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García-Lara NR, Escuder-Vieco D, Cabrera-Lafuente M, Keller K, De Diego-Poncela C, Jiménez-González C, Núñez-Ramos R, Flores-Antón B, Escribano-Palomino E, Alonso-Díaz C, Vázquez-Román S, Ureta-Velasco N, Cruz-Bértolo JDL, Pallás-Alonso CR. Clinical Impact of Supplementation with Pasteurized Donor Human Milk by High-Temperature Short-Time Method versus Holder Method in Extremely Low Birth Weight Infants: A Multicentre Randomized Controlled Trial. Nutrients 2024; 16:1090. [PMID: 38613123 PMCID: PMC11013736 DOI: 10.3390/nu16071090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open
Abstract
Nosocomial infections are a frequent and serious problem in extremely low birth weight (ELBW) infants. Donor human milk (DHM) is the best alternative for feeding these babies when mother's own milk (MOM) is not available. Recently, a patented prototype of a High-Temperature Short-Time (HTST) pasteurizer adapted to a human milk bank setting showed a lesser impact on immunologic components. We designed a multicentre randomized controlled trial that investigates whether, in ELBW infants with an insufficient MOM supply, the administration of HTST pasteurized DHM reduces the incidence of confirmed catheter-associated sepsis compared to DHM pasteurized with the Holder method. From birth until 34 weeks postmenstrual age, patients included in the study received DHM, as a supplement, pasteurized by the Holder or HTST method. A total of 213 patients were randomized; 79 (HTST group) and 81 (Holder group) were included in the analysis. We found no difference in the frequency of nosocomial sepsis between the patients of the two methods-41.8% (33/79) of HTST group patients versus 45.7% (37/81) of Holder group patients, relative risk 0.91 (0.64-1.3), p = 0.62. In conclusion, when MOM is not available, supplementing during admission with DHM pasteurized by the HTST versus Holder method might not have an impact on the incidence of catheter-associated sepsis.
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Affiliation(s)
- Nadia Raquel García-Lara
- Department of Neonatology, 12 de Octubre University Hospital, 28041 Madrid, Spain; (C.D.D.-P.); (B.F.-A.); (C.A.-D.); (S.V.-R.); (N.U.-V.); (C.R.P.-A.)
- Aladina-MGU-Regional Human Milk Bank, 12 de Octubre University Hospital, 28041 Madrid, Spain; (D.E.-V.); (K.K.)
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain;
| | - Diana Escuder-Vieco
- Aladina-MGU-Regional Human Milk Bank, 12 de Octubre University Hospital, 28041 Madrid, Spain; (D.E.-V.); (K.K.)
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain;
| | - Marta Cabrera-Lafuente
- Department of Neonatology, La Paz University Hospital, 28046 Madrid, Spain; (M.C.-L.); (C.J.-G.); (E.E.-P.)
- Institute for Health Research–IdiPaz, La Paz University Hospital, 28046 Madrid, Spain
| | - Kristin Keller
- Aladina-MGU-Regional Human Milk Bank, 12 de Octubre University Hospital, 28041 Madrid, Spain; (D.E.-V.); (K.K.)
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain;
| | - Cristina De Diego-Poncela
- Department of Neonatology, 12 de Octubre University Hospital, 28041 Madrid, Spain; (C.D.D.-P.); (B.F.-A.); (C.A.-D.); (S.V.-R.); (N.U.-V.); (C.R.P.-A.)
- Aladina-MGU-Regional Human Milk Bank, 12 de Octubre University Hospital, 28041 Madrid, Spain; (D.E.-V.); (K.K.)
| | - Concepción Jiménez-González
- Department of Neonatology, La Paz University Hospital, 28046 Madrid, Spain; (M.C.-L.); (C.J.-G.); (E.E.-P.)
