
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Daniels B, Reimers P, King T, Schmidt S, Coutsoudis A. Effect of the PiAstra Benchtop Flash-Heating Pasteurizer on Immune Factors of Donor Human Milk. Breastfeed Med 2018; 13:281-285. [PMID: 29565633 DOI: 10.1089/bfm.2018.0017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION PiAstra is a simulated flash-heat (FH) pasteurization temperature monitoring system designed using Raspberry Pi technology for the pasteurization of human milk. This study analyzed the effect of the PiAstra FH method on human milk immune components (immunoglobulin A [IgA] and lactoferrin activity). METHODS Donor milk samples (N = 45) were obtained from a human milk bank, and pasteurized. Concentrations of IgA and lactoferrin activity were compared to their unpasteurized controls using the Student's t test. RESULTS The PiAstra FH method retained 34.2% of IgA (p < 0.0001) and 40.4% of lactoferrin activity (p < 0.0001) when compared to unpasteurized controls. The retention of IgA by the PiAstra is similar to previous FH studies, while retention of lactoferrin activity was higher than previous FH studies. DISCUSSION The high-technology, low-cost PiAstra system, which is able to retain vital immune components of human milk, provides safe donor milk for low-resourced settings. This enables the use of pasteurized donor milk when human milk is not available, potentially saving vulnerable infant lives.
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Affiliation(s)
- Brodie Daniels
- 1 Department of Paediatrics and Child Health, School of Clinical Medicine, University of KwaZulu-Natal , Durban, South Africa
| | - Penny Reimers
- 1 Department of Paediatrics and Child Health, School of Clinical Medicine, University of KwaZulu-Natal , Durban, South Africa
| | - Tracy King
- 2 Discipline of Microbiology, School of Life Sciences, University of KwaZulu-Natal , Pietermaritzburg, South Africa
| | - Stefan Schmidt
- 2 Discipline of Microbiology, School of Life Sciences, University of KwaZulu-Natal , Pietermaritzburg, South Africa
| | - Anna Coutsoudis
- 1 Department of Paediatrics and Child Health, School of Clinical Medicine, University of KwaZulu-Natal , Durban, South Africa
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Daniels B, Coutsoudis A, Autran C, Amundson Mansen K, Israel-Ballard K, Bode L. The effect of simulated flash heating pasteurisation and Holder pasteurisation on human milk oligosaccharides. Paediatr Int Child Health 2017; 37:204-209. [PMID: 28262036 DOI: 10.1080/20469047.2017.1293869] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Human milk oligosaccharides (HMOs) have important protective functions in human milk. A low-cost remote pasteurisation temperature-monitoring system has been designed using FoneAstra, a cell phone-based networked sensing system to monitor simulated flash heat pasteurisation. AIM To compare the pasteurisation effect on HMOs of the FoneAstra FH method with the current Sterifeed Holder method used by human milk banks. METHODS Donor human milk samples (n = 48) were obtained from a human milk bank and pasteurised using the two pasteurisation methods. HMOs were purified from samples and labelled before separation using high-performance liquid chromatography. Concentrations of total HMOs, sialylated and fucosylated HMOs and individual HMOs using the two pasteurisation methods were compared using repeated-measures ANOVA. RESULTS The study demonstrated no difference in total concentration of HMOs between the two pasteurisation methods and a small but significant increase in the total concentration of HMOs regardless of pasteurisation methods compared with controls (unpasteurised samples) (p<0.0001). CONCLUSION The FoneAstra FH pasteurisation system does not negatively affect oligosaccharides in human milk and therefore is a possible alternative for providing safely sterilised human milk for low- and middle-income countries.
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Affiliation(s)
- Brodie Daniels
- a Department of Paediatrics and Child Health , Nelson R Mandela School of Medicine , Durban , South Africa
| | - Anna Coutsoudis
- a Department of Paediatrics and Child Health , Nelson R Mandela School of Medicine , Durban , South Africa
| | - Chloe Autran
- b Department of Pediatrics , University of California , San Diego , CA , USA
| | | | - Kiersten Israel-Ballard
- c Maternal, Newborn and Child Health and Nutrition Global Program , PATH , Seattle , WA , USA
| | - Lars Bode
- b Department of Pediatrics , University of California , San Diego , CA , USA
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DeMarchis A, Israel-Ballard K, Mansen KA, Engmann C. Establishing an integrated human milk banking approach to strengthen newborn care. J Perinatol 2017; 37:469-474. [PMID: 27831549 PMCID: PMC5415705 DOI: 10.1038/jp.2016.198] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/24/2016] [Accepted: 08/30/2016] [Indexed: 02/07/2023]
Abstract
The provision of donor human milk can significantly reduce morbidity and mortality among vulnerable infants and is recommended by the World Health Organization as the next best option when a mother's own milk is unavailable. Regulated human milk banks can meet this need, however, scale-up has been hindered by the absence of an appropriate model for resource-limited settings and a lack of policy support for human milk banks and for the operational procedures supporting them. To reduce infant mortality, human milk banking systems need to be scaled up and integrated with other components of newborn care. This article draws on current guidelines and best practices from human milk banks to offer a compilation of universal requirements that provide a foundation for an integrated model of newborn care that is appropriate for low- and high-resource settings alike.
