Maintaining safety and service provision in human milk banking: a call to action in response to the COVID-19 pandemic

Shenker, Natalie; Aprígio, João; Arslanoğlu, Sertaç; Aye, Nant San San; Bærug, Anne; Yam, Naomi Bar; Barnett, Debbie; Bellad, Roopa; Bertino, Enrico; Adhisivam, B; Bharadva, Ketan; Olin, Anne Bille; Billeaud, Claude; Buffin, Rachel; Cassidy, Tanya; Sachdeva, Ruchika; Clifford, Vanessa; Coutsoudis, Anna; Deb, Sibnath; Domjan, Andreja; Fang, Li Jung; Festival, Janette; Franks, Anthea; García-Lara, Nadia Raquel; Gayà, Antoni; Golubiú-Úepuliú, Branka; Groff, Lindsay; Grøvslien, Anne; Spence, Erin Hamilton; Heidarzadeh, Mohammad; Hosseini, Mohammadbagher; Hughes, Jackie; Israel‐Ballard, Kiersten; Jain, Kajal; Jain, Suksham; Jayaraman, Selvaraj; Jones, F. S.; Kale, Pratibha; Kasar, Jayendra; Kithua, Angela; Klein, Laura D; Klotz, Daniel; Lin, Yungchieh; Xi-hong, Liu; Borman, Laraine Lockhart; Lundstrom, Josefin; Malzacher, Andreas; Mansen, Kimberly; Mathisen, Roger; Mileusnić-Milenović, Radmila; Moe, Zaw Win; Moro, Guido E.; Mukherjee, Suchandra; Myint, San San; Nangia, Sushma; Ngerncham, Sopapan; Njeru, Faith; Olonan-Jusi, Estrella J.; Opie, Gillian; Palmquist, Aunchalee E. L.; Reimers, Penny; Saboute, Maryam; Sakamoto, Pauline; Sanchez, Sybil; Singh, Himabindu; Singh, Jai; Singh, Poonam; Staff, Marta; Sulfaro, Christine; Hoang, Tran Thi; Tiit-Vesingi, Annika; Tiwari, Satish; Goudoever, Johannes B. van; Vickers, Amy; Waiyego, Mary; Weaver, Gillian; Wesołowska, Aleksandra; Wright, Jenny

doi:10.1016/s2352-4642(20)30134-6

Cited by 41 publications

(49 citation statements)

References 8 publications

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“…As the COVID-19 pandemic evolves, human milk banks world-wide continue to provide donor human milk to vulnerable infants who lack access to mother's own milk. 1 Under these circumstances, ensuring the safety of donor human milk is paramount, as the risk of vertical transmission of SARS-CoV-2 is not fully understood. 2 Although case series have reported that SARS-CoV-2 was not detected in breast milk, 3 there have been recent case reports 4,5 of SARS-CoV-2 detected in breast milk from women with symptomatic COVID-19 infection.…”

Section: What This Paper Addsmentioning

confidence: 99%

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SARS‐CoV‐2 in human milk is inactivated by Holder pasteurisation but not cold storage

Walker

Clifford

Bansal

et al. 2020

J Paediatrics Child Health

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Aim As the COVID‐19 pandemic evolves, human milk banks world‐wide continue to provide donor human milk to vulnerable infants who lack access to mother's own milk. Under these circumstances, ensuring the safety of donor human milk is paramount, as the risk of vertical transmission of SARS‐CoV‐2 is not fully understood. Here, we investigate the inactivation of SARS‐CoV‐2 in human milk by pasteurisation and the stability of SARS‐CoV‐2 in human milk under cold storage. Methods SARS‐CoV‐2 was experimentally inoculated into human milk samples from healthy donors or into a control medium. Triplicates of each sample were layered onto uninfected cells after Holder pasteurisation (63°C for 30 min), heating to 56°C for 30 min, or after 48 h of storage at 4°C or −30°C. Infectious titres of virus were determined at 72 h post‐infection by endpoint titration. Results Following heating to 63°C or 56°C for 30 min, replication competent (i.e. live) SARS‐CoV‐2 was undetected in both human milk and the control medium. Cold storage of SARS‐CoV‐2 in human milk (either at 4°C or −30°C) did not significantly impact infectious viral load over a 48 h period. Conclusion SARS‐CoV‐2 is effectively inactivated by Holder pasteurisation, suggesting that existing milk bank processes will effectively mitigate the risk of transmission of SARS‐COV‐2 to vulnerable infants through pasteurised donor human milk. The demonstrated stability of SARS‐CoV‐2 in refrigerated or frozen human milk may assist in the development of guidelines around safe expressing and storing of milk from COVID‐19 infected mothers.