- Institute for Health Research–IdiPaz, La Paz University Hospital, 28046 Madrid, Spain
| | - Raquel Núñez-Ramos
- Department of Pediatric Nutrition, 12 de Octubre University Hospital, 28041 Madrid, Spain;
| | - Beatriz Flores-Antón
- Department of Neonatology, 12 de Octubre University Hospital, 28041 Madrid, Spain; (C.D.D.-P.); (B.F.-A.); (C.A.-D.); (S.V.-R.); (N.U.-V.); (C.R.P.-A.)
- Aladina-MGU-Regional Human Milk Bank, 12 de Octubre University Hospital, 28041 Madrid, Spain; (D.E.-V.); (K.K.)
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain;
| | - Esperanza Escribano-Palomino
- Department of Neonatology, La Paz University Hospital, 28046 Madrid, Spain; (M.C.-L.); (C.J.-G.); (E.E.-P.)
- Institute for Health Research–IdiPaz, La Paz University Hospital, 28046 Madrid, Spain
| | - Clara Alonso-Díaz
- Department of Neonatology, 12 de Octubre University Hospital, 28041 Madrid, Spain; (C.D.D.-P.); (B.F.-A.); (C.A.-D.); (S.V.-R.); (N.U.-V.); (C.R.P.-A.)
- Aladina-MGU-Regional Human Milk Bank, 12 de Octubre University Hospital, 28041 Madrid, Spain; (D.E.-V.); (K.K.)
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain;
| | - Sara Vázquez-Román
- Department of Neonatology, 12 de Octubre University Hospital, 28041 Madrid, Spain; (C.D.D.-P.); (B.F.-A.); (C.A.-D.); (S.V.-R.); (N.U.-V.); (C.R.P.-A.)
- Aladina-MGU-Regional Human Milk Bank, 12 de Octubre University Hospital, 28041 Madrid, Spain; (D.E.-V.); (K.K.)
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain;
| | - Noelia Ureta-Velasco
- Department of Neonatology, 12 de Octubre University Hospital, 28041 Madrid, Spain; (C.D.D.-P.); (B.F.-A.); (C.A.-D.); (S.V.-R.); (N.U.-V.); (C.R.P.-A.)
- Aladina-MGU-Regional Human Milk Bank, 12 de Octubre University Hospital, 28041 Madrid, Spain; (D.E.-V.); (K.K.)
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain;
| | - Javier De La Cruz-Bértolo
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain;
- Clinical Research Platform IC+12, Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Carmen Rosa Pallás-Alonso
- Department of Neonatology, 12 de Octubre University Hospital, 28041 Madrid, Spain; (C.D.D.-P.); (B.F.-A.); (C.A.-D.); (S.V.-R.); (N.U.-V.); (C.R.P.-A.)
- Aladina-MGU-Regional Human Milk Bank, 12 de Octubre University Hospital, 28041 Madrid, Spain; (D.E.-V.); (K.K.)
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain;
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Arduino I, Calvo J, Rittà M, Cabeza S, Llobera M, Lembo D, Gayà A, Donalisio M. Impact of time-temperature combinations on the anti-Cytomegalovirus activity and biological components of human milk. Pediatr Res 2023; 94:956-964. [PMID: 37059899 DOI: 10.1038/s41390-023-02606-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 03/22/2023] [Accepted: 03/30/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND There is extensive evidence that Holder pasteurization (HoP) (30 min at 62.5 °C) has harmful effects on the bioactivities of human milk (HM). We previously demonstrated that lowering HoP temperature is sufficient to inactivate Cytomegalovirus (HCMV). Here, we analyzed the effect of lowering time/temperature on the antiviral activity against HCMV and IgA levels of HM. METHODS Eighty HM samples from five mothers were pasteurized in a range of temperature (62.5-56 °C) and time (40-10 min) in a conventional setting of Human Milk Bank. Unpasteurized HM from each mother was used as control. The samples were assayed against HCMV-AD169 strain in cell cultures and IgA levels were determined by ELISA. RESULTS All HM samples exhibited anti-HCMV activity, to a different extent. An improvement of antiviral activity was observed in samples treated at 60, 58 and 56 °C compared to those at 62.5 °C, with ID50 values near those of unpasteurized milk. Similarly, better retention in IgA levels was observed by reducing the temperature of treatment. CONCLUSIONS We demonstrated that a 2.5 °C reduction of heat treatment significantly preserved the IgA content and fully restored the anti-HCMV activity of HM, supporting this variant of HoP as a valid alternative to preserve HM bioactivities. IMPACT This work questions the standard HoP and opens the debate on whether the pasteurization temperature commonly used in Human Milk Banks should be lowered to better preserve the biological components of the milk. A reduction of HoP temperature at 60 °C determined a significant preservation of anti-HCMV activity and IgA content of donor HM, compared to standard HoP. This alternative HoP is highly feasible compared to other substitute pasteurization techniques, since it would employ the same pasteurizer equipment found in most Human Milk Banks.
