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Barin J, Touati J, Martin A, Fletgen Richard C, Jox RJ, Fontana S, Legardeur H, Amiguet N, Henriot I, Kaech C, Belat A, Tolsa JF, Prudent M, Fischer Fumeaux CJ. Bridging the Milk Gap: Integrating a Human Milk Bank-Blood Bank Model to Reinforce Lactation Support and Neonatal Care. Nutrients 2025; 17:1765. [PMID: 40507034 PMCID: PMC12158243 DOI: 10.3390/nu17111765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2025] [Revised: 05/17/2025] [Accepted: 05/21/2025] [Indexed: 06/16/2025] Open
Abstract
Mother's own milk (MOM) offers the highest protection for preterm and low birth weight infants. However, breastfeeding can be challenging during neonatal hospitalization. When MOM is unavailable, donor human milk (DHM) is the recommended alternative for feeding vulnerable neonates. Human milk banks (HMBs) collect, process, and deliver DHM, playing a key role in lactation support and promoting MOM availability. Although HMBs are expanding globally, scale-up remains hindered, restricting equitable DHM access. In Switzerland, despite the existence of eight HMBs, the western region lacked such a facility until 2022. To address this gap, an interdisciplinary team from the Lausanne University Hospital (CHUV) and the Swiss Red Cross Interregional Blood Transfusion Centre (TIR) collaborated to establish a regional HMB. This partnership leveraged both institutions' available expertise, infrastructure, and resources. After two years of preparation, the CHUV Lactarium launched in 2022 with the support of the Department of Health and Social Action (DSAS) of the Canton of Vaud. This novel human milk bank-blood bank model is fully integrated into the hospital's neonatal care, nutrition, and breastfeeding programs, operating under a strict quality and coordination system. Since its implementation, the HMB has met 100% of DHM needs, with an 80% breastfeeding bridging rate. It has had a positive impact on neonatal care, family engagement, professional interest, and community awareness of human milk. This case study illustrates how synergistic collaboration can help bridge gaps in establishing a safe, efficient, and equitable HMB model. It also offers a scalable framework adaptable to other settings.
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Affiliation(s)
- Jacqueline Barin
- Clinic of Neonatology, Department of Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland; (J.B.); (N.A.); (I.H.); (J.-F.T.)
- Interdisciplinary Perinatal Unit for Breastfeeding Support and Infant Nutrition, Department of Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
| | - Jeremy Touati
- Laboratoire de Préparation Cellulaire et d’Analyses, Transfusion Interrégionale CRS, 1066 Epalinges, Switzerland; (J.T.); (A.M.); (A.B.); (M.P.)
| | - Agathe Martin
- Laboratoire de Préparation Cellulaire et d’Analyses, Transfusion Interrégionale CRS, 1066 Epalinges, Switzerland; (J.T.); (A.M.); (A.B.); (M.P.)
| | - Carole Fletgen Richard
- Gynaecology-Obstetrics, Department of Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland; (C.F.R.); (H.L.)
| | - Ralf J. Jox
- Unité d’Éthique Clinique, Institut des Humanités en Médecine, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland;
- Faculty of Biology and Medicine, University of Lausanne, 1011 Lausanne, Switzerland;
| | - Stefano Fontana
- Faculty of Biology and Medicine, University of Lausanne, 1011 Lausanne, Switzerland;
- Transfusion Interrégionale CRS, 3008 Bern, Switzerland
| | - Hélène Legardeur
- Gynaecology-Obstetrics, Department of Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland; (C.F.R.); (H.L.)
| | - Nathalie Amiguet
- Clinic of Neonatology, Department of Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland; (J.B.); (N.A.); (I.H.); (J.-F.T.)
| | - Isabelle Henriot
- Clinic of Neonatology, Department of Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland; (J.B.); (N.A.); (I.H.); (J.-F.T.)
- Interdisciplinary Perinatal Unit for Breastfeeding Support and Infant Nutrition, Department of Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
| | - Christelle Kaech
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, 1011 Lausanne, Switzerland;
| | - Aurélia Belat
- Laboratoire de Préparation Cellulaire et d’Analyses, Transfusion Interrégionale CRS, 1066 Epalinges, Switzerland; (J.T.); (A.M.); (A.B.); (M.P.)
| | - Jean-François Tolsa
- Clinic of Neonatology, Department of Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland; (J.B.); (N.A.); (I.H.); (J.-F.T.)
| | - Michel Prudent
- Laboratoire de Préparation Cellulaire et d’Analyses, Transfusion Interrégionale CRS, 1066 Epalinges, Switzerland; (J.T.); (A.M.); (A.B.); (M.P.)
- Laboratoire de Recherche sur les Produits Sanguins, Transfusion Interrégionale CRS, 1066 Epalinges, Switzerland
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, 1205 Geneva, Switzerland
| | - Céline J. Fischer Fumeaux
- Clinic of Neonatology, Department of Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland; (J.B.); (N.A.); (I.H.); (J.-F.T.)
