Hygiene Aspects of Premature Nutrition

Abstract

The very low birth weight and the not fully developed immune system make preterm infants especially susceptible to infections. Therefore microbiological food safety of preterm nutrition is a particular challenge. This is also due to the fact that breastfeeding is often not possible in these infants. There are several obstacles to breastfeeding, such as intensive care conditions and individual nutritional requirements of the newborn. The chapter covers the microbiological aspects of preterm nutrition, including quality requirements for commercial infant formulas, breastmilk fortifiers and extracted breast milk. The main pathogens of concern (e.g. Cronobacter spp. Salmonella spp. and Clostridium botulinum) are discussed in detail, including related food safety indicators. An important part of the chapter is devoted to the hygienic aspects of preterm formula preparation techniques, storage conditions and microbiological risks linked to certain feeding techniques (e.g. tube feeding). The risks associated with microorganisms found in commercial infant formula and in the prepared environment, as well as the risk of biofilm formation, are described. Options and requirements for risk mitigation are discussed in detail.