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Affiliation(s)
- A DeMarchis
- Maternal, Newborn, Child Health and Nutrition Program PATH, Seattle, WA, USA
- Nutritional Sciences Program, University of Washington, Seattle, WA, USA
| | - K Israel-Ballard
- Maternal, Newborn, Child Health and Nutrition Program PATH, Seattle, WA, USA
| | - Kimberly Amundson Mansen
- Maternal, Newborn, Child Health and Nutrition Program PATH, Seattle, WA, USA
- Seattle Children's Hospital, Seattle, WA, USA
| | - C Engmann
- Maternal, Newborn, Child Health and Nutrition Program PATH, Seattle, WA, USA
- Seattle Children's Hospital, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
- Department of Global Health University of Washington, Seattle, WA, USA
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Abstract
The aim of human milk banks is to deliver safe and high quality donor human milk. Treatment of human milk has to destroy most microorganisms while preserving immunological and nutrient components, which is obtained when using low time low temperature pasteurization. However it destroys bile-simulated lipase, reduces lactoferrin, lysozyme, immunoglobulins, and bactericidal capacity of human milk. New methods are under investigation such as high temperature short time pasteurization, high pressure processing, or ultraviolet irradiation. They have been tested in experimental conditions and there are promising results, but they have to be tested in real conditions in human milk bank.
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Affiliation(s)
- Jean-Charles Picaud
- Neonatal Unit, Hôpital de la Croix-Rousse, Lyon F-69004, France; Rhone-Alpes Auvergneregional Human Milk Bank, Hôpital de la Croix-Rousse, Lyon F-69004, France; Lyon Sud Charles Merieux School of Medicine, Université Claude Bernard Lyon 1, Pierre-Bénite F-69310, France; Rhone-Alpes Human Nutrition Research Center, Hôpital Lyon Sud, Pierre-Bénite F-69310, France; European Milk Bank Association (EMBA), Milano, Italy.
| | - Rachel Buffin
- Neonatal Unit, Hôpital de la Croix-Rousse, Lyon F-69004, France; Rhone-Alpes Auvergneregional Human Milk Bank, Hôpital de la Croix-Rousse, Lyon F-69004, France
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13
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The Effect of Simulated Flash-Heat Pasteurization on Immune Components of Human Milk. Nutrients 2017; 9:nu9020178. [PMID: 28241418 PMCID: PMC5331609 DOI: 10.3390/nu9020178] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 01/05/2017] [Accepted: 01/23/2017] [Indexed: 01/01/2023] Open
Abstract
A pasteurization temperature monitoring system has been designed using FoneAstra, a cellphone-based networked sensing system, to monitor simulated flash-heat (FH) pasteurization. This study compared the effect of the FoneAstra FH (F-FH) method with the Sterifeed Holder method currently used by human milk banks on human milk immune components (immunoglobulin A (IgA), lactoferrin activity, lysozyme activity, interleukin (IL)-8 and IL-10). Donor milk samples (N = 50) were obtained from a human milk bank, and pasteurized. Concentrations of IgA, IL-8, IL-10, lysozyme activity and lactoferrin activity were compared to their controls using the Student’s t-test. Both methods demonstrated no destruction of interleukins. While the Holder method retained all lysozyme activity, the F-FH method only retained 78.4% activity (p < 0.0001), and both methods showed a decrease in lactoferrin activity (71.1% Holder vs. 38.6% F-FH; p < 0.0001) and a decrease in the retention of total IgA (78.9% Holder vs. 25.2% F-FH; p < 0.0001). Despite increased destruction of immune components compared to Holder pasteurization, the benefits of F-FH in terms of its low cost, feasibility, safety and retention of immune components make it a valuable resource in low-income countries for pasteurizing human milk, potentially saving infants’ lives.
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Giribaldi M, Coscia A, Peila C, Antoniazzi S, Lamberti C, Ortoffi M, Moro GE, Bertino E, Civera T, Cavallarin L. Pasteurization of human milk by a benchtop High-Temperature Short-Time device. INNOV FOOD SCI EMERG 2016. [DOI: 10.1016/j.ifset.2016.07.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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Eidelman AI. Even when feeding breastmilk there are no free lunches. Breastfeed Med 2015; 10:75-6. [PMID: 25746857 DOI: 10.1089/bfm.2015.9995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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