Possible hazards of hypochlorite disinfection for feeding equipment for premature infants

The Use of Human Milk in the Neonatal Intensive Care Unit: Practices in Belgium and Luxembourg

“…For equipment involved with feeding of high-risk premature infants, appropriate heating methods or single-use devices are preferable to hypochlorite solutions with risk of chemical toxicity, especially in case of inadequate rinsing. 11 Cost implications of disposable kits should be weighed against safety issues and workload of disinfecting the material in the hospital sterile services. As breast pumps are a potential source of contamination, guidance on the choice of correctly designed pumps with separate internal circuits and a safety valve should be provided and not be left to the choice of the lactating mother.…”

Pros, cons and potential risks of on-site decontamination methods used on neonatal units for articles indirectly associated with infant feeding, including breast pump collection kits and neonatal dummies

“…As colostrum is collected in very small quantities (as little as 1–214;mls on initiation of lactation), there is a possibility that any disinfectant solution left within a kit after assembly could dilute and affect the composition of the colostrum and possibly also have an effect on the neonatal gut (Atkinson, 2001). A tissue culture study has demonstrated a toxic effect of a hypochlorite disinfectant, although the need for caution when extrapolating from in vitro models was also mentioned (Price et al, 2006). Infants on present day neonatal units are even more premature than their predecessors and likely to be more susceptible to insults involving the gut.…”

“…For premature infants, a subsequent report noted that the amount of hypochlorite disinfectant remaining after soaking utensils could form a significant proportion of a small volume feed and could add to its sodium content (Lucas, 1977). Also, replies to a questionnaire from 71 UK neonatal units revealed that 48 (68%) did not rinse off the disinfectant after use (Price et al, 2006).…”

Advantages of Sodium Hypochlorite or Sodium Dichloroisocyanurate Disinfection for Teats and Bottles in Newborn Infants' Feeding

“…In the same paper, the authors demonstrated that subcellular damage to cells could be due to chlorine or other related chemicals present in the biocidal solution. Therefore, they presumed a possible toxic effect in newborns in neonatal units (or at home) after treating feeding bottles and teats with the chlorine solution (Price et al, 2006). Consequently, the authors underline the need for final rinsing of the disinfected material before the use for neonates' feeding.…”

“…In particular, examining the disinfection procedures for feeding equipment, Price et al (2006) reported subcellular damage to caco 2 cells, a cell line with the characteristics of polarized intestinal epithelium, exposed in vitro to two different solutions at 10 and 100 ppm of available chlorine (AvCl), respectively. In the same paper, the authors demonstrated that subcellular damage to cells could be due to chlorine or other related chemicals present in the biocidal solution.…”