Effects of Extended Freezer Storage on the Integrity of Human Milk

Ahrabi, Ali Faraghi; Handa, Deepali; Codipilly, Champa N; Shah, Syed Nisar Hussain; Williams, Janet E.; McGuire, Mark A.; Potak, Debra; Aharon, Grace Golda; Schanler, Richard J.

doi:10.1016/j.jpeds.2016.06.024

Cited by 72 publications

(49 citation statements)

References 17 publications

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“…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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“…Furthermore, it was reported that the bactericidal activity of human milk that had been frozen for seven days was similar to fresh human milk, but longer times were not tested . On the other hand, one study reported that immunoactive components were preserved and the bacterial count decreased in human milk stored for nine months at −20°C . Definitions of the upper limit should consider these data, together with the decrease in vitamin C and lactoferrin reported after two to three months.…”

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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Section: Discussionmentioning

confidence: 95%

“…As shown by many studies, freezing the BM does not eliminate the risk of CMV infection, and the immune activity of BM changes after pasteurization; thus, fresh BM is still encouraged for feeding. [28][29][30] In this study, all pathologically jaundiced infants were fed fresh BM. We should inform parents of the corresponding risks to infants with BM-acquired CMV infection and suggest that long-term examinations, such as CBC, a liver function examination, a physical examination, and hearing and nerve functional development tests, be given to infants.…”

mentioning

confidence: 99%

High prevalence of breastmilk‐acquired cytomegalovirus infection in jaundiced infants

Hou¹,

Liu²,

Fan³

et al. 2020

Clinical Laboratory Analysis

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Background Our objective was to evaluate the prevalence and different diagnostic methods of breastmilk (BM)‐acquired cytomegalovirus (CMV) infection in a pathologically jaundiced cohort. Methods A total of 400 infants confirmed with pathological jaundice at The People's Hospital of Qingyang City were screened for BM‐acquired CMV infection between February 2018 and February 2019. A total of 300 infants were finally enrolled in our study. CMV infection was confirmed by detecting both CMV‐DNA in various samples using FQ‐PCR and CMV‐IgM with chemiluminescence. Clinical and other laboratory data were collected from these infants during their hospitalization or regular visits. Results Ninety‐eight (32.67%) subjects were confirmed to be BM CMV‐DNA–positive, and 18 (18.37%) were diagnosed with a BM‐acquired CMV infection. All 18 (100%) infants with a BM‐acquired CMV infection were CMV‐DNA–positive in urine, while 5 (27.78%) cases and 11 (61.11%) cases were confirmed in plasma and peripheral blood mononuclear cells (PBMCs), respectively. Only 6 (33.33%) infants were CMV‐IgM–positive. Birthweight, direct bilirubin, aspartate aminotransferase, and the viral load in BM of the BM‐acquired CMV group were higher than those in the non‐infected group (P < .05). Low birthweight and viral load in BM were risk factors for BM‐acquired CMV infection. Detecting CMV‐DNA in urine samples exhibited better performance than the other methods for screening BM‐acquired CMV infections. Conclusions Our study found a high prevalence of BM‐acquired CMV infection in jaundiced infants, and detecting CMV‐DNA in a urine sample was the most sensitive method for disease screening.

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Effects of Extended Freezer Storage on the Integrity of Human Milk

Cited by 72 publications

References 17 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

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

High prevalence of breastmilk‐acquired cytomegalovirus infection in jaundiced infants

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