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Section: What This Paper Addsmentioning

confidence: 99%

“…2 Although low, the potential risk of SARS-CoV-2 transmission through human milk is concerning for milk banks globally. 1 Here, we investigate the inactivation by pasteurisation of SARS-CoV-2 experimentally inoculated in to human milk and the stability of SARS-CoV-2 in human milk under cold storage (freezing or refrigeration).…”

Section: What This Paper Addsmentioning

confidence: 99%

SARS‐CoV‐2 in human milk is inactivated by Holder pasteurisation but not cold storage

Walker

Clifford

Bansal

et al. 2020

J Paediatrics Child Health

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“…A Virtual Communication Network of milk bank leaders started to form on March 17, 2020 and now has more than 80 members from 34 countries. [29] If both mother and infant are positive for infection, separation is not necessary. [30] If women choose to administer formula feed, the healthy caregiver is preferred for the same.…”

Section: Breastfeedingmentioning

confidence: 99%

Pregnancy and Coronavirus Disease 19

Shankar

Nishanth

2020

Integr J Med Sci

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As Coronavirus disease 2019 (COVID 19) is declared a global pandemic. Management of expecting mothers and newborn care becomes a great challenge to the physicians and their family. They should follow same guidelines as the general population to avoid exposure to the virus as much as possible. Pregnancy does not seem to increase the risk of infection nor accelerate its natural history or the severity of illness. Routine prenatal-antenatal care should be home monitored and tele-medicine encouraged as much as possible. Women with comorbidities or at high risk of infection such as recent history of travel, from a containment zone, history of primary or secondary contact should be closely monitored for symptoms. RT PCR is recommended prior to labour or one day prior to elective surgery. Supportive treatment is important in infected patients. Low molecular weight heparin can be used for thromboprophylaxis in severe illness. Data on use of Remdesivir, hydroxychloroquine, Lopinavir-Ritonavir are limited. There is limited data on placental transmission of the virus. Newborn should also be immediately be tested following delivery of a COVID19 pregnant women. If newborn is found to be negative, strict hygienic measures according to CDC should be followed to express breast milk. According to WHO, breast milk banks are a safe alternative. Few mothers may prefer to give formula feeds, which can be administered by healthy care givers. There is limited data regarding transmission of virus through breast milk.

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“…Globally, efforts are on to address such challenges. Recently, a virtual group consisting of members from 37 countries has been formed to facilitate the sharing of information and best practices and discussion of evidence to prepare human milk banks to deal with COVID-19 challenges [15].…”

Section: Ensuring Access To Human Milkmentioning

confidence: 99%

“…PDHM provided during any COVID-19 related separation, should be coupled with optimal lactation support to ensure maternal milk supply at the earliest. This reduces the excess demand for PDHM which can be given to those who need it the most [15]. Guidelines by professional bodies suggest greater vigilance and modification of donor screening procedures [11].…”

Section: Donor Human Milkmentioning

confidence: 99%

Ensuring Exclusive Human Milk Diet for All Babies in COVID-19 Times

et al. 2020

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The coronavirus disease (COVID-19) pandemic has ramifications for the delivery of newborn nutrition and care services. World Health Organization recommends continuation of breastfeeding in these difficult times, with due precautions. If direct breastfeeding is not possible, milk expression should be explored. Pasteurized donor human milk from milk banks may be fed if mother's own milk is not available. To universalize access to human milk, the Indian government has proposed the establishment of comprehensive lactation management centers/milk banks, lactation management units, and lactation support units at all levels of the public health system. Due to COVID-19, these centers are encountering additional challenges cutting across interventions of rooming in, breastfeeding, milk expression, and provision of donor milk and kangaroo mother care. We discuss issues faced and alleviation measures taken by these centres in relation to provision of an exclusive human milk diet for infants during the pandemic.

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Maintaining safety and service provision in human milk banking: a call to action in response to the COVID-19 pandemic

Abstract: 3 Sarna A, Porwal A, Ramesh S, et al. Characterisation of the types of anaemia prevalent among children and adolescents aged 1-19 years in India: a population-based study.

Cited by 41 publications

References 8 publications

SARS‐CoV‐2 in human milk is inactivated by Holder pasteurisation but not cold storage

SARS‐CoV‐2 in human milk is inactivated by Holder pasteurisation but not cold storage

Pregnancy and Coronavirus Disease 19

Ensuring Exclusive Human Milk Diet for All Babies in COVID-19 Times

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