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Affiliation(s)
- Irene Arduino
- Department of Clinical and Biological Sciences, Laboratory of Molecular Virology and Antiviral Research, University of Turin, Orbassano, Italy
| | - Javier Calvo
- Banc de Teixits, Fundació Banc de Sang i Teixits de les Illes Balears (FBSTIB), Palma, Spain
- Cell Therapy and Tissue Engineering Group (TERCIT), Balearic Islands Health Research Institute (IdISBa), Palma, Spain
| | - Massimo Rittà
- Department of Clinical and Biological Sciences, Laboratory of Molecular Virology and Antiviral Research, University of Turin, Orbassano, Italy
| | - Sergio Cabeza
- Banc de Teixits, Fundació Banc de Sang i Teixits de les Illes Balears (FBSTIB), Palma, Spain
| | - Marta Llobera
- Banc de Teixits, Fundació Banc de Sang i Teixits de les Illes Balears (FBSTIB), Palma, Spain
| | - David Lembo
- Department of Clinical and Biological Sciences, Laboratory of Molecular Virology and Antiviral Research, University of Turin, Orbassano, Italy
| | - Antoni Gayà
- Banc de Teixits, Fundació Banc de Sang i Teixits de les Illes Balears (FBSTIB), Palma, Spain
- Cell Therapy and Tissue Engineering Group (TERCIT), Balearic Islands Health Research Institute (IdISBa), Palma, Spain
| | - Manuela Donalisio
- Department of Clinical and Biological Sciences, Laboratory of Molecular Virology and Antiviral Research, University of Turin, Orbassano, Italy.
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Ureta-Velasco N, Montealegre-Pomar A, Keller K, Escuder-Vieco D, Fontecha J, Calvo MV, Megino-Tello J, Serrano JCE, García-Lara NR, Pallás-Alonso CR. Associations of Dietary Intake and Nutrient Status with Micronutrient and Lipid Composition in Breast Milk of Donor Women. Nutrients 2023; 15:3486. [PMID: 37571421 PMCID: PMC10421487 DOI: 10.3390/nu15153486] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/01/2023] [Accepted: 08/05/2023] [Indexed: 08/13/2023] Open
Abstract
The influence of the diet and nutritional status of milk donors on the nutritional composition of donor human milk (DHM) is unknown. The present study aimed to determine the nutritional profile of DHM and the associations between donors' dietary intake and nutritional status and the micronutrient and lipid composition in DHM. For this purpose, 113 donors completed a food frequency questionnaire, provided a five-day weighed dietary record, and collected milk for five consecutive days. Nutrient determinations in donors' erythrocytes, plasma, urine, and milk were performed. Multiple linear regressions were conducted for the evaluation of the associations. We highlight the following results: DHM docosahexaenoic acid (DHA) was positively associated with donors' plasma DHA content and donors' DHA intake (R2 0.45, p < 0.001). For every 1 g/day DHA intake, an increase of 0.38% in DHA content and 0.78% in total omega-3 content was observed in DHM (R2 0.29, p < 0.001). DHM saturated fatty acids were positively associated with erythrocyte dimethyl acetals, plasma stearic acid, trans fatty acids intake, and breastfeeding duration and negatively associated with erythrocyte margaroleic acid (R2 0.34, p < 0.01). DHM cholecalciferol was associated with plasma cholecalciferol levels and dairy intake (R2 0.57, p < 0.01). Other weaker associations were found for free thiamin, free riboflavin, pyridoxal, dehydroascorbic acid, and the lipid profile in DHM. In conclusion, the diet and nutritional status of donors influence the fatty acid profile and micronutrient content of DHM.
