What are Optimal Bacteriological Screening Test Cut-Offs for Pasteurized Donor Human Milk Intended for Feeding Preterm Infants?

2020 ◽  
pp. 089033442098101
Author(s):  
Vanessa Clifford ◽  
Laura D. Klein ◽  
Christine Sulfaro ◽  
Tass Karalis ◽  
Veronica Hoad ◽  
...  
Keyword(s):  
Human Milk ◽  
Clinical Excellence ◽  
Screening Criteria ◽  
Acceptance Criterion ◽  
Donor Human Milk ◽  
Safety Risks ◽  
Food Standards ◽  
Milk Bank ◽  
Microbial Screening ◽  
The Impact

Background Definitive criteria for microbial screening of pasteurized donor human milk are not well established and international recommendations vary. Aims (1) To review pasteurized donor human milk batch discard due to failed microbial screening criteria at our milk bank (following United Kingdom National Institute of Clinical Excellence guidelines), and (2) to compare our known milk discard proportion with estimated milk discard proportions that would be required by other international milk bank guidelines. Methods We reviewed our microbial screening results ( N = 783) over 18-months (July 2018-December 2019) and compared our known milk discard proportion with estimated milk discard proportions using other international milk bank guidelines. Results Of samples, n = 50 (6.4%) failed pre-pasteurization screening, most commonly due to the presence of >104 CFU/mL Enterobacterales in the pre-pasteurization sample ( n = 30; 3.8%). Two (0.3%) samples failed post-pasteurization screening, with Bacillus cereus identified in both cases, resulting in total discard proportion of 6.7% ( n = 52) of batches. Applying European Milk Bank Association recommended bacterial screening criteria, approximately 23.3% ( n = 183) of milk batches would have been discarded. Conclusions Further research is required to justify the stringent European Milk Bank Association recommendations for pre-pasteurization discard criteria, although we believe that a post-pasteurization acceptance criterion of <1 CFU/mL is appropriate and aligns with international guidance. Further work is needed to understand pasteurized donor human milk microbiological safety risks, to better integrate screening criteria within current food standards regulation, and to consider risk-based assessment including the impact on availability and affordability.

scholarly journals BACTERIOLOGICAL ANALYSIS OF DONOR HUMAN MILK IN MILK BANK IN AN INDIAN SETTING

2017 ◽  
Vol 04 (01) ◽  
pp. 7-9 ◽  
Author(s):  
Poonam H Singh ◽  
Amita Uday Surana ◽  
Vaishali Chaudhari
Keyword(s):  
Human Milk ◽  
Bacteriological Analysis ◽  
Donor Human Milk ◽  
Milk Bank ◽  
Indian Setting

scholarly journals SARS-CoV-2 in human milk is inactivated by Holder pasteurization but not cold storage

2020 ◽  
Author(s):  
Gregory J. Walker ◽  
Vanessa Clifford ◽  
Nidhi Bansal ◽  
Alberto Ospina Stella ◽  
Stuart Turville ◽  
...  
Keyword(s):  
Viral Load ◽  
Human Milk ◽  
Cold Storage ◽  
Control Medium ◽  
Live Virus ◽  
Donor Human Milk ◽  
Milk Bank ◽  
The Stability ◽  
Milk Banks ◽  
Mother’S Own Milk

ABSTRACTAs the COVID-19 pandemic evolves, human milk banks worldwide 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 well 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 (freezing or refrigeration). Following heating to 63°C or 56°C for 30 minutes, SARS-CoV-2 replication competent (i.e. live) virus 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 hour period. Our findings demonstrate that SARS-CoV-2 can be effectively inactivated by Holder pasteurisation, and confirm that existing milk bank processes will effectively mitigate the risk of transmission of SARS-COV-2 to vulnerable infants through pasteurised donor human milk.

Human milk bank as a strategy for the nursing care to the newborn

2011 ◽  
Vol 6 (1) ◽  
pp. 188
Author(s):  
Quezia Cristina da Silva Simões Lessa ◽  
Fernanda Almenara Silva Dos Santos ◽  
Inês Maria Diniz Da Horta ◽  
Rita de Cássia Ramos Medeiros
Keyword(s):  
Human Milk ◽  
Breast Feeding ◽  
Nursing Care ◽  
Rio De Janeiro ◽  
Observational Research ◽  
Milk Bank ◽  
De Se ◽  
Human Milk Bank ◽  
The Impact ◽  
De Medicina

