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Li R, Shenker N, Gray J, Megaw J, Weaver G, Cameron SJ. Microbiological analysis of donor human milk over seven years from the Hearts Milk Bank (United Kingdom). Food Microbiol 2025; 126:104661. [PMID: 39638441 DOI: 10.1016/j.fm.2024.104661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Revised: 10/02/2024] [Accepted: 10/17/2024] [Indexed: 12/07/2024]
Abstract
When maternal milk is unavailable, donor human milk (DHM) from human milk banks (HMBs) is the optimal alternative, as recommended by the World Health Organisation. The microbiota of DHM could contain opportunistic pathogens, which means rigorous microbiological screening for DHM, prior to pasteurisation, is recommended to safeguard recipients. Here, an analysis of 6863 DHM samples from 1419 donors at the Hearts Milk Bank between 2017 and 2023 showed approximately 70.1% of samples exhibited a total viable count (TVC) between 10³-10⁵ CFU/mL, while 18.3% yielded no growth; 11.5% of samples exceeded the 10⁵ CFU/mL threshold. Staphylococcus was the most prevalent genus, with S. epidermidis found in 61.5% of samples. A significant (p < 0.05) negative co-occurrence was observed between S. epidermidis and Gram-negative opportunistic pathogens. Overall, 16.8% of DHM samples failed to meet UK microbiological screening criteria, with 68.3% of these failures due to exceeding TVC thresholds. S. epidermidis accounted for approximately 10.2% of the total failed samples. The majority of DHM samples met the current microbiological criteria specified in the National Institute for Health and Care Excellence (NICE) clinical guidance (CG93), "Donor milk banks: service operation". The core species in DHM reflects microorganisms typically found on the skin. These findings highlight that the current UK thresholds and criteria could potentially be modified to increase the available supply of DHM without increasing microbiological risk.
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Affiliation(s)
- Ranran Li
- School of Biological Sciences and Institute for Global Food Security, Queen's University Belfast, UK
| | - Natalie Shenker
- Department of Surgery and Cancer, Du Cane Road, Imperial College London, W12 0NN, UK; Human Milk Foundation, Gossoms End NHS Health Centre, Victory Road, Berkhamsted, Hertfordshire, HP4 1DL, UK
| | - Jim Gray
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham Children's Hospital, B4 6NH, UK
| | - Julianne Megaw
- School of Biological Sciences and Institute for Global Food Security, Queen's University Belfast, UK
| | - Gillian Weaver
- Human Milk Foundation, Gossoms End NHS Health Centre, Victory Road, Berkhamsted, Hertfordshire, HP4 1DL, UK
| | - Simon Js Cameron
- School of Biological Sciences and Institute for Global Food Security, Queen's University Belfast, UK.
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dos Santos BG, Shenker N, Weaver G, Perrin MT. Donation barriers, enablers, patterns and predictors of milk bank donors in the United States and United Kingdom. MATERNAL & CHILD NUTRITION 2024; 20:e13652. [PMID: 38606492 PMCID: PMC11168376 DOI: 10.1111/mcn.13652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/25/2024] [Accepted: 03/26/2024] [Indexed: 04/13/2024]
Abstract
Pasteurised donor human milk is recommended for very low birthweight infants who do not have access to their mother's milk. Although the use of donor milk continues to increase, little is known about the donation experiences of milk bank donors. We aimed to describe and compare enablers, barriers and patterns of human milk donation and identify factors predicting donation volume in a convenience sample of approved milk bank donors in the United Kingdom and the United States. A cross-sectional online survey was conducted from August 2022 to December 2022. Approved milk bank donors (n = 556) from three milk banks in the United States (n = 369, Mothers' Milk Bank of Florida, Mother's Milk Bank of North Texas and Northwest Mothers Milk Bank) and one milk bank in the United Kingdom (n = 187, Hearts Milk Bank) completed the survey. A substantial portion of donors in both settings reported participating in other forms of milk exchange (51% of U.S. donors vs. 39% of UK donors, p = 0.009). Top donation barriers reported in both settings were completing the serological screening and having enough space to store collected milk. Most donors started donating when their infant was 3 months old or older and reported donating mature milk. The most common source of information related to milk banking in each setting was the internet (United Kingdom-70% vs. United States - 63%, p = 0.112). Variables that predicted lifetime donation volume differed between the United States and the United Kingdom, highlighting the importance of setting-specific milk banking research.
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Affiliation(s)
| | - Natalie Shenker
- Human Milk FoundationRothamsted InstituteHarpendenUK
- Department of Surgery and CancerImperial College London, IRDBLondonUK
| | | | - Maryanne T. Perrin
- Department of NutritionUniversity of North Carolina GreensboroGreensboroNorth CarolinaUSA
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Kim EB, Song JH, Le LNH, Kim H, Koh JW, Seo Y, Jeong HR, Kim HT, Ryu S. Characterization of exosomal microRNAs in preterm infants fed with breast milk and infant formula. Front Nutr 2024; 11:1339919. [PMID: 38304545 PMCID: PMC10830786 DOI: 10.3389/fnut.2024.1339919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/04/2024] [Indexed: 02/03/2024] Open
Abstract
Breastfeeding not only reduces infection-related morbidity, but also increases growth of preterm infants. Advantages of breast milk (BM) for preterm infants are significant. They continue to be studied. However, because not all preterm infants can receive breastfeeding, bovine-based infant formula (IF) is used as an alternative, which may increase the risk of several preterm complications. Exosomes isolated from biofluids are emerging as biomarkers in research of various diseases. Here, we characterized miRNA contents of exosomes in urine and serum samples of preterm infants who were BM and IF fed and performed transcriptomic analysis of small RNA libraries. We identified significantly up-regulated 6 miRNAs and 10 miRNAs, respectively. Gene Ontology (GO) analysis revealed that target genes of these miRNAs might participate in neuronal development, immunity modulation, detoxification of reactive oxygen species, and transmembrane exchange. Our data suggest that exosome-based systemic screening for preterm infants with breastfeeding might be a screening tool for identifying target molecules involved in therapy for preterm infants in neonatal intensive care unit (NICU) and for future application as nutraceutical formulations or pharmaceuticals.