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Affiliation(s)
- Noelia Ureta-Velasco
- Department of Neonatology, 12 de Octubre University Hospital, 28041 Madrid, Spain; (N.R.G.-L.); (C.R.P.-A.)
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain; (K.K.); (D.E.-V.)
- Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Adriana Montealegre-Pomar
- Epidemiología Clínica, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá 110231, Colombia;
| | - Kristin Keller
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain; (K.K.); (D.E.-V.)
- “Aladina-MGU”—Regional Human Milk Bank, 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Diana Escuder-Vieco
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain; (K.K.); (D.E.-V.)
- “Aladina-MGU”—Regional Human Milk Bank, 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Javier Fontecha
- Food Lipid Biomarkers and Health Group, Institute of Food Science Research (CIAL), CSIC-UAM, 28049 Madrid, Spain; (J.F.); (M.V.C.); (J.M.-T.)
| | - María V. Calvo
- Food Lipid Biomarkers and Health Group, Institute of Food Science Research (CIAL), CSIC-UAM, 28049 Madrid, Spain; (J.F.); (M.V.C.); (J.M.-T.)
| | - Javier Megino-Tello
- Food Lipid Biomarkers and Health Group, Institute of Food Science Research (CIAL), CSIC-UAM, 28049 Madrid, Spain; (J.F.); (M.V.C.); (J.M.-T.)
| | - José C. E. Serrano
- Department of Experimental Medicine, Faculty of Medicine, University of Lleida, 25008 Lleida, Spain;
| | - Nadia Raquel García-Lara
- Department of Neonatology, 12 de Octubre University Hospital, 28041 Madrid, Spain; (N.R.G.-L.); (C.R.P.-A.)
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain; (K.K.); (D.E.-V.)
- “Aladina-MGU”—Regional Human Milk Bank, 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Carmen R. Pallás-Alonso
- Department of Neonatology, 12 de Octubre University Hospital, 28041 Madrid, Spain; (N.R.G.-L.); (C.R.P.-A.)
- Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain; (K.K.); (D.E.-V.)
- Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
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Escuder Vieco D, Arenas Vidal J, Rojas García P, Gónzález MJ, García Lara NR, Pallás Alonso CR. Comparative analyses of holder pasteurization vs. HTST pasteurization for donor milk: a cost-minimization study applicable to human milk banks. Int Breastfeed J 2023; 18:20. [PMID: 37060103 PMCID: PMC10103489 DOI: 10.1186/s13006-023-00557-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 03/30/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND High-temperature short-time (HTST) pasteurization (72-75 °C, 15 s) is an alternative treatment to traditional Holder pasteurization (HoP) (62ºC, 30 min) for donor milk. HTST pasteurization guarantees the milk's microbiological safety and retains more of its biologically and nutritionally active compounds, but the cost of implementing this technology for a human milk bank is unknown. METHODS A cost-minimization study was carried out on the facilities of a regional human milk bank in a public hospital. Total production costs (fixed plus variables) were quantified using HTST pasteurization and HoP in three hypothetical scenarios: (1) costs of the first 10 L of pasteurized milk in a newly opened milk bank; (2) costs of the first 10 L of pasteurized milk in an active milk bank; and (3) costs using the maximum production capacity of both technologies in the first two years of operation. The following costs were analyzed: health care professionals, equipment and software, external services, and consumables. RESULTS In scenario 1, the total production costs were € 228,097.00 for the HTST method versus € 154,064.00 for the HoP method. In scenario 2, these costs were similar (€ 6,594.00 for HTST pasteurization versus € 5,912.00 for HoP). The cost of healthcare professionals was reduced by more than half when pasteurization was carried out by the HTST method versus the Holder method (€ 84.00 and € 191.00, respectively). In scenario 3, the unit cost of milk pasteurized by the HTST method decreased from the first to the second year by 43.5%, while for the HoP method, it decreased by 30%. CONCLUSIONS HTST pasteurization requires a high initial investment in equipment; however, it provides a significant minimization of production costs in the long term, pasteurizes large quantities of donor milk per working day and achieves a more efficient management of the time of the health care professionals in charge of the bank's operation compared to HoP.