ABSTRACTObjective: to evaluate the impact of the human milk bank (HMB) on the nursing care to the newborn and her/his family and highlight the importance of this strategy for the nurse's work. Method: this is an observational research with a qualitative approach, consisting in the experience lived by university students from the undergraduate Nursing course during their 5th semester and the experience of nursing professionals, accomplished through the practice of performing educative activities in the HMB of a university hospital, in 2010, in Rio de Janeiro, Brazil. The research was approved by the Research Ethics Committee of Faculdade de Medicina/Hospital Universitario Antonio Pedro (CEP CMM/HUAP), under the Protocol 129/08. The experiences lived were reported in a field diary and posteriorly analyzed. Results: It was observed that anxiety, along with maternal  fears, collaborate to increase the difficulty in the process of breast feeding (BF). This fact reflects the unqualified prenatal care, the importance of the education process for preventing complications in the BF during the puerperium, and the importance of having a quiet and adequate environment for these practices, which is HMB. Besides, one can notice that the work of HMB with regard to these women provides an increase in the quality of life of the mother, the baby, and the whole community around them. Conclusion: one stresses the need for creating systematic nursing actions that contribute to a better treatment offered to these women, considering the impact that the nursing actions in HMB have on them. Descriptors: nursing care; breast feeding; infant, newborn.RESUMOObjetivo: avaliar o impacto do banco de leite humano (BLH) no cuidado de enfermagem ao neonato e seus familiares e destacar a importância dessa estratégia para o trabalho do enfermeiro. Metodologia:  trata-se de pesquisa observacional com abordagem qualitativa, consistindo na experiência vivenciada por acadêmicas do curso de graduação em Enfermagem durante o 5º período e na experiência de profissionais de enfermagem, concretizada na prática com a realização de atividades educativas no BLH de um hospital universitário, em 2010, no Rio de Janeiro. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da Faculdade de Medicina/Hospital Universitário Antônio Pedro (CEP CMM/HUAP), sob o Protocolo n. 129/08. As experiências vivenciadas foram relatadas num diário de campo e posteriormente analisadas. Resultados: observou-se que a ansiedade, unida aos medos maternos, colaboram para o aumento da dificuldade no processo de aleitamento materno (AM). Tal fato reflete o atendimento pré-natal desqualificado, a importância do processo de educação para prevenção de complicações no AM durante o puerpério e a importância de se ter um ambiente tranquilo e adequado para essas práticas, que é o BLH. Além disso, pode-se notar que a atuação do BLH em relação a essas mulheres proporciona o aumento da qualidade de vida da mãe, do bebê e de toda comunidade ao redor destes. Conclusão: ressalta-se a necessidade de criar ações sistematizadas de enfermagem que contribuam para um melhor atendimento oferecido a essas mulheres, dado o impacto que as ações de enfermagem no BLH geram sobre estas. Descritores: cuidado de enfermagem; aleitamento materno; recém-nascidoRESUMENObjetivo: evaluar el impacto del banco de leche humana (BLH) en la atención de enfermería al neonato y sus familiares y resaltar la importancia de esa estrategia para el trabajo del enfermero. Método: esta es una investigación observacional con abordaje cualitativo, consistiendo en la experiencia vivida por académicas del curso de graduación en Enfermería durante el 5º periodo y en la experiencia de profesionales de enfermería, concretizada en la práctica con la realización de actividades educativas en el BLH de un hospital universitario, en 2010, en Rio de Janeiro, Brasil. La investigación fue aprobada por el Comité de Ética en Investigación de la Faculdade de Medicina/Hospital Universitário Antônio Pedro (CEP CMM/HUAP), bajo el Protocolo 129/08. Las experiencias vividas fueron relatadas en un diario de campo y analizadas posteriormente. Resultados: se observó que la ansiedad, junto con los miedos maternos, colaboran con el aumento  de la dificultad en el proceso de lactancia materna (LM). Ese facto refleja la atención prenatal descalificada, la importancia del proceso de educación para prevención de complicaciones en el LM durante el puerperio y la importancia de se tener un ambiente tranquilo y adecuado para esas prácticas, que es el BLH. Además, es posible notar que la actuación del BLH con relación a esas mujeres proporciona el aumento de la calidad de vida de la madre, del bebé y de toda la comunidad en torno de ellos. Conclusión:  resaltase la necesidad de crear acciones sistematizadas de enfermería que contribuyan para un mejor atendimiento ofrecido a esas mujeres, dado el impacto que las acciones de enfermería en el BLH generan sobre estas. Descriptores: atención de enfermería; lactancia materna; recién nacido.

scholarly journals Addition of Calcium and Phosphorus to Preterm Donor Human Milk and the Impact on Protein, Fat, and Calcium Digestibility In Vitro