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Affiliation(s)
- Eun-Bit Kim
- Soonchunhyang Institute of Med-bio Science (SIMS), Soonchunhyang University, Cheonan, Republic of Korea
| | - Jun Hwan Song
- Soonchunhyang University Cheonan Hospital, College of Medicine, Soon-chunhyang University, Cheonan, Republic of Korea
| | - Linh Nguy-Hoang Le
- Department of Integrated Biomedical Science, Soonchunhyang University, Cheonan, Republic of Korea
| | - Ho Kim
- Soonchunhyang University Cheonan Hospital, College of Medicine, Soon-chunhyang University, Cheonan, Republic of Korea
| | - Ji Won Koh
- Soonchunhyang University Cheonan Hospital, College of Medicine, Soon-chunhyang University, Cheonan, Republic of Korea
| | - Yekyeng Seo
- Soonchunhyang University Cheonan Hospital, College of Medicine, Soon-chunhyang University, Cheonan, Republic of Korea
| | - Hwal Rim Jeong
- Department of Pediatrics, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | - Hyun-Taek Kim
- Soonchunhyang Institute of Med-bio Science (SIMS), Soonchunhyang University, Cheonan, Republic of Korea
| | - Seongho Ryu
- Department of Integrated Biomedical Science, Soonchunhyang University, Cheonan, Republic of Korea
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Wang H, Hu XL, Li QF, Zhou J, Wu MY. Operation Status of the Mutual Aid Human Milk Bank for Preterm Infants and Data Analysis. J Multidiscip Healthc 2023; 16:3521-3530. [PMID: 38024124 PMCID: PMC10658946 DOI: 10.2147/jmdh.s440114] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/03/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives This study aimed to investigate the matching degree between the donated supply and demand, clinical characteristics of both donors and recipients, along with the operation cost. Methods From January 1, 2018 to December 31, 2021, the data on human milk donation and usage, the clinical characteristics of donors and recipients, and the cost of each operating center were collected from the Manual Donation Registration Form and Information Management System of the selected human milk bank. Results During the four years that the human milk bank was in operation, the volume of donated milk was slightly greater than the volume of consumed milk. A total of 1364 donors donated 2434.63 liters of qualified human milk, for RMB 1,791,000 (USD 257, 202), ie, RMB 385.3 (USD 55.3)/L; 97.8% of the donors were preterm puerperae, and 59% of the donors donated between 1 week and 1 month after delivery. All recipients were preterm infants and received donated human milk for a duration of 9.4 days on average. During the four years of operation, the proportion of donors who had previously received donated milk among all donors showed an overall increasing trend, while the incidence of NEC in preterm infants gradually decreased. Conclusions The increasingly optimized structure of donors, the more economical operation, and the fact that the use of donated milk may not affect breastfeeding of the recipients have made it a human milk bank operation mode worthy of promotion.
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Affiliation(s)
- Hua Wang
- Department of NICU, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, People’s Republic of China
| | - Xiao-Li Hu
- Department of Obstetrics, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, People’s Republic of China
| | - Qiu-Fang Li
- Department of Nursing, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, People’s Republic of China
| | - Jie Zhou
- Department of NICU, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, People’s Republic of China
| | - Ming-Yuan Wu
- Department of NICU, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, People’s Republic of China
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Tran HT, Nguyen TT, Nguyen OTX, Barnett D, Weaver G, Mathisen R. Characteristics and factors influencing the volume of breastmilk donated by women to the first human milk bank in Vietnam. Front Glob Womens Health 2023; 4:1185097. [PMID: 37849562 PMCID: PMC10577291 DOI: 10.3389/fgwh.2023.1185097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/18/2023] [Indexed: 10/19/2023] Open
Abstract
Background Donor human milk (DHM) is essential to the operation of human milk banks (HMB). This study examined characteristics and factors associated with higher volumes of DHM donation at the first HMB in Vietnam. Method Data from an online HMB monitoring system collected between February 2017 and July 2022 included demographic characteristics, child information, the timing of donation, and the volume of DHM. Higher volume is defined as equal to or greater than the median DHM volume per donor of 14.4 liters (L). Potential contributors to higher DHM volume were examined using the chi-square test in univariate and multivariable logistic regression analysis. Results During the 5.5-year operation, this HMB recruited 517 donors with an average age of 28.6 years. Approximately 60.9% of donors had a college or higher degree and 97.3% gave birth in Da Nang city. Of these donors, the prevalence of cesarean birth was 48.2%, preterm births was 40.2%, and 27.9% had babies with a birth weight of less than 1,500 g. There was a similar proportion of donors between the hospital (48.2%) and community (51.8%). On average, hospital donors started their donations 15 days after birth when their newborns were 33.9 weeks corrected age compared to 63 days and 47.7 weeks among community-based donors. The overall median volume of DHM per donor was 14.4 L over a period of 46 days. The amount and duration were higher in community-based donors (17.5 L in 72 days, 300 ml/day) than those in the hospital (8.4 L in 30 days, 258 ml/day). More than 37% of donors contacted the HMB themselves; the remainder were introduced by health professionals. Factors associated with higher volumes of DHM included higher education (OR: 1.77; 95% CI: 1.09, 2.87), having a full-term newborn (OR: 2.46; 95% CI: 1.46, 4.13), and community-based donors (OR: 2.15; 95% CI: 1.22, 3.78). Conclusions Mothers with higher education and from the community donate more breastmilk over a longer duration than those with lower education and from the hospital. Breastfeeding protection, promotion, and support should be offered to all mothers with specialized breastfeeding support for mothers of preterm and sick infants. This will ensure mothers have sufficient breastmilk for their newborns and potentially surplus breastmilk for donation.