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Affiliation(s)
- Diana Escuder Vieco
- Servicio de Neonatología, Banco Regional de Leche Materna, Hospital Universitario 12 de Octubre, Instituto de Investigación i+12, Madrid, Spain.
| | | | | | - Marino J Gónzález
- Department of Economics, University of La Rioja, Logroño, Spain
- Center for Biomedical Research of La Rioja (CIBIR), Logroño, Spain
| | - Nadia Raquel García Lara
- Servicio de Neonatología, Banco Regional de Leche Materna, Hospital Universitario 12 de Octubre, Instituto de Investigación i+12, Madrid, Spain
| | - Carmen Rosa Pallás Alonso
- Servicio de Neonatología, Instituto de Investigación i+12, Banco Regional de Leche Materna, Hospital Universitario 12 de Octubre, Universidad Complutense de Madrid, Madrid, Spain
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5
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Ureta-Velasco N, Keller K, Escuder-Vieco D, Fontecha J, Calvo MV, Megino-Tello J, Serrano JCE, Romero Ferreiro C, García-Lara NR, Pallás-Alonso CR. Human Milk Composition and Nutritional Status of Omnivore Human Milk Donors Compared with Vegetarian/Vegan Lactating Mothers. Nutrients 2023; 15:nu15081855. [PMID: 37111074 PMCID: PMC10146700 DOI: 10.3390/nu15081855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/05/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Women of childbearing age in Western societies are increasingly adopting vegetarian diets. These women are sometimes rejected as milk donors, but little about the composition of their milk is known. The present study aimed to compare the intake, nutritional status, and nutritional composition of human milk from omnivore human milk donors (Donors) and vegetarian/vegan lactating mothers (Veg). Milk, blood, and urine samples from 92 Donors and 20 Veg were used to determine their fatty acid profiles, as well as vitamins and minerals. In a representative sample of both groups, we also determined the lipid class profile as a distribution of neutral and polar lipids, the molecular species of triacylglycerols, and the relative composition of phospholipids in their milk. A dietary assessment was conducted with a five-day dietary record (while considering the intake of supplements). We highlight the following results, expressed as the mean (SE), for the Veg vs. Donors: (1) Their docosahexaenoic acid (DHA) intake was 0.11 (0.03) vs. 0.38 (0.03) g/day; the plasma DHA was 0.37 (0.07) vs. 0.83 (0.06)%; and the milk DHA was 0.15 (0.04) vs. 0.33 (0.02)%. (2) Their milk B12 levels were 545.69 (20.49) vs. 482.89 (4.11) pM; 85% of the Veg reported taking B12 supplements (mean dose: 312.1 mcg/day); and the Veg group showed no differences with Donors in terms of total daily intake or plasma B12. (3) Their milk phosphatidylcholine levels were 26.88 (0.67) vs. 30.55 (1.10)%. (4) Their milk iodine levels were 126.42 (13.37) vs. 159.22 (5.13) mcg/L. In conclusion, the Vegs' milk was shown to be different from the Donors' milk, mainly due to its low DHA content, which is concerning. However, raising awareness and ensuring proper supplementation could bridge this gap, as has already been achieved for cobalamin.