2012 ◽  
Vol 4 (4) ◽  
pp. 199-206 ◽  
Author(s):  
April Danielle Fogleman ◽  
Ronald S. Cohen ◽  
Pauline Sakamoto ◽  
Jonathan C. Allen
Keyword(s):  
Human Milk ◽  
Donor Human Milk ◽  
Calcium And Phosphorus ◽  
The Impact

Ebola Virus and Marburg Virus in Human Milk Are Inactivated by Holder Pasteurization

2017 ◽  
Vol 33 (2) ◽  
pp. 351-354 ◽  
Author(s):  
Erin Hamilton Spence ◽  
Monica Huff ◽  
Karen Shattuck ◽  
Amy Vickers ◽  
Nadezda Yun ◽  
...  
Keyword(s):  
Human Milk ◽  
Ebola Virus ◽  
Culture Media ◽  
Plaque Assay ◽  
Marburg Virus ◽  
Donor Human Milk ◽  
Milk Bank ◽  
Viral Plaque ◽  
High Risk Infants ◽  
Milk Banks

Background: Potential donors of human milk are screened for Ebola virus (EBOV) using standard questions, but testing for EBOV and Marburg virus (MARV) is not part of routine serological testing performed by milk banks. Research aim: This study tested the hypothesis that EBOV would be inactivated in donor human milk (DHM) by standard pasteurization techniques (Holder) used in all North American nonprofit milk banks. Methods: Milk samples were obtained from a nonprofit milk bank. They were inoculated with EBOV (Zaire strain) and MARV (Angola strain) and processed by standard Holder pasteurization technique. Plaque assays for EBOV and MARV were performed to detect the presence of virus after pasteurization. Results: Neither EBOV nor MARV was detectable by viral plaque assay in DHM or culture media samples, which were pasteurized by the Holder process. Conclusion: EBOV and MARV are safely inactivated in human milk by standard Holder pasteurization technique. Screening for EBOV or MARV beyond questionnaire and self-deferral is not needed to ensure safety of DHM for high-risk infants.

scholarly journals Human milk banks in the response to COVID-19: a statement of the regional human milk bank network for Southeast Asia and beyond

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Estrella Olonan-Jusi ◽  
Paul G. Zambrano ◽  
Vu H. Duong ◽  
Nguyen T. T. Anh ◽  
Nant S. S. Aye ◽  
...  
Keyword(s):  
Southeast Asia ◽  
Human Milk ◽  
Newborn Care ◽  
World Health ◽  
National Guidelines ◽  
Donor Human Milk ◽  
Skin Contact ◽  
Milk Bank ◽  
Human Milk Bank ◽  
Milk Banks

Abstract Background The World Health Organization (WHO) recommendations on infant feeding in the context of COVID-19 uphold standing recommendations for breastfeeding, non-separation, and skin-to-skin contact, including the use of donor human milk when mother’s own milk is not available. Insufficient guidance on the use of donor human milk and the role of human milk banks in the pandemic response COVID-19 clinical management guidelines in seven countries in Southeast Asia are not aligned with WHO recommendations despite the lack of evidence of transmission through either breastmilk or breastfeeding. The use of safe donor human milk accessed through human milk banks is also insufficiently recommended, even in countries with an existing human milk bank, leading to a gap in evidence-based management of COVID-19. This highlights long-standing challenges as well as opportunities in the safe, equitable, and resilient implementation of human milk banks in the region. Conclusions This statement reflects the expert opinion of the Regional Human Milk Bank Network for Southeast Asia and Beyond on the need to revisit national guidelines based on the best evidence for breastfeeding during the COVID-19 pandemic, to incorporate human milk bank services in national obstetric and newborn care guidelines for COVID-19 where possible, and to ensure that operations of human milk banks are adapted to meet the needs of the current pandemic and to sustain donor human milk supply in the long-term. The Network also recommends sustained engagement with the global human milk bank community.

scholarly journals The Impact of Homogenization on Donor Human Milk and Human Milk-Based Fortifiers and Implications for Preterm Infant Health

2021 ◽  
Author(s):  
Sarah M Reyes ◽  
Biranchi Patra ◽  
Melinda J Elliott
Keyword(s):  
Human Milk ◽  
Preterm Infant ◽  
Milk Fat ◽  
Infant Health ◽  
Cow Milk ◽  
Published Data ◽  
Donor Human Milk ◽  
Milk Fat Globule ◽  
Health Complications ◽  
The Impact