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Affiliation(s)
- Hoang Thi Tran
- Neonatal Unit and Human Milk Bank, Da Nang Hospital for Women and Children, Da Nang, Vietnam
- Department of Pediatrics, School of Medicine and Pharmacy, Da Nang University, Da Nang, Vietnam
| | | | - Oanh Thi Xuan Nguyen
- Neonatal Unit and Human Milk Bank, Da Nang Hospital for Women and Children, Da Nang, Vietnam
| | - Debbie Barnett
- Milk Bank Scotland, Queen Elizabeth University Hospital, Glasgow, United Kingdom
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Sivanandan S, Bethou A, Jebakani S, Calevanane V, Pushkaralochanan D. A quality improvement project to improve voluntary milk donation in a human milk bank in South India. Med J Armed Forces India 2023; 79:565-571. [PMID: 37719911 PMCID: PMC10499859 DOI: 10.1016/j.mjafi.2020.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/21/2020] [Indexed: 10/22/2022] Open
Abstract
Background Mother's milk is the ideal food for a neonate. When mother's milk is unavailable for any reason, pasteurised donor human milk (PDHM) is the next best option. This quality improvement (QI) project aimed at improving voluntary donation in a public human milk bank (HMB) in South India. Methods Between January 2018 and June 2019, the HMB received an average of 15 L of donor milk per month (0.5 L/day). Our aim was to increase voluntary donation by 50% from the baseline over a period of 8 months from July 2019 to March 2020 using QI methods. Two plan-do-study-act (PDSA) cycles were done during the intervention period (4 months). Interventions included the formation of micro teams in postnatal wards to promote exclusive breastfeeding and to liaison with the core QI team. We created a milk expression area in the postnatal ward, counseled postnatal mothers, and addressed supply chain issues like sterile pumping accessories. Results The average daily voluntary milk donation to HMB increased from 0.83 L/day in the baseline phase to 1.16 and 1.14 L per day in the intervention and postintervention phases, respectively. The mean (SD) monthly donated volumes increased from 28.2 (6.1) L to 34.1 (3.7) L; mean difference (95% CI) 5.9 (0.33-11.4); P = 0.03. The volume of PDHM disbursed from HMB increased from 26.6 (3.2) L/month to 32.2 (9.2) L/month, although not statistically significant (p = 0.15). The number of mothers donating milk did not increase during the study period. Conclusions A multipronged QI intervention effort focusing on exclusive breastfeeding improved voluntary milk donation in HMB bank. Multiple micro-teams and local networking facilitated the QI initiative.
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Affiliation(s)
- Sindhu Sivanandan
- Assistant Professor (Neonatology), Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| | - Adhisivam Bethou
- Additional Professor & Head (Neonatology), Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| | - Sylvia Jebakani
- Senior Nursing Officer (Neonatology), Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| | - Vijaya Calevanane
- Senior Nursing Officer (Neonatology), Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
| | - Divya Pushkaralochanan
- Lactation Counselor (Neonatology), Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India
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McCune S, Perrin M. The Effects of Refrigerated Storage of Donor Human Milk with Limited Bacterial Presence After Holder Pasteurization on Nutrient Concentration and Bacterial Growth. Breastfeed Med 2023. [PMID: 37367215 DOI: 10.1089/bfm.2023.0084] [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: 06/28/2023]
Abstract
Background: The Human Milk Banking Association of North America (HMBANA) sets the purity and quality standards for donor human milk (DHM) in the United States, which includes zero bacterial presence after Holder pasteurization. This study aimed to determine if nutrient and bacterial composition of DHM with limited bacterial presence after pasteurization change over 4 days of refrigerated storage. Methods: Twenty-five unique samples of DHM with limited bacterial growth postpasteurization were collected from two HMBANA milk banks. Infant formula was used as a comparison. Samples were stored in the refrigerator and a portion of milk was removed at 24-hour intervals beginning at hour 0 to 96 for analysis. Aerobic bacteria, protein, lactose, and immunoglobulin A (IgA) content were measured. Longitudinal changes between 0 and 96 hours were analyzed using repeated measures analysis of variance and mixed models test. p < 0.05 was deemed significant. Results: There was no significant difference in lactose, protein, bacteria, or IgA content over storage duration (p = 0.649, p = 0.690, and p = 0.385, p = 0.805, respectively). Total aerobic bacteria were less than 102 colony-forming units (CFUs) in 81% of the time points tested for DHM samples. Total aerobic bacteria were too many to count (>300 CFUs) in the infant formula sample at all time points. Conclusion: In periods of high demand for DHM, DHM with low bacteria growth postpasteurization may be an option as a supplemental food for the growing number of healthy infants who receive DHM. Future studies should investigate the bacterial strains in this milk.
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Affiliation(s)
- Sydney McCune
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Maryanne Perrin
- Department of Nutrition, University of North Carolina Greensboro, Greensboro, North Carolina, USA
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Obeng C, Jackson F, Amissah-Essel S, Nsiah-Asamoah C, Perry CA, Gonzalez Casanova I, Obeng-Gyasi E. Women's perspectives on human milk banking in Ghana: results from a cross-sectional study. Front Public Health 2023; 11:1128375. [PMID: 37304082 PMCID: PMC10248423 DOI: 10.3389/fpubh.2023.1128375] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/05/2023] [Indexed: 06/13/2023] Open
Abstract
Background Although political and academic interest exists in Ghana to include human milk banks (HMB) into current maternal and child health programs, efforts to establish a HMB have not yet been subjected to any real empirical inspection with the view toward implementation. Furthermore, views toward the establishment of a HMB in Ghana have not been assessed among Ghanaian women. The aims of the current study were to examine Ghanaian women's views about HMB, and to investigate women's willingness to donate to a HMB. Methods Quantitative and qualitative responses were received from Ghanaian females (n = 1,270) aged 18+ years. Excluding outliers and missing data (n = 321), a final sample of 949 was retained for final analysis. Chi-square tests and logistic regression analysis were computed on quantitative data; Thematic analysis was performed on the qualitative responses. Results In our sample, 64.7% of respondents indicated that Ghana is ready for a HMB. The majority (77.2%) were willing to donate milk, and 69.4% believed that donating to the HMB would favor their child. The main concerns for the unwillingness to donate excess milk included: (i) the idea of HMBs as strange/bizarre (n = 47), (ii) fear of infections (n = 15), (iii) religious beliefs (n = 9), and (iv) insufficient information (n = 24). This study serves as the first step toward the development of a HMB in Ghana. Conclusions Overall, Ghanaian women support the building of a HMB to enhance infant nutrition and reduce childhood morbidity and mortality.
