ABM Clinical Protocol #8: Human Milk Storage Information for Home Use for Full-Term Infants, Revised 2017

Eglash, Anne; Simon, Liliana; Brodribb, Wendy; Reece-Stremtan, Sarah; Noble, Larry; Brent, Nancy B.; Bunik, Maya; Harrel, Cadey; Lawrence, Ruth A.; LeFort, Yvonne; Marinelli, Kathleen A.; Rosen-Carole, Casey; Rothenberg, Susan; Seo, Tomoko; Fleur, Rose St.; Young, Michal

doi:10.1089/bfm.2017.29047.aje

Cited by 90 publications

(55 citation statements)

References 49 publications

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“…Current guidelines for the safe handling of expressed human milk focus largely on microbiological safety, whereby Holder pasteurization (at 62.5 • C for 30 min) of donor milk is mandatory in all North American hospitals [16]. Additionally, it is recommended that milk be stored in the refrigerator at ≤4 • C for no more than eight days, and in the freezer at −17 • C for up to 12 months [17]. Whilst evidence suggests that refrigeration, freezing and pasteurization impact human milk concentration of folate, vitamin B6, vitamin C, and other nutrients to various degrees [18][19][20][21], the effect of pasteurization and short-and long-term storage at different temperatures on water-soluble forms of choline in expressed human milk is not known.…”

Section: Introductionmentioning

confidence: 99%

Variability of Water-Soluble Forms of Choline Concentrations in Human Milk during Storage, after Pasteurization, and among Women

Moukarzel¹,

Wiedeman

Soberanes

et al. 2019

Nutrients

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Choline is critical for infant development and mother's milk is the sole source of choline for fully breastfed infants until six months of age. Human milk choline consists to 85% of water-soluble forms of choline including free choline (FC), phosphocholine (PhosC), and glycerophosphocholine (GPC). Donor milk requires safe handling procedures such as cold storage and pasteurization. However, the stability of water-soluble forms of choline during these processes is not known. The objectives of this research were to determine the effect of storage and pasteurization on milk choline concentration, and the diurnal intra-and inter-individual variability of water-soluble choline forms. Milk samples were collected from healthy women who were fully breastfeeding a full-term, singleton infant <6 months. Milk total water-soluble forms of choline, PhosC, and GPC concentrations did not change during storage at room temperature for up to 4 h. Individual and total water-soluble forms of choline concentrations did not change after storage for 24 h in the refrigerator or for up to one week in the household freezer. Holder pasteurization decreased PhosC and GPC, and thereby total water-soluble choline form concentrations by <5%. We did not observe diurnal variations in PhosC and total water-soluble forms of choline concentrations, but significant differences in FC and GPC concentrations across five sampling time points throughout one day. In conclusion, these outcomes contribute new knowledge for the derivation of evidence-informed guidelines for the handling and storage of expressed human milk as well as the development of optimized milk collection and storage protocols for research studies.

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Section: Introductionmentioning

confidence: 99%

Variability of Water-Soluble Forms of Choline Concentrations in Human Milk during Storage, after Pasteurization, and among Women

Moukarzel¹,

Wiedeman

Soberanes

et al. 2019

Nutrients

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“…All other dependent variables were not significantly predicted by storage days ( p > .05). A total of 29/121 samples (24.0%) had been stored longer than 1 year, which is beyond the current storage guidelines (Eglash et al, ). The proportion of samples stored more than 1 year differed significantly by treatment group (26.7% BANKED, 6.7% MOM, 40.0% SCREENED, and 22.6% SHARED; p = .025).…”

Section: Resultsmentioning

confidence: 96%

A pilot study on nutrients, antimicrobial proteins, and bacteria in commerce‐free models for exchanging expressed human milk in the USA