- Interdisciplinary Perinatal Unit for Breastfeeding Support and Infant Nutrition, Department of Mother-Woman-Child, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, 1011 Lausanne, Switzerland;
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Gene M, Guthrie JL, Li K, Teatero S, Paterson A, Li A, Doyen A, Yamamura D, Khan S, Srigley JA, Stone D, O’Connor DL, Poutanen S, Unger S, McGeer A, Fittipaldi N. High Genetic Diversity Among Bacillus cereus Isolates Contaminating Donated Milk at a Canadian Human Milk Bank. Microorganisms 2025; 13:1136. [PMID: 40431308 PMCID: PMC12114557 DOI: 10.3390/microorganisms13051136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2025] [Revised: 05/02/2025] [Accepted: 05/10/2025] [Indexed: 05/29/2025] Open
Abstract
Bacillus cereus poses a persistent challenge for human milk banks (HMBs) due to its ability to survive Holder pasteurization (HoP; 62.5 °C for 30 min). To ensure neonatal safety, any milk found to be contaminated post-HoP must be discarded, which impacts milk supply and adds to the operational demands of HMBs. In this study, we analyzed 688 B. cereus isolates from human milk (pre- and post-HoP), as well as from patient and environmental sources, to investigate human milk contamination by B. cereus at a Canadian HMB. Despite the limited temporal and geographic scope of the collection, the isolates exhibited remarkable genomic diversity, comparable to global B. cereus collections. Phylogenetic analysis at the core genome level revealed no clear clustering by isolate source, suggesting multifactorial pathways of B. cereus contamination. Isolates surviving HoP displayed gene variants linked to sporulation and cell wall integrity, suggesting a potential basis for HoP tolerance. Our findings emphasize that while genomic analyses offer major valuable insights, they alone are insufficient to address the complexities of B. cereus contamination in HMBs. Addressing this challenge will require combining genomic tools with robust monitoring systems, improved human milk-handling protocols, and pasteurization strategies better-suited to countering B. cereus resilience.
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Affiliation(s)
- Mathew Gene
- Department of Cell and Systems Biology, University of Toronto, Toronto, ON M5S 3G5, Canada;
| | - Jennifer L. Guthrie
- Public Health Ontario, Toronto, ON M5G 1M1, Canada; (J.L.G.); (S.T.)
- Department of Microbiology and Immunology, Western University, London, ON N6A 3K7, Canada
| | - Kevin Li
- GREMIP and CRIPA, Faculty of Veterinary Medicine, University of Montreal, St-Hyacinthe, QC J2S 2M2, Canada;
| | - Sarah Teatero
- Public Health Ontario, Toronto, ON M5G 1M1, Canada; (J.L.G.); (S.T.)
| | - Aimee Paterson
- Sinai Health System, Toronto, ON M5G 1X5, Canada; (A.P.); (A.L.); (D.S.); (S.P.); (A.M.)
| | - Angel Li
- Sinai Health System, Toronto, ON M5G 1X5, Canada; (A.P.); (A.L.); (D.S.); (S.P.); (A.M.)
| | - Alain Doyen
- Department of Food Sciences, Institute of Nutrition and Functional Foods (INAF) and Dairy Science and Technology Research Center (STELA), Laval University, Quebec City, QC G1V 0A6, Canada;
| | - Deborah Yamamura
- Microbiology Department, Hamilton General Hospital, Hamilton, ON L8L 2X2, Canada;
- Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Sarah Khan
- Division of Pediatric Infectious Diseases, McMaster Children’s Hospital, Hamilton Health Sciences, Hamilton, ON L8N 3Z5, Canada;
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Jocelyn A. Srigley
- Department of Pathology & Laboratory Medicine, BC Children’s Hospital & BC Women’s Hospital + Health Centre, Vancouver, BC V6H 3N1, Canada;
- Department of Pathology & Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- BC Children’s Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada
| | - Debbie Stone
- Sinai Health System, Toronto, ON M5G 1X5, Canada; (A.P.); (A.L.); (D.S.); (S.P.); (A.M.)
- The Rogers Hixon Ontario Human Milk Bank, Toronto, ON M5G 1X5, Canada;
| | - Deborah L. O’Connor
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5G 1A8, Canada;
| | - Susan Poutanen
- Sinai Health System, Toronto, ON M5G 1X5, Canada; (A.P.); (A.L.); (D.S.); (S.P.); (A.M.)
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 3K3, Canada
| | - Sharon Unger
- The Rogers Hixon Ontario Human Milk Bank, Toronto, ON M5G 1X5, Canada;
- IWK Health Centre, Halifax, NS B3K 6R8, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - Allison McGeer
- Sinai Health System, Toronto, ON M5G 1X5, Canada; (A.P.); (A.L.); (D.S.); (S.P.); (A.M.)