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Affiliation(s)
- Cecilia Obeng
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN, United States
| | - Frederica Jackson
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN, United States
| | - Salome Amissah-Essel
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | | | - Cydne A. Perry
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN, United States
| | - Ines Gonzalez Casanova
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN, United States
| | - Emmanuel Obeng-Gyasi
- Department of Built Environment, North Carolina Agricultural and Technical State University, Greensboro, NC, Canada
- Environmental Health and Disease Laboratory, North Carolina Agricultural and Technical State University, Greensboro, NC, Canada
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Differences in the Microbiological Profile of Raw and Pasteurized Breastmilk from Hospital and Community-Based Donors at the First Human Milk Bank in Vietnam. Nutrients 2023; 15:nu15020412. [PMID: 36678283 PMCID: PMC9864883 DOI: 10.3390/nu15020412] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/06/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
Background: Microbiological quality is one of the key safety standards in human milk bank (HMB) operations. We describe the profiles of bacteria in donor human milk (DHM) before and after the pasteurization of samples collected from breastfeeding women in the hospital and from the community in the first HMB in Vietnam. Methods: Data were collected between February 2017 and January 2022 from an online HMB monitoring system. First, DHM samples were cultured, and the number of colony-forming units (CFU) were counted before (n = 708) and after pasteurization (n = 1146). The gram-staining method combined with the Vitek 2 Compact system were used to identify types of organisms at the Da Nang Hospital for Women and Children’s Laboratory. Passing criteria for DHM included pre-pasteurization samples had a total colony count <105 CFU/mL and post-pasteurization was <10 CFU/mL. Results: During five years of operation, Da Nang HMB had 491 donors (48.7% were hospital and the rest community donors) who donated an average amount of 14.2 L over 45 days. Of this DHM volume, 84.9% of donor samples passed the pre- and post-pasteurization microbiological tests. DHM from community donors had a higher pass rate (87.8%) compared to that from hospital donors (79.5%). Before pasteurization, 15.4% of DHM samples had a bacteria count <103 CFU/mL, 63.0% had 103-<105 CFU/mL, and 21.6% had ≥105 CFU/mL. Most of the unpasteurized DHM samples (93.0%) had microorganism growth: with one organism (16.4%), two (33.9%), three or more (43.6%). After pasteurization, 17.9% samples had a bacteria count of 1−9 CFU/mL and 7.2% had ≥10 CFU/mL. DHM samples from community donors had a lower bacterial count and number of organisms than those from hospital donors both before and after pasteurization. The highest microorganisms from unpasteurized DHM samples were Staphylococcus epidermidis (74.2%), Acinetobacter sp. (52.1%), gram-positive bacillus (51.7%), Staphylococcus coagulase-negative (15.8%), and Staphylococcus aureus (10.5%). Common microorganisms from pasteurized DHM were gram-positive bacillus (21.0%), Staphylococcus epidermidis (3.9%), and Acinetobacter sp. (0.9%). Samples from the hospital tended to have a higher contamination with those microorganisms than those from community donors. Conclusions: The majority of DHM samples in Da Nang passed microbiological testing criteria. DHM from community donors had higher pass rates than hospital donors. Corrective actions are needed to improve HMB operations and hospital microbiological quality standards, as well as general improvements in water and sanitation.
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Kim TH, Chung SH, Kim JH, Ahn Y, Shin SM, Lee WR, Choi EK, Lee J, Shin HJ, Jung E, Heo JS, Lee JA, Lee SM, Bae SP, Song J, Kim CY, Yi DY. Survey on the Status of Breastfeeding in Korean Medical Institution Workers. J Korean Med Sci 2022; 37:e120. [PMID: 35437968 PMCID: PMC9015900 DOI: 10.3346/jkms.2022.37.e120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/17/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Human breast milk is essential and provides irreplaceable nutrients for early humans. However, breastfeeding is not easy for various reasons in medical institution environments. Therefore, in order to improve the breastfeeding environment, we investigated the difficult reality of breastfeeding through questionnaire responses from medical institution workers. METHODS A survey was conducted among 179 medical institution workers with experience in childbirth within the last five years. The survey results of 175 people were analyzed, with incoherent answers excluded. RESULTS Of the 175 people surveyed, a total of 108 people (61.7%) worked during the day, and 33 people (18.9%) worked in three shifts. Among 133 mothers who stayed with their babies in the same nursing room, 111 (93.3%) kept breastfeeding for more than a month, but among those who stayed apart, only 10 (71.4%) continued breastfeeding for more than a month (P = 0.024). Ninety-five (88.0%) of daytime workers, 32 (94.1%) two-shift workers, and 33 (100%) three-shift workers continued breastfeeding for more than a month (P = 0.026). Workers in general hospitals tended to breastfeed for significantly longer than those that worked in tertiary hospitals (P = 0.003). A difference was also noted between occupation categories (P = 0.019), but a more significant difference was found in the comparison between nurses and doctors (P = 0.012). Longer breastfeeding periods were noted when mothers worked three shifts (P = 0.037). Depending on the period planned for breastfeeding prior to childbirth, the actual breastfeeding maintenance period after birth showed a significant difference (P = 0.002). Of 112 mothers who responded to the question regarding difficulties in breastfeeding after returning to work, 87 (77.7%) mentioned a lack of time caused by being busy at work, 82 (73.2%) mentioned the need for places and appropriate circumstances. CONCLUSION In medical institutions, it is recommended that environmental improvements in medical institutions, the implementation of supporting policies, and the provision of specialized education on breastfeeding are necessary to promote breastfeeding.
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Affiliation(s)
- Tae Hyeong Kim
- Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Sung-Hoon Chung
- Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
| | - Jun Hwan Kim
- Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Youngmin Ahn
- Department of Pediatrics, Jangs Hospital, Seoul, Korea
| | - Son Moon Shin
- Department of Pediatrics, Inje University Busan Paik Hospital, Busan, Korea
| | - Woo Ryoung Lee
- Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Eui Kyung Choi
- Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Juyoung Lee
- Department of Pediatrics, Bucheon St. Mary's Hospital, The Catholic University College of Medicine, Bucheon, Korea
| | - Hye-Jung Shin
- Department of Pediatrics, National Medical Center, Seoul, Korea
| | - Euiseok Jung
- Department of Pediatrics, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea
| | - Ju Sun Heo
- Department of Pediatrics, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jin A Lee
- Department of Pediatrics, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Soon Min Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
| | - Seong Phil Bae
- Department of Pediatrics, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jeonglyn Song
- Chung-Ang University Industry Academic Cooperation Foundation, Seoul, Korea
| | - Chae-Young Kim
- Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Dae Yong Yi
- Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
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Strom K, Jarzynka S, Minkiewicz-Zochniak A, Barbarska O, Olędzka G, Wesolowska A. Microbiological Quality of Milk Donated to the Regional Human Milk Bank in Warsaw in the First Four Years of Activity. Healthcare (Basel) 2022; 10:healthcare10030444. [PMID: 35326922 PMCID: PMC8949421 DOI: 10.3390/healthcare10030444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/21/2022] [Accepted: 02/24/2022] [Indexed: 11/16/2022] Open
Abstract
As the survival rate for preterm infants increases, more emphasis is placed on improving health-related quality of life through optimal nutritional management. Human Milk Banks (HMBs) provide bioactive nutrients and probiotic microorganisms to premature newborns, especially in the first year of life. Donated milk screening and selection of potential donors ensures the quality and microbiological safety of the donated milk. Therefore we reviewed the basic characteristics of donors and the amounts and contamination of breast milk donated to the Regional Human Milk Bank (RHMB) in Warsaw. In four years, the RHMB collected 1445.59 L of milk, of which 96.60% was distributed among hospitalised infants. Additionally, breastmilk from donor candidates (139 samples from 96 women) was tested at least once in the first year of lactation. First analyses showed that 18 women’s milk samples were microbiologically pure, and 78 samples had one or more species of commensal and/or potentially pathogenic bacteria. In human milk samples from 31 women, the bacteria level was above the standard required by the RHMB; therefore, donors were re-educated, and further samples were tested. Most women followed the recommendations on hygienic expression and storage of milk before transfer to the RHMB. Our analysis will help to increase the accessibility and quality of raw donor milk and to meet the needs of more newborns.