Perrin

Fogleman

Davis

et al. 2018

Maternal & Child Nutrition

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Expressed human milk can be donated or sold through a variety of channels, including human milk banks, corporations or individuals, or peer‐to‐peer milk sharing. There is a paucity of research regarding the nutrient and bioactive profiles of expressed human milk exchanged through commerce‐free scenarios, including peer‐to‐peer milk sharing. The study objective was to evaluate the macronutrient, antimicrobial protein, and bacteria composition in expressed human milk acquired via commerce‐free arrangements. Expressed human milk samples were collected from the following commerce‐free scenarios: milk expressed for a mother's or parent's own infant (MOM; N = 30); unpasteurized milk donated to a non‐profit milk bank (BANKED; N = 30); milk expressed for peer‐to‐peer milk sharing (SHARED; N = 31); and health professional‐facilitated milk sharing where donors are serologically screened and milk is dispensed raw (SCREENED; N = 30). Analyses were conducted for total protein, lactose, percent fat and water, lysozyme activity, immunoglobulin A (IgA) activity, total aerobic bacteria, coliform, and Staphylococcus aureus. No bacterial growth was observed in 52/121 samples, and 15/121 had growth greater than 5.0 log colony‐forming units/mL. There was no evidence of differences by groups (p > .05) in lactose, fat, water, lysozyme activity, sIgA activity, aerobic bacteria, coliforms, and S. aureus. Mean protein values (95% confidence interval) were 1.5 g/dL (1.4, 1.6) for BANKED, 1.4 g/dL (1.3, 1.5) for MOM, 1.6 g/dL (1.5, 1.7) for SCREENED, and 1.5 g/dL (1.4, 1.6) for SHARED, which was not significantly different (p = .081). This research contributes to growing literature on the risks and benefits of uncompensated, peer‐to‐peer milk sharing.

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“…When it was extended to 72 hours, bactericidal capacity and total anti‐oxidant capacity were halved . An upper limit of 72 hours has been proposed by the Academy of Breastfeeding medicine for home use for full‐term infants . The Academy considered that an upper limit of eight days was acceptable when the milk was collected in a clean, careful way and stored in the back of the refrigerator .…”

Section: Resultsmentioning

confidence: 99%

Review concludes that specific recommendations are needed to harmonise the provision of fresh mother's milk to their preterm infants

Buffin

Gremmo-Féger

et al. 2018

Acta Paediatrica

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AimThere are no specific recommendations for using a mother's fresh milk for her preterm infant. We reviewed the available evidence on its collection, storage and administration.MethodsThe working group of the French Neonatal Society on fresh human milk use in preterm infants searched the MEDLINE database and Cochrane Library up to June 2017 for papers published in English or French. They specifically analysed 282 papers providing information on prospective, retrospective and clinical studies and examined guidelines from various countries.ResultsThe review concluded that fresh mother's own milk should be favoured in accordance with the latest recommendations. However, it must be carried out under stringent conditions so that the expected benefits are not offset by risks related to different practices. The working group has summarised the best conditions for feeding preterm infants with human milk, balancing high nutritional and immunological quality with adequate virological and bacteriological safety. Professionals must provide parents with the necessary conditions to establish breastfeeding, together with specific and strong support.ConclusionBased on their review, the working group has made specific recommendations for using fresh mother's own milk under careful conditions, so that the expected benefits are not offset by risks related to practices.

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ABM Clinical Protocol #8: Human Milk Storage Information for Home Use for Full-Term Infants, Revised 2017

Cited by 90 publications

References 49 publications

Variability of Water-Soluble Forms of Choline Concentrations in Human Milk during Storage, after Pasteurization, and among Women

Variability of Water-Soluble Forms of Choline Concentrations in Human Milk during Storage, after Pasteurization, and among Women

A pilot study on nutrients, antimicrobial proteins, and bacteria in commerce‐free models for exchanging expressed human milk in the USA

Review concludes that specific recommendations are needed to harmonise the provision of fresh mother's milk to their preterm infants

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