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 3K3, Canada
| | - Nahuel Fittipaldi
- Public Health Ontario, Toronto, ON M5G 1M1, Canada; (J.L.G.); (S.T.)
- GREMIP and CRIPA, Faculty of Veterinary Medicine, University of Montreal, St-Hyacinthe, QC J2S 2M2, Canada;
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Beggs MR, Unger S, O'Connor DL. Improving the quality of donor human milk to take advantage of more of the health benefits of mother's own milk composition. Curr Opin Clin Nutr Metab Care 2025; 28:250-256. [PMID: 39964746 DOI: 10.1097/mco.0000000000001116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2025]
Abstract
PURPOSE OF REVIEW Pasteurized donor human milk (PDHM) is the recommended supplement when there is inadequate volume of mother's own milk (MOM) for very low birth weight (<1500 g, VLBW) infants. Differences in the composition of these milks may impact growth, morbidities or long-term development of infants. The aim of this review is to highlight current trends in understanding compositional differences between MOM and PDHM, technological advances in processing PDHM, and infant outcomes when VLBW infants are fed these milks. RECENT FINDINGS Reported differences in the composition between MOM and PDHM are due to several factors including when and how milk is collected, sampled for analysis, and processed. Systematic reviews and primary research studies demonstrate that PDHM reduces the risk of necrotizing enterocolitis in VLBW infants but is also associated with slower postnatal growth. Work is ongoing to determine if alternative approaches to processing PDHM can improve milk composition and thereby infant growth and neurodevelopment and reduce morbidity. SUMMARY PDHM is a key component of feeding VLBW infants when there is inadequate volume of MOM. Recent developments aim to optimize this source of nutrition and bioactive compounds for VLBW infants while further understanding limitations of its use.
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Affiliation(s)
- Megan R Beggs
- Translational Medicine Program, The Hospital for Sick Children
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Sharon Unger
- Neonatology, IWK Health Centre
- Department of Pediatrics, Dalhousie University, Halifax
- Rogers Hixon Ontario Human Milk Bank, Sinai Health
| | - Deborah L O'Connor
- Translational Medicine Program, The Hospital for Sick Children
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario
- Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario Canada
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Cortez MV, Marchiori GN, Jubete M, Lázaro LA, López Merzbacher MI, Soria EA. Impact of Freezing, Storage, and Pasteurization on Nutritional Components and Redox Biomarkers in Human Milk Donations. Breastfeed Med 2025; 20:261-266. [PMID: 39745271 DOI: 10.1089/bfm.2024.0337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/02/2025]
Abstract
Objective: This study evaluates the impact of various processing steps in the human milk (HM) donation chain on nutritional composition and oxidative biomarkers, specifically focusing on triacylglycerols, glucose, polyphenols, and lipid peroxides. Materials and Methods: A total of 68 HM samples were collected from the Human Milk Bank of Córdoba (Argentina) between 2022 and 2023. The effects of storage and pasteurization using the Holder method were assessed. Biochemical analyses were conducted to measure nutrient levels and oxidative markers. Statistical analyses included time-related modeling and paired t tests to evaluate the effects of storage and pasteurization, respectively. Results: Triacylglycerol levels were markedly reduced during home storage (R2 = 0.802, p = 0.0210), whereas glucose, lipid peroxides, and polyphenols remained stable (R2 < 0.3, p > 0.05). Storage at the bank did not affect these biomarkers (R2 < 0.25, p > 0.05). Pasteurization resulted in increased glucose levels (p = 0.0292) and decreased triacylglycerol levels (p = 0.0073), along with a significant reduction in lipid peroxides (p < 0.0001). Conclusions: The findings indicate that home storage conditions significantly diminish triacylglycerol levels in HM, highlighting the need for improved storage practices among donors. Pasteurization provides antioxidant benefits by reducing lipid peroxides while maintaining nutritional integrity.
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Affiliation(s)
- Mariela V Cortez
- Facultad de Ciencias Médicas, Escuela de Fonoaudiología, Universidad Nacional de Córdoba, Córdoba, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, INICSA, Córdoba, Argentina
| | - Georgina N Marchiori
- Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, INICSA, Córdoba, Argentina
- Facultad de Ciencias Médicas, Escuela de Nutrición, Centro de Investigaciones en Nutrición Humana, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Manuela Jubete
- Facultad de Ciencias Médicas, Cátedra de Biología Celular, Histología y Embriología, Instituto de Biología Celular, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Lorena A Lázaro
- Ministerio de Salud de la Provincia de Córdoba, Banco de Leche Humana, Córdoba, Argentina
| | | | - Elio A Soria
- Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, INICSA, Córdoba, Argentina
- Facultad de Ciencias Médicas, Cátedra de Biología Celular, Histología y Embriología, Instituto de Biología Celular, Universidad Nacional de Córdoba, Córdoba, Argentina
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