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Affiliation(s)
- Kamila Strom
- Department of Medical Biology, Faculty of Health Sciences, Medical University of Warsaw, 14/16 Litewska St., 00-575 Warsaw, Poland; (K.S.); (S.J.); (A.M.-Z.); (O.B.); (G.O.)
| | - Sylwia Jarzynka
- Department of Medical Biology, Faculty of Health Sciences, Medical University of Warsaw, 14/16 Litewska St., 00-575 Warsaw, Poland; (K.S.); (S.J.); (A.M.-Z.); (O.B.); (G.O.)
| | - Anna Minkiewicz-Zochniak
- Department of Medical Biology, Faculty of Health Sciences, Medical University of Warsaw, 14/16 Litewska St., 00-575 Warsaw, Poland; (K.S.); (S.J.); (A.M.-Z.); (O.B.); (G.O.)
| | - Olga Barbarska
- Department of Medical Biology, Faculty of Health Sciences, Medical University of Warsaw, 14/16 Litewska St., 00-575 Warsaw, Poland; (K.S.); (S.J.); (A.M.-Z.); (O.B.); (G.O.)
| | - Gabriela Olędzka
- Department of Medical Biology, Faculty of Health Sciences, Medical University of Warsaw, 14/16 Litewska St., 00-575 Warsaw, Poland; (K.S.); (S.J.); (A.M.-Z.); (O.B.); (G.O.)
| | - Aleksandra Wesolowska
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital, Department of Medical Biology, Faculty of Health Sciences, Medical University of Warsaw, 14/16 Litewska St., 00-575 Warsaw, Poland
- Correspondence:
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Tu H, Li P, Zhu L, Quan X, Fan S, Wang Z. Postpartum women's views on human milk banking in a city in Southeast China: a cross-sectional survey. Int Breastfeed J 2022; 17:3. [PMID: 34991642 PMCID: PMC8740076 DOI: 10.1186/s13006-021-00443-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 12/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Donor human milk is the best alternative for preterm infants when their mother's own milk is insufficient or unavailable. The development of human milk banks in China started late, and in most of these banks, the amount of donor human milk is insufficient for clinical demand. Moreover, many mothers are reluctant to use donor human milk due to safety concerns. It is important to understand the potential supply and demand of donor human milk before establishing a new human milk bank. This study aimed to understand women's acceptance of human milk banking in Wenzhou, southeastern China. METHODS A cross-sectional study was conducted in three community health centers in Wenzhou, southeast China, in December 2020. Data were collected from 305 postpartum women selected through convenience sampling. Sociodemographic, perinatal and breastfeeding characteristics, awareness and knowledge of human milk banking and willingness to donate human milk, and to accept donor human milk were assessed. Multivariable logistic regression analysis was used to explore independent predictors of willingness to donate human milk and to accept donor human milk. RESULTS Only 17% (52/305) of our participants had heard of human milk banking prior to this survey. The prevalence of willingness to donate human milk and use donor human milk in our study was 73.4% (224/305) and 44.6% (136/305), respectively. Employment (adjusted odds ratio [AOR] 2.30; 95% confidence interval [CI] 1.17, 4.50) and human milk banking knowledge (AOR 1.23; 95% CI 1.12, 1.35) were independent predictors of willingness to donate human milk. Monthly household income in the previous year (AOR 2.18; 95% CI 1.17, 4.06), awareness of human milk banking (AOR 2.41; 95% CI 1.24, 4.67) and knowledge of human milk banking (AOR 1.22; 95% CI 1.11, 1.35) were significantly associated with willingness to accept donor human milk. CONCLUSIONS In our study, awareness of human milk banks among women in the first year postpartum was low. More mothers were willing to donate human milk than to use donor human milk to feed their children. In our study, knowledge of human milk banking was a predictor of both willingness to donate human milk and willingness to use donor human milk. Programs with detailed information on human milk banking are needed to help mothers improve their knowledge and increase acceptance of human milk banking.
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Affiliation(s)
- Haixia Tu
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Ping Li
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lianlian Zhu
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaozhen Quan
- Department of Obstetrics, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shuli Fan
- Department of Obstetrics, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ziyue Wang
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
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13
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Abstract
Objective: The WHO recommends that low birth weight infants receive donor human milk (DHM) when mother’s milk is not available. Systematic reviews have been published regarding clinical outcomes of infants receiving DHM, as well as the impact of pasteurisation on the composition of DHM; however, information about milk bank donors has not been systematically assessed. Design: We conducted a systematic scoping review of original research articles about milk bank donors published before August 2020. Setting: Globally. Participants: Donors to milk banks. Results: A total of twenty-eight studies were included across a variety of geographies: the USA (n 8), Brazil (n 7), Spain (n 4), India (n 2), and single studies in France, Norway, Poland, Italy, Taiwan, Korea and China. Study variables were grouped into six main categories: Donor Demographics (n 19), Clinical Characteristics (n 20), Donor Experiences (n 16), Donation Patterns (n 16), Lifestyle Characteristics (n 4) and Lactation/Breast-feeding History (n 8). Some demographic characteristics were commonly reported across regions, while other, including gender and race, were infrequently explored. Factors that might influence the composition of DHM, including birth timing (term or pre-term), milk type (colostrum, transition or mature) and maternal diet were not regularly studied. Other gaps in the literature included (1) donors’ motivations and barriers to donation, (2) lactation and breast-feeding history, including factors that influence donors to pump and amass surplus milk, and (3) donation patterns, including whether donors are also selling milk to corporations or sharing milk with peers. Conclusion: What is known about milk bank donors in different geographies is often limited to a single study, with heterogeneity in the variables reported.