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Affiliation(s)
- Noelia Ureta-Velasco
- Department of Neonatology, Research Institute i+12, 12 de Octubre University Hospital, Complutense University of Madrid, 28041 Madrid, Spain
| | - Kristin Keller
- "Aladina-MGU"-Regional Human Milk Bank, Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Diana Escuder-Vieco
- "Aladina-MGU"-Regional Human Milk Bank, Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Javier Fontecha
- Food Lipid Biomarkers and Health Group, Institute of Food Science Research (CIAL), CSIC-UAM, 28049 Madrid, Spain
| | - María V Calvo
- Food Lipid Biomarkers and Health Group, Institute of Food Science Research (CIAL), CSIC-UAM, 28049 Madrid, Spain
| | - Javier Megino-Tello
- Food Lipid Biomarkers and Health Group, Institute of Food Science Research (CIAL), CSIC-UAM, 28049 Madrid, Spain
| | - José C E Serrano
- Department of Experimental Medicine, Faculty of Medicine, University of Lleida, 25008 Lleida, Spain
| | - Carmen Romero Ferreiro
- Scientific Support Unit, Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, 28223 Madrid, Spain
| | - Nadia Raquel García-Lara
- Department of Neonatology, Research Institute i+12, 12 de Octubre University Hospital, Complutense University of Madrid, 28041 Madrid, Spain
- "Aladina-MGU"-Regional Human Milk Bank, Research Institute i+12, 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Carmen R Pallás-Alonso
- Department of Neonatology, Research Institute i+12, 12 de Octubre University Hospital, Complutense University of Madrid, 28041 Madrid, Spain
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Xiaoshan H, Xue C, Jun Z, Feng L, Xiaohui C, Zhangbin Y, Shuping H. Eight-year operation status and data analysis of the first human milk bank in East China. Int Breastfeed J 2022; 17:65. [PMID: 36050709 PMCID: PMC9435425 DOI: 10.1186/s13006-022-00502-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Human milk banks (HMBs) are essential facilities for the selection, collection, testing, transportation,storage, and distribution of DHM for special medical needs. The aim of this analysis was to analyze the operation status and data over the last 8 years of operation of the first human milk bank (HMB) in East China. Methods Data related to the costs, donors, donation, pasteurization, and recipients were extracted from the web-based electronic monitoring system of the HMB for the period August 1, 2013 to July 31, 2021. Results Over the 8 years of operation, 1,555 qualified donors donated 7,396.5L of qualified milk at a cost of ¥1.94 million($306,051), with the average cost per liter of donor human milk being ¥262.3($41.4). The donors were between 25 and 30 years of age, and the majority (80.1%) were primipara. All the donated milk was pasteurized and subjected to bacteriological tests before and after pasteurization: 95.4% passed the pre-pasteurization tests, and 96.3% passed the post-pasteurization tests. A total of 9,207 newborns received 5,775.2L of pasteurized donor milk. The main reason for the prescription of donor human milk was preterm birth. As a result of continuous quality improvements, January 2016 witnessed a significant increase in the volume of qualified DHM and the number of qualified donors. However, in 2020, as a result of the restrictions related to the COVID-19 pandemic, the volume of qualified DHM and the number of qualified donors decreased. Conclusions Over its 8 years of operation, our HMB has made steady quality improvements in its screening and information processes. Continuous quality improvement is on ongoing need, along with recruiting more qualified donors and collecting donor human milk for vulnerable newborns.
