The correlation between Dornic acidity and bacterial growth in donor milk is weak but positive. The measurement of Dornic acidity could be considered as a simple and economical method to select milk to pasteurize in a human milk bank based in quality and safety criteria.

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Donor milk with a pH over 6.57 may be accepted for subsequent processing in the milk bank. Moreover, the pH measurement seems to be more useful due to certain advantages over the Dornic method, such as objectivity, accuracy, standardization, the lack of chemical reagents required, and the fact that it does not destroy the milk sample.

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AimTo assess, at national level, the implementation of eight principles for infant‐ and family‐centred developmental care (IFCDC) in neonatal units. A European expert group established eight ‘Principles of care’ in 2018 that define neurodevelopmental and family‐centred care.MethodsThe implementation of each principle was assessed by a survey sent to level‐III Spanish units. A principle was considered to be implemented if all answers to the principle‐associated questions were positive.ResultsThe response rate was 84.5% (65/77). No unit had implemented eight principles. Principle 1 (free parental access) was implemented in 21.5% of the centres; Principle 2 (psychological support) 40%; Principle 3 (pain management) 7.7%; Principle 4 (environmental influences) 29%; Principle 5 (postural support) 84.6%; Principle 6 (kangaroo‐care) 67.7%; Principle 7 (breastfeeding) 23% and Principle 8 (sleep protection) in 46%. In units attending ≥50 very low birth weight (VLBW) infants, four or more principles had been implemented in 31% vs 13% <50 VLBW neonates (odds ratio 3.0 CI 95% 0.9‐10.1, P .07).ConclusionThe principle with the highest implementation was related to newborn body positioning. Pain management was the principle with lowest implementation. More principles for IFCDC tend to be implemented in units providing care for a higher number of VLBW infants.

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Dear Editor, We have attentively read the Vickers et al 1 article about storage of pasteurized donor human milk (PDHM) at 4ºC for 96 hours. In this study, its authors resolve that there was no evidence of microbes in PDHM that had been defrosted and stored at 4ºC for up to 9 days. Previously, Slutzah et al 2 had shown how bacterial growth in fresh milk remained unchanged for 96 hours and, therefore, concluded that fresh mother's milk may be stored at refrigerator temperature for as long as 96 hours. However, they also showed how fresh milk's pH significantly decreased during this refrigeration period (from 7.21 to 6.68 over 96 hours of storage), which relates to the increase in free fatty acids. Although fresh milk appears to be safe after 96 hours of refrigeration, the acidification that takes place in this process may alter its quality. Acid milk seems to hinder calcium absorption; its proteins become thermosensitive and changes in the milk's cellular content have also been described. 3 In this same article, apart from 36 fresh milk samples, Slutzah 2 also analyzes pH evolution in 5 samples of PDHM during refrigeration and points out that it barely suffers any modifications (pH of 6.3 ± 0.1). Our team analyzed changes in pH in 30 PDHM samples stored at 4ºC for 96 hours, and we observed that the pH hardly varies (from 7.56 to 7.58). These results, together with those of Vickers, 1 suggest that PDHM stored at 4ºC for up to 96 hours remains safe regarding bacterial growth and quality due to pH stability. However, our attention is drawn to the low pH values for PDHM reported in Slutzah's article in comparison to the ones that our team obtained. The average pH values reported for fresh milk range from 7.68 to 7.07 with a median of 7.56, 4 which are very similar to those obtained in our study. In a previous research study, it was also established that the minimum acceptable pH for subsequent processing of milk in the bank would be 6.57. 5 The pH that Slutzah 2 reported for PDHM is below this limit.