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Trends and Dynamics in the First Four Years of Operation of the First Human Milk Bank in Vietnam. Nutrients 2021; 13:nu13041107. [PMID: 33800596 PMCID: PMC8067108 DOI: 10.3390/nu13041107] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Since 1979, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) have recommended the use of pasteurized human milk from a human milk bank (HMB) to feed low birthweight (LBW) and preterm newborns as the ‘first alternative’ when mothers are unable to provide their own milk. However, they have not issued any guidelines for the safe establishment and operation of an HMB. This gap contributes to the demand for gathering experiences from HMB networks, especially those from lower-middle income countries. To fill this knowledge gap, this study examines the characteristics of donors, donation, pasteurization, and recipients during the first four years of operation in the first HMB in Vietnam. Methods: Data about the donors, donation, pasteurization, and recipients were extracted from the web-based electronic monitoring system of the HMB from 1 February 2017 to 31 January 2021. Results: In the first four years of operation there were 433 donors who donated 7642 L of milk (66% from the community) with an increased trend in the amount of donated milk, donation duration, and average amount of milk donated by a donor. Approximately 98% of the donated milk was pasteurized, and 82% passed both pre- and post-pasteurization tests. Although the pass rate tended to increase with time, a few dips occurred. Of 16,235 newborns who received pasteurized donor milk, two thirds were in the postnatal wards. The main reason for the prescription of pasteurized donor milk was insufficient mothers’ own milk in the first few days after birth. There was a decreased trend in the amount and duration of using pasteurized donor milk in both postnatal wards and the neonatal unit. Conclusions: The HMB has operated efficiently in the previous four years, even during the COVID-19 pandemic, to serve vulnerable newborns. Ongoing evidence-based adjustments helped to improve the operation to recruit suitable donors, to increase the access to and quality of raw donor milk, to improve the pasteurization process, and to meet the need of more newborns.
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A Preterm Case of Cow's Milk Allergy Presenting with Recurrent Ascites Treated with Donor Breast Milk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031187. [PMID: 33572724 PMCID: PMC7908441 DOI: 10.3390/ijerph18031187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 01/22/2023]
Abstract
We report a case of a preterm infant who developed cow’s milk allergy. This male infant presented with recurrent ascites and was successfully treated with donated breast milk. He was born at 24 weeks’ gestation with a birthweight of 506 g. From day 20, infant formula, soy protein-based formula, and casein-hydrolyzed formula were used due to insufficient maternal lactation. This resulted in abdominal distention, generalized edema, and recurrent ascites. We diagnosed him with cow’s milk allergy since these symptoms improved on exclusive breast milk feeding. No recurrence of symptoms occurred when donated breast milk was used in combination with the mother’s own milk. Ascites should be regarded as a clinical symptom of neonatal cow’s milk allergy. Donated breast milk may be effective in the treatment of the allergy if breastfeeding is not available.
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Chagwena DT, Mugariri F, Sithole B, Mataga SF, Danda R, Matsungo TM, Maponga CC. Acceptability of donor breastmilk banking among health workers: a cross-sectional survey in Zimbabwean urban settings. Int Breastfeed J 2020; 15:37. [PMID: 32393361 PMCID: PMC7216340 DOI: 10.1186/s13006-020-00283-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 04/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The World Health Organization (WHO) recommends that donor human milk is superior to artificial infant formula in situations where the baby cannot feed on the mother's breastmilk. The purpose of this study was to determine the acceptability of donor human milk banking among health workers in Zimbabwean urban settings. METHODS A cross sectional study was conducted among 535 health workers and 15 key informants. Three referral hospitals were purposively selected and systematic random sampling was used to select the health workers. The study was conducted between October 2017 and October 2018. RESULTS The concept of donor human milk banking was acceptable among health workers. One-third (31%) of the study participants reported that they would accept donor breastmilk for their children while 56% of them would encourage their clients to donate breastmilk. Acceptance of donor human milk banking was associated with a high level of knowledge on breastmilk banks (p = 0.009) and the study participants' health profession (p = 0.001). Clinical staff were more receptive to donor human milk banking compared to non-clinical health workers. Donor human milk banking was not associated with religion (p = 0.498) or marital status (p = 0.714). CONCLUSIONS The results showed that health workers and policy informers would accept the establishment of breastmilk banks subject to resource availability. Commitment to the establishment of breastmilk banks was moderately acceptable among opinion leaders responsible for spearheading health and nutrition policies.
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Affiliation(s)
- Dexter T. Chagwena
- School of Pharmacy, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
- Nutri@ctive Zimbabwe, 96 Golden Stairs Rd, Mt Pleasant, Harare, Zimbabwe
| | - Felistas Mugariri
- Institute of Food, Nutrition and Family Sciences, Mt Pleasant, Harare, Zimbabwe
| | - Bhekimpilo Sithole
- Nutri@ctive Zimbabwe, 96 Golden Stairs Rd, Mt Pleasant, Harare, Zimbabwe
| | | | - Ruvimbo Danda
- UNICEF, 6 Fairbridge Avenue, Belgravia, Harare, Zimbabwe
| | | | - Charles C. Maponga
- School of Pharmacy, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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Dos Santos e Silva RK, Sany de Moura MS, Carvalho MDL, Braz ZR, Moura NDS, Mendes AN, Rodrigues MP. Desejo de doar leite: relação com características maternas. AVANCES EN ENFERMERÍA 2020. [DOI: 10.15446/av.enferm.v38n2.82838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objetivo: relacionar o desejo de doar leite materno aos aspectos sociodemográficos, clínicos e obstétricos.Materiais e métodos: estudo transversal e analítico com abordagem quantitativa, realizado com 226 mulheres durante o puerpério imediato, em um Hospital de Referência do interior do Piauí, Brasil, entre dezembro de 2016 e junho de 2018. Na estatística analítica, realizaram-se os testes de Kolmogorov-Smirnov, Qui-quadrado de Pearson, Razão de verossimilhança e o teste t Student.Resultados: a caracterização sociodemográfica revelou que as participantes do estudo eram predominantemente casadas (n = 165; 73 %); pardas (n = 145; 64,1 %) e 79 (34,9 %) praticavam atividade física. 78,3 % (n = 177) das entrevistadas desejavam ser doadoras de leite materno, o que indica relação significativa com os anos de estudo (p = 0,038) e com as que receberam orientações sobre o assunto durante o pré-natal (p = 0,028).Conclusões: o desejo de doar leite 3 materno esteve significativamente relacionado às variáveis de maior escolaridade da mulher e às orientações recebidas no pré-natal sobre o assunto, demonstrando a relevância da educação em saúde dentro do contexto.