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Affiliation(s)
- Hu Xiaoshan
- Department of Pediatrics, Maternity Hospital Affiliated to Nanjing Medical University/Nanjing Maternal and Child Health Hospital, 123 Tianfeixiang,Mochou Road, Nanjing, China
| | - Chu Xue
- Department of Pediatrics, Maternity Hospital Affiliated to Nanjing Medical University/Nanjing Maternal and Child Health Hospital, 123 Tianfeixiang,Mochou Road, Nanjing, China
| | - Zhang Jun
- Department of Pediatrics, Maternity Hospital Affiliated to Nanjing Medical University/Nanjing Maternal and Child Health Hospital, 123 Tianfeixiang,Mochou Road, Nanjing, China
| | - Liu Feng
- Department of Pediatrics, Maternity Hospital Affiliated to Nanjing Medical University/Nanjing Maternal and Child Health Hospital, 123 Tianfeixiang,Mochou Road, Nanjing, China
| | - Chen Xiaohui
- Department of Pediatrics, Maternity Hospital Affiliated to Nanjing Medical University/Nanjing Maternal and Child Health Hospital, 123 Tianfeixiang,Mochou Road, Nanjing, China
| | - Yu Zhangbin
- Department of Pediatrics, Maternity Hospital Affiliated to Nanjing Medical University/Nanjing Maternal and Child Health Hospital, 123 Tianfeixiang,Mochou Road, Nanjing, China
| | - Han Shuping
- Department of Pediatrics, Maternity Hospital Affiliated to Nanjing Medical University/Nanjing Maternal and Child Health Hospital, 123 Tianfeixiang,Mochou Road, Nanjing, China.
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7
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Martínez-Serrano MG, Díaz-Aparicio E, Palomares-Reséndiz G, Tórtora-Pérez JL, Ramírez-Álvarez H, Ortega-Hernández N, Salinas-Lorente J, Morales-Alvarez JF, Cervantes-Morali JJC. Presence of Chlamydia abortus in colostrum, milk and vaginal discharge samples of sheep. REV COLOMB CIENC PEC 2022. [DOI: https:/doi.org/10.17533/udea.rccp.v35n2a04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background: The main transmission route of Chlamydia abortus is by ingesting the microorganism that has been eliminated in vaginal secretions, placental membranes or abortions that contaminate the environment and, possibly, through milk and colostrum. Elimination through vaginal secretions is well documented. However, there are no reports about isolation and identification of C. abortus in the colostrum or milk of infected sheep, so it is important to determine whether or not C. abortus may be present in these secretions, which are the only food of lambs. Objective: To detect C. abortus in colostrum, milk, and vaginal secretions of sheep with a history of reproductive disorders. Methods: Colostrum, milk, and vaginal exudates were collected from 66 sheep. The samples were inoculated in mouse fibroblast cell cultures and the presence of C. abortus determined by direct immunofluorescence. Results: 19 out of 66 colostrum samples (28.7%), 14 out of 66 milk samples (21.2%) and 17 out of 66 vaginal swabs (25.7%) were positive for C. abortus. The 50 samples positive for isolation and detected by immunofluorescence, together with 42 negative samples were subjected to qPCR to amplify a fragment of the ompA gene from C. abortus. Thirty-eight of the 92 samples processed by this technique were positive for C. abortus. Conclusion: The results demonstrated the presence of C. abortus in a high proportion in colostrum, milk and vaginal secretions of infected sheep. To the best of our knowledge, this is the first field study confirming the presence of C. abortus in colostrum, which shows that excretion of Chlamydia by lactogenesis could occur in the first hours after birth.
