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

Frontiers in Pediatrics

article

Guido E. Moro¹  Aleksandra Wesolowska²  Sertac Arslanoglu³  Debbie Barnett⁴  Enrico Bertino⁵  Clair-Yves Boquien⁶  Corinna Gebauer⁷  Anne Grovslien⁸  Gillian A. Weaver⁹  Jean-Charles Picaud^1,10  Claude Billeaud^1,12  Buffin Rachel^1,10  Javier Calvo^1,13  Laura Cavallarin^1,14  Lukas Christen^1,15  Diana Escuder-Vieco^1,16  Antoni Gaya^1,13  David Lembo^1,17 

[1] Associazione Italiana delle Banche del Latte Umano Donato;Department of Neonatology, Faculty of Health Science, Medical University of Warsaw;Division of Neonatology, Department of Pediatrics, Istanbul Medeniyet University;Royal Hospital for Sick Children, United Kingdom;Neonatal Unit of Turin University, City of Health and Science;Institut National de la Recherche Agronomique, Université de Nantes;Abteilung Neonatologie Klinik und Poliklinik für Kinder und Jugendliche;Oslo University Hospital;Imperial College Healthcare NHS Trust, United Kingdom;Lactarium Auvergne Rhone Alpes, Hospices Civils de Lyon, Lyon;CarMeN Unit, Claude Bernard University Lyon 1;CIC Pédiatrique 1401 Children's Hospital;Fundació Banc Sang i Teixits de les Illes Balears;Institute of Sciences of Food Production, National Research Council;CARAG AG;Hospital Universitario 12 de Octubre;Laboratory of Molecular Virology, Department of Clinical and Biological Sciences, University of Turin

关键词: processing of human milk;    donor human milk;    human milk;    human milk bank;    preterm infants;    infant nutrition;   

DOI  :  10.3389/fped.2019.00049

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

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.

【 授权许可】

CC BY