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18
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Min X, Wang L, Cui A, Zhang C, Wang D, Liu Y, Li Z, Xu W. The nucleic acid positive rate and genotype distribution of human cytomegalovirus in human milk banks in China. Arch Virol 2020; 165:1099-1107. [PMID: 32152788 DOI: 10.1007/s00705-020-04573-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 02/01/2020] [Indexed: 12/24/2022]
Abstract
To determine the status of human cytomegalovirus (HCMV) infection in human milk in China, a total of 510 human milk samples obtained from three provinces, including 211 donor human milk samples from human milk banks and 299 milk samples obtained from the mothers of premature infants, were tested to detect HCMV DNA. Overall, 46.4% of the donated milk samples and 59.2% of the samples obtained from mothers of premature infants were positive for HCMV DNA. The concentration of HCMV DNA was approximately 103 -104 copies/ml in the HCMV-DNA-positive human milk samples. Based on the nucleotide sequence of a 299- to 305-bp fragment of the glycoprotein B (gB) gene, three HCMV genotypes (gB1, gB2 and gB3) were identified in human milk samples. Mixed infection with genotypes gB1 and gB3 was also found in four milk samples from mothers. Genotype gB1 was the predominant genotype in the HCMV-DNA-positive human milk samples, and it could be subdivided into three lineages. There were also some characteristic nucleotides and amino acids in the three HCMV genotypes, which were helpful for distinguishing the genotypes. This is the first study to clarify the HCMV infection status and genetic characteristics of human milk obtained from banks in China, which will be helpful in preventing postnatal HCMV infections and ensuring the safety of human milk banks.
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Affiliation(s)
- Xiaoyu Min
- Medical School, Anhui University of Science and Technology, Huainan, 232001, Anhui, People's Republic of China
| | - Lin Wang
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China
| | - Aili Cui
- NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Centers for Disease Control and Prevention), WHO WPRO Regional Reference Measles/Rubella Laboratory, Beijing, 102206, People's Republic of China
| | - Chunli Zhang
- Department of Neonatal Medicine, Inner Mongolia People's Hospital, Huhhot, 010017, People's Republic of China
| | - Dan Wang
- Department of Obstetrics and Gynecology, Southwest Hospital, The Third Medical University (Army Medical University), Chongqing, 400038, People's Republic of China
| | - Ying Liu
- NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Centers for Disease Control and Prevention), WHO WPRO Regional Reference Measles/Rubella Laboratory, Beijing, 102206, People's Republic of China
| | - Zhenghong Li
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, People's Republic of China.
| | - Wenbo Xu
- Medical School, Anhui University of Science and Technology, Huainan, 232001, Anhui, People's Republic of China. .,NHC Key Laboratory of Medical Virology and Viral Diseases (National Institute for Viral Disease Control and Prevention, Chinese Centers for Disease Control and Prevention), WHO WPRO Regional Reference Measles/Rubella Laboratory, Beijing, 102206, People's Republic of China.
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19
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Cayer MP, Dussault N, de Grandmont MJ, Cloutier M, Lewin A, Brouard D. Evaluation of the Tempo® System: Improving the Microbiological Quality Monitoring of Human Milk. Front Pediatr 2020; 8:494. [PMID: 32984208 PMCID: PMC7492530 DOI: 10.3389/fped.2020.00494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/14/2020] [Indexed: 11/25/2022] Open
Abstract
Background: Bacteriological testing of donor human milk is mostly done both before and after pasteurization to control contamination in the end-product and meet the microbiological standards. Although the plate count method represents a reliable and sensitive technique and is considered the gold standard for bacteriological testing, it is recognized for being time-consuming and requiring qualified personnel. Recently, faster testing technologies, mostly geared toward the food industry, have been developed. Among these, the bioMérieux TEMPO® system uses the most probable number method to assess microbiological content in a semi-automated fashion. Objective: The performances of the TEMPO® system in enumerating bacterial quality indicators in human milk were assessed and compared to the reference plate count method. Methods: Naturally and artificially contaminated human milk samples were used to compare the analytical performances of the TEMPO® system to the plate count technique. More specifically, bacteria belonging to the genera Bacillus, Enterobacteriaceae, Staphylococcus aureus, and total aerobic flora were screened using both methods. Bacteria isolated on agar plates containing selective media were identified by supplemental testing. Bacterial testing results and method parameters were compared using linear regression analyses and Bland-Altman approaches. Results: Naturally contaminated milk samples (n = 55) tested for total aerobic flora showed < 1 log (CFU/ml) discrepancy between the two methods in the output results for 98% of the samples. Comparative linear regression analyses demonstrate good correlations between the two methods (R 2 > 0.9). At lower levels of bacterial contamination, the TEMPO® method precision (C.V. < 8%) and accuracy (> 83%) were comparable to plate counts. Conclusions: The analytical performances of the TEMPO® system for human milk bacteriological testing are equivalent to the reference plate count method. Results from the TEMPO® system are available within a 24-h turnaround time from sample inoculation without the need for further supplemental testing, suggesting that this semi-automated method could be implemented within milk bank operations as an in-process monitoring technology to optimize end-product quality and safety.