Abstract An exclusive human milk diet (EHMD) has been shown to reduce health complications of prematurity in infants born weighing ≤1250 grams compared to cow milk-based diets. Accordingly, the number of available human milk (HM)-based nutritional products continues to increase. Newly available products, and those reportedly soon to enter the market include homogenized donor human milk (DHM) and homogenized HM–based fortifiers. Existing literature demonstrating the benefits of an EHMD, however, is limited to non-homogenized HM-based products. Herein, we summarize existing evidence on the impact of homogenization on HM, with a particular focus on changes to the macromolecular structure of the milk fat globule and its subsequent impact on digestion kinetics. We use these published data to create a conceptual framework for the potential implications of homogenized HM-based nutritional products on preterm infant health. Importantly, we underscore that the safety and efficacy of homogenized HM-based products warrant investigation.

scholarly journals Improving donor human milk collection in a hospital without a human milk bank: a quality improvement initiative at an urban tertiary-care teaching hospital

2021 ◽  
Vol 10 (Suppl 1) ◽  
pp. e001467
Author(s):  
Reema Garegrat ◽  
Nandini Malshe ◽  
Pradeep Suryawanshi ◽  
Suprabha K Patnaik
Keyword(s):  
Quality Improvement ◽  
Human Milk ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Quality Improvement Initiative ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Donor Human Milk ◽  
Milk Bank ◽  
Human Milk Bank

Feed intolerance and necrotising enterocolitis (NEC) are challenges while treating sick neonates. These can be reduced by giving human milk, but adequate availability of mother’s own milk or pasteurised donor human milk (PDHM) is a challenge in neonatal setups, like ours, without an attached human milk bank. Hence, this quality improvement initiative was taken to improve donor human milk collection in our urban tertiary-care teaching hospital, to at least 500 mL per week in 4 weeks. After analysing the problem, our quality improvement team identified a shortage of human milk donation that was due to low awareness among the stakeholders and lack of a system to collect and store human milk and transport it to a milk bank. The team first established a system of supplies needed for milk collection, storage and transportation. It then tested change idea of information, education and counselling to increase milk donation. The team carried out a few plan-do-study-act cycles (individual and group counsellings, and usage of videos and information leaflets) to test the change ideas and adapted a few and abandoned some. During this journey, the milk collection increased to above the target amount. Various challenges were addressed, and there was a need for constant motivation of the stakeholders, especially the mothers, and now there is sustained milk donation in the setup. This is incorporated in the standard operating procedure and as a quality indicator of the unit for sustaining the changes in the unit. Our initiative can be replicated in other setups for increasing collection of donor human milk. Greater PDHM availability for sick neonates will, in effect, reduce NEC and feeding intolerance rates, leading to reduced hospital stay, morbidity, mortality and economic burden.

Receiving Screened Donor Human Milk for Their Infant Supports Parental Wellbeing: a Mixed-methods Study

2021 ◽  
Author(s):  
Amy Brown ◽  
Natalie Shenker
Keyword(s):  
Mental Health ◽  
Human Milk ◽  
Infant Health ◽  
Positive Impact ◽  
Online Questionnaire ◽  
Donor Human Milk ◽  
Increased Risk ◽  
Health And Development ◽  
Almost All ◽  
The Impact

Abstract Background: Donor human milk (DHM) protects the health and development of premature infants but there has been little examination of the broader impact of an infant receiving it upon parental mental health. Breastfeeding and mental health are closely tied with women who experience breastfeeding difficulties or are unable to meet their own breastfeeding goals often experiencing feelings of guilt, sadness and anger, alongside an increased risk of postnatal depression. The aim of the current study was to explore how experience of receiving DHM for their baby affected the wellbeing of parents.Methods: UK parents of infants aged 0 – 12 months who had received screened DHM from a milk bank (typically on the neonatal unit or in some cases in the community) completed an online questionnaire exploring their experiences. The questionnaire included Likert scale items examining perceived impact upon infant health, own wellbeing and family functioning alongside open-ended questions exploring perceptions of how receiving DHM affected wellbeing.Results: Almost all of the 107 participants (women=102) agreed that receiving DHM had a positive impact upon infant health and development, their own mental and physical health, and their family’s wellbeing. Parents felt relieved that their infant was receiving DHM for health reasons but also due to the experience of being listened to, supported and having their infant feeding decisions facilitated. Receiving DHM helped mothers to process some of their emotions at not being able to breastfeed, in part because knowing their baby was being fed gave them the space to focus on recovery and bonding with their baby. Some parents did experience challenges, feeling guilty at receiving DHM, insecure that another woman was able to feed their baby when they could not, with some negative reactions from family. Although the impact of receiving DHM upon breastfeeding was not measured, some women who were working to build their own milk supply noted that it helped motivate them to continue.Conclusions: DHM may play an important role not only in protecting infant health and development but in supporting the mental health and wellbeing of mothers for whom their infant receiving human milk is important.

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