Improving Pasteurization to Preserve the Biological Components of Donated Human Milk

Abstract

Donor human milk (DHM) in human milk banks (HMB) is routinely subjected to heat treatment to ensure microbiological security, most guidelines recommending a temperature of 62. 5°C for 30 min. However, this procedure negatively impacts on milk quality, due to the destruction of biological components. Different studies have called for a more respectful treatment of DHM to preserve its properties, and have explored the use of alternative technologies. There is also clear evidence that bacterial and viral contamination in human milk can be effectively destroyed by temperatures lower than that currently recommended (62.5°C). Thus, a simple option would be to optimize the conventional pasteurization technique so the treated milk is free of infectious elements yet retains a maximum amount of biological components. An advantage of this approach is that it would be unnecessary to replace the pasteurization equipment currently available in most HMB. On the basis of a literature review, we here analyze and discuss evidence that pasteurization of human milk at a temperature below 62.5°C results in an improved preservation of its properties without compromising safety regarding the transmission of infectious agents.

Is Donated Breast Milk Better Than Formula for Feeding Very Low Birth Weight Infants? A Systematic Review and Meta‐Analysis

“…In this case, donated breast milks or infant formulas act as the substitutes for nutritional support, but the safety and efficacy of these two feeding methods merit further verifications (García Lara & Peña Caballero, ). The disinfection process of donated breast milk may affect its nutritional value and immune components and are therefore many ways in which breast milk is donated informally in name of “sharing” with potential risks; its clinical application effect is also questioned in this way (ESPGHAN Committee on Nutrition et al, ; Gaya & Calvo, ). While for formula, its ingredients and related proportion may exert great influence on the prognosis of infants (Jia et al, ; Kent, ), it is still necessary to further address the role of donated breast milk and formula use in feeding infants.…”

Analysis of Thermal Sensitivity of Human Cytomegalovirus Assayed in the Conventional Conditions of a Human Milk Bank

“…Therefore, the aim of this work has been to evaluate the temperature sensitivity of HCMV during the processing of donor breast milk under the same conditions that are commonly used in human milk banks. If it is confirmed that HCMV is destroyed at temperatures lower than that used in Holder pasteurization, as shown in the literature for most infectious agents (16,17), the possibility of a thermal treatment of donated milk more respectful with its biological components would be possible and this would be beneficial for the receptors.…”

“…The authors conclude that the current practice, Holder pasteurization, may be considered as excessive for pasteurizing human milk donated to the milk banks. This overheating is probably explained, as we discussed in a previous paper (16), because the temperature chosen to pasteurize in the human milk banks, 62.5 • C for 30 min, comes from data obtained with cow's milk in dairy industry and not from a systematic analysis using human milk. It should be noted that the analysis was done by using an experimental pasteurizer, designed specifically for that study and not in the conventional conditions of a human milk bank.…”

“…There are clear evidences that temperatures lower than those recommended nowadays (Holder pasteurization; 30 min at 62.5 • C) are less deleterious with the biological components of milk, whereas, retaining the capacity to destroy bacterial and viral [HIV, HTLV-I, Polioviruses, Chikungunya Virus (CHIKV), West Nile Virus (WNV)] contaminations in donor human milk (16,17). Unfortunately, there are few data about the sensitivity of Human Cytomegalovirus (HCMV) to the range of temperatures between 56 and 63 • C. In a recent paper (18) Maschmann et al, concluded that temperatures above 60 • C for performing short-term pasteurization are enough for the purpose of CMV inactivation.…”

Examining weight gain: A retrospective study on preterm newborn growth on a diet exclusively of fortified donor breast milk

“…While retaining many of the properties inherent in MOM, the pasteurization process needed to make DBM safe for use for feeding to PTNBs can reduce or destroy some of the beneficial qualities of human milk (14). Research comparing the growth of PTNBs fed with MOM to those fed with PDBM have reported reduced growth in infants receiving the PDBM (15).…”