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How to Provide Breast Milk for the Preterm Infant and Avoid Symptomatic Cytomegalovirus Infection with Possible Long-Term Sequelae. Life (Basel) 2022; 12:life12040504. [PMID: 35454995 PMCID: PMC9031638 DOI: 10.3390/life12040504] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/25/2022] [Accepted: 03/26/2022] [Indexed: 12/04/2022] Open
Abstract
Cytomegalovirus (CMV) is able to replicate in the breast milk of lactating mothers and thus the offspring might be affected by mild to severe symptoms of postnatal CMV disease in case of prematurity; not in term infants. Sepsis-like syndrome affects only very low birth infants; and few cases have been reported. The neurodevelopmental long-term outcome of those preterm infants revealed possible subtle deficiencies, but no major neurodevelopmental impairment. Neurodevelopmental sequelae are still in discussion and seem somewhat overestimated after careful evaluation of the published evidence. The main focus of postnatal CMV disease lies upon the extremely low birth weight of infants. Elimination of CMV is provided by short-term heating methods like the most widely used Holder pasteurization. Freezing and thawing methods leave a risk for CMV acquisition. The benefits of untreated breast milk have to be considered to outweigh the possible sequelae of postnatal CMV infection in the most vulnerable preterm infants.
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Martínez-Serrano MG, Palomares-Reséndiz G, Tórtora-Pérez JL, Ramírez-Álvarez H, Ortega-Hernández N, Salinas-Lorente J, Morales-Alvarez JF, Cervantes-Morali JJC, Díaz-Aparicio E. Presence of Chlamydia abortus in colostrum, milk and vaginal discharge samples of sheep. REV COLOMB CIENC PEC 2021. [DOI: 10.17533/udea.rccp.v35n2a04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Kontopodi E, Boeren S, Stahl B, van Goudoever JB, van Elburg RM, Hettinga K. High-Temperature Short-Time Preserves Human Milk's Bioactive Proteins and Their Function Better Than Pasteurization Techniques With Long Processing Times. Front Pediatr 2021; 9:798609. [PMID: 35127595 PMCID: PMC8811466 DOI: 10.3389/fped.2021.798609] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/29/2021] [Indexed: 12/14/2022] Open
Abstract
Donor human milk is generally processed by holder pasteurization (HoP) at 62. 5°C for 30 min. This temperature-time combination is sufficient for eliminating pathogens in donor milk, but also negatively affects several bioactive milk components. Long heating up times may further affect the bioactive properties of pasteurized milk. High-Temperature-Short-Time (HTST), a treatment with shorter processing times (72°C for 15 sec), was investigated as a suitable alternative to HoP. In addition, pasteurization methods that follow the same temperature regime but with varying heating up times were compared. Human milk samples from four different donors were combined into one pool, which was then used to perform all analyses. The effects of these methods on the levels and functionality of immunoglobulin A, lactoferrin, lysozyme and bile salt-stimulated lipase, were evaluated with LC-MS/MS-based proteomics and activity assays, while the pasteurization efficacy was evaluated with an alkaline phosphatase test. HoP, a treatment with long processing times, times, caused the highest reduction in all proteins studied (reduced by 50-98%). Compounds such as lactoferrin and bile salt-stimulated lipase that are more sensitive to heat treatments were better retained with HTST, but their levels and functionality were still significantly lower than those of untreated donor milk (52 and 81% reduction of lactoferrin and bile salt-stimulated lipase activity, respectively). Our findings showed that a treatment with considerably shorter processing times, such as HTST, may reduce the thermal damage caused to the bioactive proteins compared to HoP, without affecting pasteurization efficacy. Since the vast majority of the donor human milk banks that are currently operating on a global level apply HoP to donor milk, our findings may provide relevant information for the optimization of donor milk processing.
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Affiliation(s)
- Eva Kontopodi
- Emma Children's Hospital, Amsterdam UMC, Amsterdam, Netherlands.,Food Quality and Design Group, Wageningen University and Research, Wageningen, Netherlands
| | - Sjef Boeren
- Laboratory of Biochemistry, Wageningen University, Wageningen, Netherlands
| | - Bernd Stahl
- Department of Chemical Biology and Drug Discovery, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands.,Danone Nutricia Research, Utrecht, Netherlands
| | | | | | - Kasper Hettinga
- Food Quality and Design Group, Wageningen University and Research, Wageningen, Netherlands
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