Processing of Donor Human Milk: Update and Recommendations From the European Milk Bank Association (EMBA)

Frontiers in Pediatrics. 2019;7 DOI 10.3389/fped.2019.00049

 

Journal Homepage

Journal Title: Frontiers in Pediatrics

ISSN: 2296-2360 (Online)

Publisher: Frontiers Media S.A.

LCC Subject Category: Medicine: Pediatrics

Country of publisher: Switzerland

Language of fulltext: English

Full-text formats available: PDF, HTML, ePUB, XML

 

AUTHORS


Guido E. Moro (Associazione Italiana delle Banche del Latte Umano Donato, Milan, Italy)

Claude Billeaud (Neonatology Nutrition, Lactarium Bordeaux-Marmande, CIC Pédiatrique 1401 Children's Hospital, Bordeaux, France)

Buffin Rachel (Lactarium Auvergne Rhone Alpes, Hospices Civils de Lyon, Lyon, France)

Javier Calvo (Fundació Banc Sang i Teixits de les Illes Balears, Palma de Mallorca, Spain)

Laura Cavallarin (Institute of Sciences of Food Production, National Research Council, Turin, Italy)

Lukas Christen (CARAG AG, Baar, Switzerland)

Diana Escuder-Vieco (Banco Regional de Leche Materna, Hospital Universitario 12 de Octubre, Madrid, Spain)

Antoni Gaya (Fundació Banc Sang i Teixits de les Illes Balears, Palma de Mallorca, Spain)

David Lembo (Laboratory of Molecular Virology, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy)

Aleksandra Wesolowska (Department of Neonatology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland)

Sertac Arslanoglu (0Division of Neonatology, Department of Pediatrics, Istanbul Medeniyet University, Istanbul, Turkey)

Debbie Barnett (1Greater Glasgow and Cycle Donor Milk Bank, Royal Hospital for Sick Children, Glasgow, United Kingdom)

Enrico Bertino (2Neonatal Unit of Turin University, City of Health and Science, Turin, Italy)

Clair-Yves Boquien (3PhAN, Institut National de la Recherche Agronomique, Université de Nantes, CRNH-Ouest, Nantes, France)

Corinna Gebauer (4Abteilung Neonatologie Klinik und Poliklinik für Kinder und Jugendliche, Leipzig, Germany)

Anne Grovslien (5Breast Milk Bank, Oslo University Hospital, Oslo, Norway)

Gillian A. Weaver (6The Milk Bank, Imperial College Healthcare NHS Trust, London, United Kingdom)

Jean-Charles Picaud (Lactarium Auvergne Rhone Alpes, Hospices Civils de Lyon, Lyon, France)

Jean-Charles Picaud (7CarMeN Unit, INSERM U1397, Claude Bernard University Lyon 1, Lyon, France)

EDITORIAL INFORMATION

Blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 14 weeks

 

Abstract | Full Text

Background: A mother's own milk (MOM) is the gold standard for the feeding and nutrition of preterm and full term infants. When MOM is not available or there is not enough, donor human milk (DHM) should be used. Milk delivered to Human Milk Banks (HMBs) should be pasteurized to inactivate viral and bacterial agents. Currently, a pasteurization process at 62.5°C for 30 min (Holder pasteurization, HoP) is recommended in all international HMBs guidelines.State of the art: It is known that HoP affects some of the nutritional and biological components of human milk. Studies have demonstrated that temperature cycle in HoP is not always controlled or calibrated. A better check of these parameters in the pasteurizers on the market today may contribute to an improvement of the quality of HM, still maintaining some of the negative effects of the heat treatment of human milk. So, food industry, and dairy industry in particular, are evaluating innovative methodologies alternative to HoP to better preserve the nutritional and biological properties of fresh human milk, while assuring at least the same microbiological safety of HoP. The most studied processing techniques include High-Temperature-Short-Time (HTST) pasteurization, High Pressure Processing (HPP), and Ultraviolet-C (UV-C) irradiation. HTST is a thermal process in which milk is forced between plates or pipes that are heated on the outside by hot water at a temperature of 72°C for 5–15 s. HPP is a non-thermal processing method that can be applied to solid and liquid foods. This technology inactivates pathogenic microorganisms by applying a high hydrostatic pressure (usually 300–800 MPa) during short-term treatments (<5–10 min). UV irradiation utilizes short-wavelength ultraviolet radiation in the UV-C region (200–280 nm), which is harmful to microorganisms. It is effective in destroying the nucleic acids in these organisms, so that their DNA is disrupted by UV radiation.Aim: The aim of this paper is to present the EMBA recommendations on processing of HM, based on the most recent results obtained with these new technologies.Conclusions: Although research on the most promising technologies that will represent an alternative to HoP (HTST, HPP, UV-C) in the future is progressing, it is now important to recognize that the consistency and quality assurance of the pasteurizers on the market today represent a fundamental component that was previously lacking in the Holder approach.