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Affiliation(s)
| | | | | | - Marc Cloutier
- Affaires Médicales et Innovation, Héma-Québec, Québec, QC, Canada.,Département de biochimie, Université Laval, Québec, QC, Canada
| | - Antoine Lewin
- Affaires Médicales et Innovation, Héma-Québec, Québec, QC, Canada.,Département d'obstétrique et gynécologie, Université de Sherbrooke, Québec, QC, Canada
| | - Danny Brouard
- Affaires Médicales et Innovation, Héma-Québec, Québec, QC, Canada.,Département de chimie, Université Laval, Québec, QC, Canada
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Yu F, Cao B, Wen Z, Li M, Chen H, Xie G. Is Donated Breast Milk Better Than Formula for Feeding Very Low Birth Weight Infants? A Systematic Review and Meta‐Analysis. Worldviews Evid Based Nurs 2019; 16:485-494. [PMID: 31743577 DOI: 10.1111/wvn.12410] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Fei Yu
- Department of Laboratory Children’s Hospital of Nanjing Medical University Nanjing China
| | - Bo Cao
- Department of Laboratory Children’s Hospital of Nanjing Medical University Nanjing China
| | - Zunjia Wen
- SICU Children’s Hospital of Nanjing Medical University Nanjing China
| | - Meng Li
- Department of Laboratory Children’s Hospital of Nanjing Medical University Nanjing China
| | - Hongbin Chen
- Department of Laboratory Children’s Hospital of Nanjing Medical University Nanjing China
| | - Guojin Xie
- Department of Laboratory Children’s Hospital of Nanjing Medical University Nanjing China
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21
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Capriati T, Goffredo BM, Argentieri M, De Vivo L, Bernaschi P, Cairoli S, Laureti F, Reposi MP, Marino D, Benedetti S, Diamanti A. A Modified Holder Pasteurization Method for Donor Human Milk: Preliminary Data. Nutrients 2019; 11:nu11051139. [PMID: 31121859 PMCID: PMC6566761 DOI: 10.3390/nu11051139] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/18/2019] [Accepted: 05/20/2019] [Indexed: 12/31/2022] Open
Abstract
Background: Holder pasteurization (HoP) is the recommended method of pasteurization for donor human milk (DHM). The aim of the present study was to compare nutritional and microbiological impact on DHM of a new technique of pasteurization based on technical changes of HoP. Methods: We analyzed milk samples from 25 donors. Each sample, derived from one breast milk expression, was subdivided into three aliquots according to pasteurization: The first was not pasteurized, the second pasteurized by HoP, and the third was pasteurized by modified HoP (MHoP). Each aliquot was assessed as to its microbiological and nutritional profile. Nutritional profile included calcium and triglycerides concentrations detected by spectrophotometry and amino acid levels assessed by high-performance liquid chromatography (HPLC). Results: Triglycerides were significantly lower in pasteurized, by both methods, than in not pasteurized aliquots, while calcium and amino acids concentration were similar. Microbiological profile did not differ between HoP and MHoP aliquots. Conclusions: HoP and MHoP seem to have similar efficacy in preserving some nutritional characteristics of DHM and to confer similar microbiological safety. MHoP is time-saving and potentially costs-effective when compared to HoP, and it is; therefore, potentially of more interest from a practical point of view. Further studies are needed to confirm these findings.
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Affiliation(s)
- Teresa Capriati
- Artificial Nutrition Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
| | - Bianca Maria Goffredo
- Biochemistry Laboratory, Department of Specialist Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
| | - Marta Argentieri
- Unit of Microbiology, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
| | - Liliana De Vivo
- Clinical Engineering Department, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
| | - Paola Bernaschi
- Unit of Microbiology, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
| | - Sara Cairoli
- Biochemistry Laboratory, Department of Specialist Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
| | - Francesca Laureti
- Artificial Nutrition Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
| | - Maria Paola Reposi
- Artificial Nutrition Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
| | - Daniela Marino
- Artificial Nutrition Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
| | - Sabina Benedetti
- Biochemistry Laboratory, Department of Specialist Pediatrics, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
| | - Antonella Diamanti
- Artificial Nutrition Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
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Recent development of chromatographic methods to determine parabens in breast milk samples: A review. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1093-1094:82-90. [DOI: 10.1016/j.jchromb.2018.06.059] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 04/10/2018] [Accepted: 06/30/2018] [Indexed: 12/27/2022]
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23
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Froh EB, Vanderpool J, Spatz DL. Best Practices to Limit Contamination of Donor Milk in a Milk Bank. J Obstet Gynecol Neonatal Nurs 2018; 47:547-555. [PMID: 29304316 DOI: 10.1016/j.jogn.2017.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2017] [Indexed: 11/30/2022] Open
Abstract
Human milk donated to a milk bank can become contaminated in a number of ways, but processes exist to eradicate pathogenic bacterial growth. Donor human milk may be cultured before or after pasteurization or both. The purpose of this article is to describe standard operations of the Mothers' Milk Bank of the Children's Hospital of Philadelphia, best practices to limit the bacterial contamination of donor human milk, and implications for future research.
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Kim EJ, Lee NM, Chung SH. A retrospective study on the effects of exclusive donor human milk feeding in a short period after birth on morbidity and growth of preterm infants during hospitalization. Medicine (Baltimore) 2017; 96:e7970. [PMID: 28858132 PMCID: PMC5585526 DOI: 10.1097/md.0000000000007970] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The risks and benefits of feeding preterm formula (PF) versus donor human milk (DHM) in preterm infants are uncertain, and studies evaluating the efficacy of DHM to the morbidities and growth of preterm infants in the neonatal intensive care unit are confused by the need for milk fortification. We aimed to determine and compare the outcome of short-term morbidities in neonatal intensive care unit and growth between premature infants fed exclusively DHM only until a volume of 130 mL/kg/d of enteral feeding was achieved and infants fed with a PF mix after birth. The data of 132 infants with low birth weight of <1500 g and gestational age of less than 32 weeks were considered. Ninety infants were analyzed, of which 86 were discharged alive. The DHM group (n = 36) was made up of infants who were fed exclusively with DHM, whereas the PF group (n = 54) consisted of infants who were fed with a combination of PF and either DHM or human milk, until a volume of 130 mL/kg/d of enteral feeding was achieved. Once feeding in the DHM group progressed to volumes greater than 130 mL/kg/d, infants were fed fortified DHM and PF alternately. One infant (2.8%) in the DHM group had late-onset sepsis or necrotizing enterocolitis compared with 21 (38.9%) in the PF group (adjusted odds ratio 0.05, 95% confidence interval 0.01-0.41); 13 (36.1%) infants in the DHM group had bronchopulmonary dysplasia compared with 38 (70.4%) in the PF group (odds ratio 0.18, 95% confidence interval 0.05-0.41). Although the DHM group demonstrated a comparatively lower rate of weight gain, head circumference increment, and height increment from birth to the age at which an enteral feeding volume of 130 mL/kg/d was achieved, there were no significant differences in these values at 36 weeks' postmenstrual age between both groups.
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Affiliation(s)
- Eun Jeong Kim
- Department of Pediatrics, Kyung Hee University School of Medicine
| | - Na Mi Lee
- Department of Pediatrics, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Sung-Hoon Chung
- Department of Pediatrics, Kyung Hee University School of Medicine
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Cho H, Shin J, Yun HR, Kim J, Choi CW, Jung YH, Kim BI. Decreased Incidence of Necrotizing Enterocolitis after Introduction of Exclusive Breast Milk Feeding in a Single Neonatal Intensive Care Center. NEONATAL MEDICINE 2017. [DOI: 10.5385/nm.2017.24.3.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Hannah Cho
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Jeongmin Shin
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Hye Ri Yun
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Jihyun Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Chang Won Choi
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Young Hwa Jung
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Beyong Il Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
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